Update on bladder evaluation recommendations and bladder management guideline in patients with spinal cord injury

Improvements in bladder evaluation and management following spinal cord injury have resulted in a significant decline in morbidity and mortality from urologic causes. Several bladder evaluation protocols and types of urologic management have evolved. Expert opinion and guidelines regarding these evaluation and management programs have been lacking. This paper presents highlights of two documents on these topics. The first is an expert opinion paper on urologic evaluation in spinal cord injury and the second is a recent clinical guideline on bladder management. Bladder managements that were evaluated include intermittent catheterization, the Credé and Valsalva maneuvers, indwelling catheterization (urethral and suprapubic), reflex voiding (facilitated using α-blockers, botulinum toxin, stents, sphincterotomy), neurostimulation, and urinary diversions. The panel members concluded that the different management programs have distinct advantages and disadvantages. © 2007 Springer Science+Business Media, LLC.