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Thread: Bladder Management for Adults with Spinal Cord Injury

  1. #1

    Bladder Management for Adults with Spinal Cord Injury

    The Consortium for Spinal Cord Medicine, an organization of 22 different professional and consumer organizations concerned with spinal cord injury care, has released their latest clinical practice guideline. This one has been a long time in development, but was written by the leading experts in the field. You can download a free copy of the professional version here (this is the direct PDF):

    Bladder Management for Adults with Spinal Cord Injury

    The consumer version will probably not be completed until 2007. I would still recommend printing this out and sharing a copy with your urologist or PCP. There is some excellent information in here, esp. for those professionals who are less experienced in working with problems of neurologic urology.

    You can find all of the Consortium Clinical Practice Guidelines (consumer or professional versions) on this page now (the URL has changed). They are now all free for downloading:

    http://www.pva.org/site/PageServer?p...bs_generalpubs

    (KLD)

  2. #2
    thank you for this! i am in the middle of trying to make a big descision regarding a blader aug.. so hopefully this will help.
    "The Task Ahead Of You, Is Never As Great As The Power Within You" www.chrisskinner.org

  3. #3
    Junior Member
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    Apr 2003
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    warren,nj,somerset
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    my son is having the superpubic method of catherization. he is a quadriplegic for 4 years he now has to be ic 6 to 8 times a day . what advice can anyone give us. what kind of bags are the best . can we have them on the outside of the electic wheel chair in some kind of leasther or vinyl bag that looks like a computer bag. how long can the catheter be closed ? will thge bladderf still hiold a couple of hundred cc of urine when the catheter is closed. kpcstrx@aol.com

  4. #4
    Senior Member
    Join Date
    Dec 2006
    Location
    western MA USA
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    I appreciate the link to the recently published bladder management guide. I was disappointed however that there appears to be no mention of mitranoff surgery as another alternative for urinary diversion. It seems that even among specialists in this field of bladder management and SCI do not have sufficient familarity with mitranoff. If anyone can point me to an MD who is experioenced in this, I would appreciate it.

  5. #5
    The clinical practice guidelines are based on published research studies, and there have been very few (if any) specifically about Mitrofanoff surgery in adults with SCI. I suspect this is why it was not addressed in the guidelines. I would suggest contacting your local large children's hospital (ideally a teaching hospital), since pediatric urologists are generally the most experienced in this procedure. It has been used much longer for children with spina bifida than for those with SCI.

    (KLD)

  6. #6
    CARLRICCO I had super pub cathered for 14 years I used a leg bag attached to my lower leg durning the day.At night use a bed bag. Also with leg bag i got a automatic emptier just push a button and urine drain out of the bag.

  7. #7
    It covers almost every inch of my concerns, there still is the quality of life despite SCI.

  8. #8

    routine ut check up

    Dear Nurse,

    I would like to know if there is a programm that people with sci should follow regarding check-ups of the ut system, bladder/kidneys etc
    for example ultrasounds etc. yearly or every 6 months, urodinamics test etc

    Also I would like to ask if UTI can affect bowel movements

    thanks

  9. #9
    I can tell you that the VA has standards/regulations (VHA handbook 1176.1) which are research-based on routine annual follow-up/evaluations for veterans with SCI. These can be used as the basis for care in any setting. These cover all aspect of health, but I will list here only those related to the urologic system. This is the minimum that must be done:
    • Urinalysis
    • Urine culture & sensitivity (C&S)
    • Serum creatinine and BUN
    • Anatomic urologic system exam of either ultrasound or CT and/or test of renal function (creatinine clearance or renal scan) (note: we do CT on everyone annually at my center)
    • Cystoscopy after 10 years of using an indwelling catheter, or with history of hematuria, recurrent symptomatic UTI, recurrent asymptomatic colonization with stone-forming bacteria, observed stone or stone fragment in urine, or new-onset urinary retention.
    • Counseling on PSA testing, and testing based on this (for men).
    • Digital prostate exam (men)
    • Urodynamics when objective information on voiding function is needed, or for hydronephrosis, recurrent AD, or incontinence in the absence of UTI. (note: we do these every 2 years for those without long-term indwelling catheters or diversions; more often if there are problems)
    • Screening for sexuality counseling/education needs.
    UTI can sometimes effect bowel function (either way), and constipation can sometimes increase risks for UTI. The two areas are pretty intimately interlinked.

    (KLD)

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