Bladder emptying over a period of 10-45 years after a traumatic spinal cord injury

STUDY DESIGN: Epidemiological follow-up study.

OBJECTIVE: To examine the bladder-emptying methods at least 10 years after a traumatic spinal cord injury (SCI).

SETTING: Clinic for Para- and Tetraplegia and Department of Urology, Rigshospitalet, Copenhagen University Hospital, Denmark.

METHODS: Retrospective data collection from patient records and data collected with a follow-up questionnaire. The response rate was 84.6% corresponding to 236 SCI individuals, injured in 1956-1990. There were 82/18% male/female patients and 47/53% tetraplegic/paraplegic. Age at the time of follow-up was 50.5 years in mean (range 28-84). Years from time of injury were 24.1 years in mean (range 10-45).

RESULTS: The use of clean intermittent catheterisation (CIC) rose from 11% at the initial discharge to 36% at the time of follow-up. The use of suprapubic tapping fell from 57 to 31% in the same period, while the use of Crede manoeuvre rose from 5 to 19%. During follow-up, 46% changed bladder-emptying method. The results showed the following trends in change of method: a high proportion of discontinuation in normal bladder emptying, suprapubic tapping and abdominal pressure and a high proportion of continuation when using CIC. 28% found their bladder-emptying method to be a problem; of these 58% were tetraplegic. Of the participants using CIC, 92% reported using hydrophilic-coated catheters.

CONCLUSIONS: Changing of bladder-emptying method among SCI individuals over time is common. CIC alone or in combination with another bladder-emptying method is the most frequently used method of bladder emptying.

SPONSORSHIP: The study was carried out as part of the primary author's PhD-study, which was financed by Medicon Valley Academy and Coloplast A/S.