Changes in the Trend in Bladder Emptying Methods in Patients With Spinal Cord Injury: A 20-Year Single-Center Retrospective Study

Ann Rehabil Med, 2020 · DOI: https://doi.org/10.5535/arm.19107 · Published: June 30, 2020

Spinal Cord Injury Urology Rehabilitation

Simple Explanation

This study investigates how bladder management techniques for individuals with spinal cord injuries (SCI) have changed over the past two decades. Historically, many patients relied on methods that didn't involve catheters. However, concerns about complications have led to a shift. The research compares data from two time periods (1994-1998 and 2012-2016) to understand these changes. The severity of the SCI, classified by the American Spinal Injury Association (AIS) impairment scale, was also considered in the analysis. The findings reveal a notable transition from voiding without a catheter to using intermittent catheterization. This shift is especially evident in patients with more severe SCI classifications (AIS-A, AIS-B, and AIS-C), indicating a move towards more proactive bladder management.

Study Duration

20 Years

Participants

667 patients with spinal cord injury

Evidence Level

Not specified

Key Findings

1
There was a significant shift in bladder emptying methods, with a decrease in voiding without catheter and an increase in intermittent catheterization over the 20-year study period.
2
In patients with AIS-A and AIS-B, the proportion using intermittent catheterization increased significantly, while voiding without catheter decreased substantially.
3
Even in patients with AIS-D, there was an increase in the use of intermittent catheterization at hospital discharge, suggesting a broader adoption of this method.

Research Summary

This retrospective study analyzed trends in bladder emptying methods among patients with SCI over a 20-year period, categorizing patients by SCI severity using the AIS scale. The results showed a significant change in practice, with a move away from voiding without catheter towards intermittent catheterization, particularly in more severe SCI cases (AIS A, B, and C). The study highlights the importance of considering SCI severity when selecting bladder management techniques and suggests a growing adoption of intermittent catheterization in Korean rehabilitation centers.

Practical Implications

Clinical Practice

Clinicians should consider intermittent catheterization as a primary bladder management strategy, especially for patients with AIS A, B, and C spinal cord injuries.

Patient Education

Active patient education is crucial to facilitate the adoption of intermittent catheterization, ensuring patients understand its benefits in preventing complications.

Urodynamic Monitoring

Regular urodynamic studies are essential to assess bladder function and adjust bladder management strategies based on individual patient needs and SCI severity.

Study Limitations

1
Single-center study limits generalizability.
2
Retrospective design lacks follow-up data post-discharge.
3
Demographic differences between the two groups might have impacted the results.

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