Management and rehabilitation of neuropathic bladder in patients with spinal cord lesion

Abstract

The patients with spinal cord lesion (SCL) develop problems of urination due to impaired neural control of the lower urinary tract, such as incontinence or retention; these conditions constitute risks for the upper urinary tract and should be treated appropriately over the various phases of the disease. The therapeutic approach in the acute and subacute post-traumatic phase is of particular importance for the early and late management of the subsequent urinary disturbances. When the rehabilitation program is completed, it is estimated that deficiencies in sphincter control have greater impact on personal and social life of individuals than the movement disability. Currently, as the number of sufferers from SCLs is constantly increasing, medical science faces two great challenges: (i) to develop and apply modern treatment modalities in the framework of advanced neurorehabilitation programs, and (ii) to provide well-organized follow-up management. All efforts should be directed towards the functional integrity of the upper urinary tract and the acquirement of the greatest possible independence for the patient. © 2007 Springer-Verlag.