Traumatic cord lesions above T12 usually result in a reflex neurogenic bladder (upper motor neurone) and lesions below that level, in mixed or lower motor neurone lesion. The optimal bladder management method should preserve renal function and minimise the risk of urinary tract complications. This article discusses the urologic management in spinal cord injured patients. Acute Phase of Spinal Shock The duration of this period is variable and can last approximately 6-12 weeks.
This phase is characterised by a hypotonic, paresthetic and flexic bladder. A more rapid recovery is expected with incomplete lesions. The treatment goal is as follows: The major goal is simply the prevention of UTI and urosepsis Intermittent sterile catheterization, small caliber (12-14 Fr) catheter is used every 4-6 hours to maintain a bladder volume < 500 ml, In the chronic phase bladder volumes should be < 100…
