title: Bladder management in individuals with chronic neurogenic lower urinary tract dysfunction.
abstract: METHODS
  Retrospective investigation.
  
  
  OBJECTIVE
  To investigate the association of patient and injury characteristics with bladder evacuation by indwelling catheterization in patients with chronic neurogenic lower urinary tract dysfunction (NLUTD).
  
  
  METHODS
  Tertiary urologic referral center.
  
  
  METHODS
  The patient database was screened for patients with chronic (>12 months) NLUTD. Patient characteristics and bladder management details were collected. Binary logistic regression analysis was used to investigate the effects of the investigated factors on bladder evacuation by indwelling catheterization.
  
  
  RESULTS
  The data of 1263 patients with a median age of 47 years (range 11-89 years) and a median NLTUD duration of 15.2 years (range 1.0-63.4 years) were investigated. The most common bladder evacuation method was intermittent catheterization (IC; 41.3%) followed by triggered reflex voiding (25.7%), suprapubic catheterization (11.8%), sacral anterior root stimulation (7.3%), spontaneous voiding (7.0%), abdominal straining (5.7%) and transurethral catheterization (1.3%). Female gender, tetraplegia, an age older than 45 years and injury duration were significant (<0.001) predictors of indwelling catheterization. The odds of bladder evacuation by indwelling catheterization were increased ~2.5, 3 and 4 times in women, patients older than 45 years and tetraplegics, respectively.
  
  
  CONCLUSIONS
  IC is the most common bladder evacuation method. However, the majority of individuals with NLUTD are using other evacuation methods, because factors such as functional deficiencies, mental impairment or the social situation are relevant for choosing a bladder evacuation method. Individuals at risk of indwelling catheterization can be identified based on female gender, age, injury severity and injury duration.
authors.affiliation: Clinical Trial Unit, Swiss Paraplegic Centre, Nottwil, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Krebs
authors.affiliation: NeuroUrology, Swiss Paraplegic Centre, Nottwil, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Wöllner
authors.affiliation: NeuroUrology, Swiss Paraplegic Centre, Nottwil, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Pannek
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002408:Catheters, Indwelling; D002648:Child; D019468:Disease Management; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications*; D015599:Trauma Severity Indices; D001750:Urinary Bladder, Neurogenic / Q000209:etiology* / Q000628:therapy*; D014546:Urinary Catheterization; D055815:Young Adult