Bladder management after spinal cord injury in the United States 1972 to 2005

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Study examined how bladder management is accomplished in patients with spinal cord injury and what factors influence the type of management used. Using data from the National Spinal Cord Injury Database from 1972 to 2005, the bladder management method was determined at discharge from rehabilitation and at 5-year intervals over a 30-year period. At discharge from rehabilitation for 24,762 patients, the selection of bladder management with a condom catheter decreased steadily from a peak of 34.6 percent in 1972 to a low of 1.50 percent in 2001. The use of clean intermittent catheterization increased from 12.6 percent in 1972 to a peak of 56.2 percent in 1991. Indwelling catheter use initially decreased from 33.1 percent in 1972 to 16.5 percent in 1991, but increased to 23.1 percent in 2001. Of 12,984 individuals with follow-up data, those originally using an indwelling catheter for bladder management were unlikely to switch to another method, with 71.1 percent continuing to use an indwelling catheter at 30 years. Most individuals using clean intermittent catheterization and condom catheterization at discharge home did not continue to use these methods. More research on the safety of each of these methods needs to be performed to provide better guidance to aid with this decision.

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