Goals of bladder management

Goals of Bladder Management

Regardless of how the bladder is managed, the goals of bladder management are:

• Achieve regular emptying
• Avoid high pressures in the renal tracts
• Maintain continence
• Prevent and treat complications

The functional goal of bladder management following spinal cord injury (SCI) is to tailor a bladder emptying program that is specific to the individual and compatible with their lifestyle and activities of daily living.

Early Management

Once a SCI has been diagnosed, an indwelling urethral catheter should be inserted until bladder dysfunction can be further assessed. This will include people with a lower motor neurone or cauda equina syndrome.

A person who sustains an injury at T6 or above and when in spinal shock should be on hourly urine measures until they are no longer in spinal shock and have had a diuresis with good urine output.

An indwelling urethral catheter is recommended until an alternative method of management is discussed and determined by consultation with the rehabilitation and urology medical specialists and the person with SCI. The rationale on the choice of the method of bladder management are outlined in Choosing the method of bladder management.

Most people with SCI have some degree of ongoing bladder dysfunction.