title: Influence of different urination methods on the urinary systems of patients with spinal cord injury.
abstract: OBJECTIVE
  This study evaluated the influence of different urination methods on the urinary systems of patients with spinal cord injury.
  
  
  METHODS
  Patients with spinal cord injury were grouped according to their usual voiding method: clean intermittent catheterization (CIC); Credé  manoeuvre/reflex voiding; indwelling catheterization; normal voiding. Urinary tract infections (UTIs) were monitored and type B-ultra-sonography (B-USG) scans, renal function tests and urodynamic studies were performed in all patients over a 2-year period.
  
  
  RESULTS
  Compared with the normal  voiding group (n = 14), incidence rates of UTIs were significantly different in the Credé manoeuvre/reflex voiding (n = 26) and indwelling catheterization (n = 12) groups but not in the CIC group (n = 15). All intervention groups had a significantly higher  rate of positive findings on B-USG scan and a significantly increased residual urine volume, compared with the normal voiding group. In addition, residual urine volume was significantly lower in the CIC group compared with the Credé manoeuvre/reflex voiding and indwelling catheterization  groups.
  
  
  CONCLUSIONS
  CIC was shown to be the optimal method for assisted bladder voiding after spinal cord injury.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: L
authors.initials: L
authors.lastname: Shen
authors.forename: X
authors.initials: X
authors.lastname: Zheng
authors.forename: C
authors.initials: C
authors.lastname: Zhang
authors.forename: B
authors.initials: B
authors.lastname: Zeng
authors.forename: C
authors.initials: C
authors.lastname: Hou
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000628:therapy; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000379:methods; D014549:Urinary Incontinence / Q000503:physiopathology / Q000628:therapy; D014552:Urinary Tract Infections / Q000209:etiology*; D014554:Urination; D014563:Urodynamics; D055815:Young Adult