Course 4 - Primary Care and Spinal Cord Injury: What Should Family Doctors Know About Bladder Health?

Up to 85% of people with Spinal cord injury (SCI) will have some form of ‘neurogenic bladder’, that is, a disruption of the ability to store and void urine. Bladder dysfunction is among the leading causes of re-hospitalization after SCI. Bladder control for people with SCI usually requires catheterization (either intermittent, indwelling, or condom) or reflex voiding, medication (e.g., anticholinergics or botox), or in some cases, surgery is done. The method(s) used depend on the patient’s anatomy, functional abilities, any medical co-morbidities, and social life. The best bladder management routine is typically determined by a physiatrist or urologist with the patient’s input. The goals of managing neurogenic bladder are continence, regular emptying, avoiding increased bladder pressure, and preventing complications. Bladder function may change as patient’s age and medical circumstances change (i.e., they acquire secondary conditions). Improper bladder management can result in significant kidney damage, kidney stones, recurrent infections, or autonomic dysreflexia. Patients with SCI are at a higher risk of UTI than people without SCI. Left untreated, UTIs can lead to sepsis, autonomic dysreflexia (life-threatening spikes in blood pressure), or other severe complications.

After completing the course, you will be able to:  

• Describe methods of bladder management for patients with SCI
• Recognize the signs/symptoms of a complex UTI (and its atypical presentation) in patients with SCI
• Determine appropriate bladder and kidney screening intervals for patients with SCI