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Neurogenic bladder in spinal cord injury patients

Authors Al Taweel W, Seyam R

Received 13 January 2015

Accepted for publication 28 February 2015

Published 10 June 2015 Volume 2015:7 Pages 85—99

DOI https://doi.org/10.2147/RRU.S29644

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Jan Colli


Waleed Al Taweel, Raouf Seyam

Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia

Abstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.

Keywords: neurogenic bladder, spinal cord injury, urodynamics, intestine, intermittent catheterization

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