World Journal of Urology

, Volume 36, Issue 10, pp 1613–1619 | Cite as

Current and future international patterns of care of neurogenic bladder after spinal cord injury

  • A. Gomelsky
  • G. E. Lemack
  • J. C. Castano Botero
  • R. K. Lee
  • J. B. Myers
  • P. Granitsiotis
  • R. R. Dmochowski
Topic Paper



We aim to summarize the literature on international patterns of care for patients with neurogenic bladder (NGB) from spinal cord injury (SCI).


We performed a PubMed database search, hand review of references, communication with professional societies, and registry evaluations for pertinent data.


Established patterns of care, including SCI registries and specialty centers, are available in high-resource countries such as the US and UK. As such, mortality rates from complications of NGB/SCI are lower. Access to intermittent catheterization supplies, among other resources, may be inadequate in many low-income regions. Cultural and religious beliefs may also hinder integration of proper bladder management in SCI patients. While guidelines exist in many parts of the world, it is unclear how rigorously they are disseminated or followed.


While there is a paucity of high-level evidence, the differences in patterns of care are closely related to socioeconomic status and resources of the geographic area. Future research efforts should focus on improving access to diagnostic modalities, supplies, and specialists in these areas.


Neurogenic bladder Spinal cord injury Intermittent catheterization Registry Guidelines 


Author contributions

AG: project development, data collection, and manuscript writing; GEL: project development and manuscript witing; JCC: project development and data collection; RKL: project development; JBM: project development and data collection; PG: project development and data collection; and RRD: project development, data collection, and manuscript writing

Compliance with ethical standards

Conflict of interest

There were no potential conflicts of interest for any of the authors.

Human and animal rights statement

All of the research involved a chart review and no research involving human participants and/or animals was performed.

Informed consent

Informed consent was not required.


  1. 1.
    Hassouna M, Hassouna T, Elmayergi N et al (2016) Pathophysiology of spinal shock. In: Corcos J, Ginsberg D, Karsenty G (eds) Textbook of the neurogenic bladder, 3rd edn. CRC Press, Taylor & Francis Group, Boca Raton, pp 145–150Google Scholar
  2. 2.
    WHO (2013) International perspectives on spinal cord injury. Malta: World Health Organization. Accessed 28 June 2017
  3. 3.
    Wolfe DL, et al (2012) Bladder health and function following spinal cord injury. In: Eng JJ et al (eds) Spinal cord injury rehabilitation evidence, Version 4. Vancouver, Spinal Cord Injury Rehabilitation Evidence (SCIRE). Accessed 25 April 2012
  4. 4.
    Weld KJ, Dmochowski RR (2000) Effect of bladder management on urological complications in spinal cord injured patients. J Urol 163:768–772CrossRefGoogle Scholar
  5. 5.
    Wyndaele JJ (2002) Intermittent catheterization: which is the optimal technique? Spinal Cord 40:432–437CrossRefGoogle Scholar
  6. 6.
    Liao L (2015) Evaluation and management of neurogenic bladder: what is new in China? Int J Mol Sci 16:18580–18600CrossRefGoogle Scholar
  7. 7.
    Singh R, Rohilla RK, Sangwan K et al (2011) Bladder management methods and urological complications in spinal cord injury patients. Indian J Orthop 45:141–147CrossRefGoogle Scholar
  8. 8.
    Rathore MF, Rashid P, Butt AW et al (2007) Epidemiology of spinal cord injuries in the 2005 Pakistan earthquake. Spinal Cord 45:658–663CrossRefGoogle Scholar
  9. 9.
    Ersoz M, Erhan B, Akkoc Y et al (2013) An evaluation of bladder emptying methods and the effect of demographic and clinical factors on spontaneous voiding frequency in stroke patients. Neurol Sci 34:729–734CrossRefGoogle Scholar
  10. 10.
    Engkasan JP, Ng CJ, Low WY (2014) Factors influencing bladder management in male patients with spinal cord injury: a qualitative study. Spinal Cord 52:157–162CrossRefGoogle Scholar
  11. 11.
    Roshanzamir F, Rouzrokh M, Mirshemirani A et al (2014) Treatment outcome of neurogenic bladder dysfunction in children: a five-year experience. Iran J Pediatr 24:323–326PubMedPubMedCentralGoogle Scholar
  12. 12.
    Martins G, Soler ZA, Batigalia F et al (2009) Clean intermittent catheterization: educational booklet directed to caregivers of children with neurogenic bladder dysfunction. J Wound Ostomy Continence Nurs 36:545–549CrossRefGoogle Scholar
  13. 13.
    Landa-Juárez S, Montes de Oca-Muñoz LE, Castillo-Fernández AM et al (2014) Laparoscopic vs opened appendicovesicostomy in pediatric patients. Cir Cir 82:496–504PubMedGoogle Scholar
  14. 14.
    Chang SM et al (2000) Urologic status of 74 spinal cord injury patients from the 1976 Tangshan earthquake, and managed for over 20 years using the Crede maneuver. Spinal Cord 38:552–554CrossRefGoogle Scholar
  15. 15.
    Cardenas DD et al (2004) Impact of urinary tract infection educational program in persons with spinal cord injury. J Spinal Cord Med 27:47–54CrossRefGoogle Scholar
  16. 16.
    Augenstein K, Nelson VS, Kogei AJ et al (2008) Development of a bladder management protocol as part of a comprehensive care program for spina bifida in Kenya. J Pediatr Rehabil Med 1:285–290PubMedGoogle Scholar
  17. 17.
    Gjerde JL, Rortveit G, Muleta M et al (2013) Silently waiting to heal experiences among women living with urinary incontinence in northwest Ethiopia. Int Urogynecol J 24:953–958CrossRefGoogle Scholar
  18. 18.
    Kovindha A, Mai WN, Madersbacher H (2004) Reused silicone catheter for clean intermittent catheterization (CIC): is it safe for spinal cord-injured (SCI) men? Spinal Cord 42:638–642CrossRefGoogle Scholar
  19. 19.
    Mazzo A, Souza-Junior VD, Jorge BM et al (2014) Intermittent urethral catheterization—descriptive study at a Brazilian service. Appl Nurs Res 27:170–174CrossRefGoogle Scholar
  20. 20.
    Neel KF, Salem MA, Soliman SM et al (2008) Clean intermittent catheterization in Saudi children. Suggestion for a common protocol. Saudi Med J 29:1014–1017PubMedGoogle Scholar
  21. 21.
    Burns AS, O’Connell C (2012) The challenge of spinal cord injury care in the developing world. J Spinal Cord Med 35:3–8CrossRefGoogle Scholar
  22. 22.
    Sultan S, Hussain I, Ahmed B et al (2008) Clean intermittent catheterization in children through a continent catheterizable channel: a developing country experience. J Urol 180:1852–1855CrossRefGoogle Scholar
  23. 23.
    Levy LF, Makarawo S, Madzivire D et al (1998) Problems, struggles and some success with spinal cord injury in Zimbabwe. Spinal Cord 36:213–218CrossRefGoogle Scholar
  24. 24.
    Yasmeen R, Rathore FA, Ashraf K, Butt AW (2010) How do patients with chronic spinal injury in Pakistan manage their bowels? A cross-sectional survey of patients. Spinal Cord 48:872–875CrossRefGoogle Scholar
  25. 25.
    Kanaheswari Y, Mohd Rizal AM (2015) Renal scarring and chronic kidney disease in children with spina bifida in a multidisciplinary Malaysian centre. J Paediatr Child Health 51:1175–1181CrossRefGoogle Scholar
  26. 26.
    Lin CC, Lin ATL, Chen KK, Chen TJ (2012) Urethral versus suprapubic catheter for patients with spinal cord injury-induced neurogenic bladder: a study applying the eleven-year nationwide database of Taiwan. J Urol 187:e31CrossRefGoogle Scholar
  27. 27. (2016) Oxybutynin, propiverine, trospium, tolteroidine and solifenacine Information from Assessed 16 June 2016
  28. 28.
    Kitisomprayoonkul W, Kovindha A (2000) The efficacy of oxyphencyclimine hydrochloride in treatment of urinary incontinence in spinal cord injured patients with detrusor sphincter dyssynergia. J Thai Rehabil 10:23–26Google Scholar
  29. 29.
    Castaño-Botero JC, Ospina-Galeano IA, Gómez-Illanes R, Lopera-Toro A (2015) Extradural implantation of sacral anterior root stimulator in spinal cord injury patients. Neurourol Urodyn 35:970–974CrossRefGoogle Scholar
  30. 30.
    Lima DX, Pires CR, Santos AC et al (2015) Quality of life evaluation of patients with neurogenic bladder submitted to reconstructive urological surgeries preserving the bladder. Int Braz J Urol 41:542–546CrossRefGoogle Scholar
  31. 31.
    Sen S, Chacko J, Karl S, George J (2014) Pediatric bladder augmentation in developing countries: lessons learnt from an experience of 195 cases. JIMSA 27:79–83Google Scholar
  32. 32.
    Adanu RM, De Lancey JO, Miller JM et al (2006) The physical finding of stress urinary incontinence among African women in Ghana. Int Urogynecol J Pelvic Floor Dysfunct 17:581–585CrossRefGoogle Scholar
  33. 33.
    Wang QW, Wen JG, Song DK et al (2006) Is it possible to use urodynamic variables to predict upper urinary tract dilatation in children with neurogenic bladder-sphincter dysfunction? BJU Int 98:1295–1300CrossRefGoogle Scholar
  34. 34.
    Robert AA, Zamzani MM (2013) Traumatic spinal cord injury in Saudi Arabia: a review of the literature. Pan African Med J 16:104CrossRefGoogle Scholar
  35. 35.
    Sengupta DK (2005) Neglected spinal injuries. Clin Orthop Relat Res 431:93–103CrossRefGoogle Scholar
  36. 36.
    Ahidjo KA, Olayinka SA, Ayokunle O et al (2012) Prehospital transport of spinal cord-injured patients in Nigeria. S Afr J Surg 50:3–5PubMedGoogle Scholar
  37. 37.
    Couris CM et al (2010) Characteristics of adults with incident traumatic spinal cord injury in Ontario, Canada. Spinal Cord 48:39–44CrossRefGoogle Scholar
  38. 38.
    Fassett DR et al (2007) Mortality rates in geriatric patients with spinal cord injuries. J Neurosurg 7:277–281Google Scholar
  39. 39.
    Nwadinigwe CU, Iloabuchi TC, Nwabude IA (2004) Traumatic spinal cord injuries (SCI): a study of 104 cases. Nigerian J Med 13:161–165Google Scholar
  40. 40.
    Gosselin RA, Coppotelli C (2005) A follow-up study of patients with spinal cord injury in Sierra Leone. Int Orthopaedics 29:330–332CrossRefGoogle Scholar
  41. 41.
    Garshick E et al (2005) A prospective assessment of mortality in chronic spinal cord injury. Spinal Cord 43:408–416CrossRefGoogle Scholar
  42. 42.
    Leal-Filho MB et al (2008) Spinal cord injury: epidemiological study of 386 cases with emphasis on those patients admitted more than four hours after the trauma. Arq Neuropsiquiatr 66:365–368CrossRefGoogle Scholar
  43. 43.
    Hagen EM et al (2012) Traumatic spinal cord injuries—incidence, mechanisms and course. Tidsskr Nor Laegeforen 132:831–837CrossRefGoogle Scholar
  44. 44.
    Soden RJ et al (2000) Causes of death after spinal cord injury. Spinal Cord 38:604–610CrossRefGoogle Scholar
  45. 45.
    National Spinal Cord Injury Statistical Center (2012) Birmingham, Alabama Spinal Cord Injury Facts and Figures at a Glance, February 2012. Accessed 9 Jan 2013
  46. 46.
    Al-Jadid MS, Al-Asmari AK, Al-Moutaery KR (2004) Quality of life in males with spinal cord injury in Saudi Arabia. Saudi Med J 25:1979–1985PubMedGoogle Scholar
  47. 47.
    Werhagen L, Aito S, Tucci L, Strayer J, Hultling C (2012) 25 years or more after spinal cord injury: clinical conditions of individuals in the Florence and Stockholm areas. Spinal Cord 50:243–246CrossRefGoogle Scholar
  48. 48.
    Rathore MFA (2013) Spinal Cord Injuries in the Developing World. In: JH Stone, M Blouin (eds). International encyclopedia of rehabilitation. Assessed 28 June 2016
  49. 49.
    Allotey P et al (2003) The DALY, context and the determinants of the severity of disease: an exploratory comparison of paraplegics in Australia and Cameroon. Social Sci Med 57:949–958CrossRefGoogle Scholar
  50. 50.
    Weerts E, Wyndaele JJ (2011) Accessibility to spinal cord injury care worldwide: the need for poverty reduction. Spinal Cord 49:767CrossRefGoogle Scholar
  51. 51.
  52. 52.
    O’Connor PJ (2000) Development and utilisation of the Australian spinal cord injury register. Spinal Cord 38:597–603CrossRefGoogle Scholar
  53. 53.
    Stover SL et al (1999) History, implementation, and current status of the national spinal cord injury database. Arch Phys Med Rehab 80:1365–1371CrossRefGoogle Scholar
  54. 54.
    DeVivo MJ, Go BK, Jackson AB (2002) Overview of the national spinal cord injury statistical center database. J Spinal Cord Med 25:335–338CrossRefGoogle Scholar
  55. 55.
    Gupta A, Taly AB, Srivastava A et al (2009) Urodynamic profile in myelopathies: a follow-up study. Ann Indian Acad Neurol 12:35–39CrossRefGoogle Scholar
  56. 56.
    Çetinel B, Tarcan T, Demirkesen O et al (2013) Management of lower urinary tract dysfunction in multiple sclerosis: a systematic review and Turkish consensus report. Neurourol Urodyn 32:1047–1057CrossRefGoogle Scholar
  57. 57.
    Smith M (2002) Efficacy of specialist versus non-specialist management of spinal cord injury within the UK. Spinal Cord 40:10–16CrossRefGoogle Scholar
  58. 58.
    New PW, Simmonds F, Stevermuer T (2011) Comparison of patients managed in specialised spinal rehabilitation units with those managed in non-specialised rehabilitation units. Spinal Cord 49:909–916CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyLSU Health-ShreveportShreveportUSA
  2. 2.Department of UrologyUniversity of Texas Southwestern, UT Southwestern Urology ClinicDallasUSA
  3. 3.Urologia CESMedellínColombia
  4. 4.Weill Cornell Medical College, Iris Cantor Men’s Health CenterNew YorkUSA
  5. 5.Department of Surgery (Urology)University of UtahSalt Lake CityUSA
  6. 6.Neurourology, Urodynamics and Reconstructive UrologyNHS: Western General Hospital-EdinburghEdinburghUK
  7. 7.Department of Urologic SurgeryVanderbilt UniversityNashvilleUSA

Personalised recommendations