Protocol for rehabilitation of neurogenic bladder dysfunction in patients with spinal cord lesions

الملخص EN

The study was conducted on 20 patients withh voiding dysfunction following spinal cord lesions.

30% of them started retraining during the stage of spinal shock (group A), while 70 % (group B) started their retraining after the stage of spinal shock.

Patients underwent full urologic evaluation including full urodynamic evaluation after the stage of spinal shock was over.

Patients followed a bladder retraining program (BRT).

As success in bladder retraining evolved, there was a decrease in the residual urine volume and an increase in the intentionally voided urine.

Patients used the aid of manual methods, pharmacotherapy, and surgical interference as required.

A catheter-free voiding state was reached in 45 % of patients : 25 % of them used manual methods, 15 % used manual and pharmacotherapies and 5 % had normal voiding.

40 % of the patients used clean intermittent self catheterization (CISC) while 15 % used other methods in the form of an indwelling catheter or an external collecting device.

Success in the retraining program correlated significantly with the time of its start and the absence of urinary tract infection (p < 0.05).

There was no significant correlation (p > 0.05) between success of the program and sex of the patient, level of the lesion, or urodynamic classification of the bladder.