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Thread: Bladder Management - Reflex Voiding Complications

  1. #1

    Exclamation Bladder Management - Reflex Voiding Complications

    Dear friends,

    I would like to ask if there is any reasearch for SCI patients who use the Reflex Voiding method to manage their bladder and possible complications in case of detrussor sphincter dyssynergia. I have already read the 'Bladder Manegement for Adults with Spinal Cord Injury for Health-Care Providers' from PVA.

    Appart from recurrent UTI and other complications listed in the guidline is it possible to affect bowel movents because of high bladder pressure?
    Can it be a factor for rectal prolapse ?
    Does increased bladder pressure affect other organs of the body that are not part of the urinary tract?

    On the other hand could rectal prolapse affect bladder management ?


  2. #2
    Reflex voiding was popular in the 1960s-1980s, but now we rarely recommend it, and the only patients that we have using it have been using it for a long time and are reluctant to change.

    Have you had or are you considering a sphincterotomy or urethral stent to try to manage your DSD? What kinds of voiding pressures do you have when you have urodynamics? Have you had videourodynamics that show you don't have reflux when you strain to void? Do you have any bladder thickening or trabeculation yet?

    Straining to void can indeed lead to complications, esp. increasing your risks for rectal prolapse. It can also increase the risks for reflux in many people.
    The same is true for Crede and "tapping" so we no longer recommend this except in very rare cases where we can assure it is safe after doing videourodynamics.

    A rectal prolapse should not change your bladder function, but if it cannot be reduced and gets incarcerated there is a risk of rectal gangrene, so emergency surgery and even a colostomy may be needed.


  3. #3


    This is the method I use since I had SCI 14 years ago. I rarely had UTIs but lately I am having them often with strange behaviour of my bowels. 2-3 times a week my bladder gets full and I have to go to the toilet and have a bowel movement and only then it empties. This might happen even on days that I had programmed BM in the morning. Although I have an upper SCI (T8) when I go to the toilet and do digital stimulation feces are low in the rectum, especially in the out of programm cases when I have to go to the toilet because I feel my bladder not emptying.

    Suprisingly my doctors never advised me to have a urodynamics test, this will be done for the first time in a few days. I do ultrasound exams every year and I was never diagnosed with any complications of the Urinary Tract.
    I neither have sphincterotomy or urethral stent. So I will wait for the results of the urodynamics and then decide what to do.

  4. #4
    Dear SCI Nurse,
    what can bladder thickening cause ?

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