Compliance with bladder management in spinal cord injury patients.
METHODS
Retrospective analysis of medical records on spinal cord injury (SCI) patients with neuropathic bladder.


OBJECTIVE
To determine SCI patients' compliance with the method of bladder management they used on discharge from inpatient rehabilitation.


METHODS
Ankara University Medical School, Department of Physical Medicine and Rehabilitation, Spinal Cord Injury Unit, which treats patients referred from throughout Turkey.


METHODS
The bladder management method of 50 new SCI patients was noted at admission, discharge and follow-up. Reasons for changing the initial method were documented. For analysis, patients were grouped by gender, level and completeness of injury. Compliance with bladder management method was compared between these groups by chi-square test.


RESULTS
The method of bladder management at admission was indwelling catheter (IC) for 86% of the patients. Most were switched to clean intermittent catheterisation (CIC) by rehabilitation discharge. Of 38 patients (76%) on CIC at discharge, 20 (52%) discontinued this method and reverted to IC during follow-up. Compliance with CIC was lower for women, for tetraplegics, and for those with complete injury. Dependence on care givers, severe spasticity interfering with catheterisation, incontinence despite anticholinergic agents, and lack of availability of external collective devices for female patients were the main reasons for low compliance with CIC.


CONCLUSIONS
The bladder management method of SCI patients should be selected so as to be suitable to the patients' life style. Besides reducing morbidity, it also has to enhance the quality of life.
Yavuzer
G
G
Department of Physical Medicine and Rehabilitation, Ankara University Medical School, Ankara, Turkey.
Gök
H
H
Tuncer
S
S
Soygür
T
T
Arikan
N
N
Arasil
T
T
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010264:Paraplegia / Q000150:complications; D010349:Patient Compliance; D011782:Quadriplegia / Q000150:complications; D012189:Retrospective Studies; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000503:physiopathology*; D014546:Urinary Catheterization