Monitoring of neurogenic bladder management from hospital admission until discharge in spinal cord injury units: the SIRCA study

Abstract

[Abstract] Study design: Prospective, descriptive, analytical, observational study involving 12 multicenter, international centers from Spain and Italy.

Objectives: Determine the method for bladder voiding in spinal cord injury (SCI) patients concerning different intrinsic and environmental variables.

Introduction: Neurogenic bladder is common in spinal cord injury (SCI) patients, profoundly impacting their quality of life. While clean intermittent catheterization (CIC) is the preferred method due to fewer complications and infections and improved quality of life, alternative methods like indwelling catheterization or condom catheters are viable options for bladder management.

Methods: Data was gathered along the acute (at hospital admission), subacute (expectations at discharge) and hospital discharge phases.

Results: Data from 266 SCI patients was gathered. Main procedure for bladder voiding at the time of admission was indwelling catheterization (n = 242, 91.0%) and CIC was the most used procedure at discharge (n = 122, 45.9%). CIC is the preferred procedure when the evaluation of expectations at discharge is done (n = 181, 68.6%). The probability of achieving reflex voiding at discharge was higher as the American Spinal Injury Association (ASIA) Impairment Scale score improved (p < 0.001). A relationship was established with the level of injury (p < 0.001) and body mass index (p = 0.017), in addition to marital status, age and history of depression. Initial information about CIC was mostly provided by the urologist (n = 137, 73.3%) while training was predominantly done by the nurse (n = 159, 87.8%).

Conclusions: Differences in neurogenic bladder management were identified regarding level and injury severity, SCIM, BMI, marital status, age and depression history.