Management of neurogenic bladder in traumatic spinal cord injury

Neurogenic bladder in persons with spinal cord injury (SCI) is a critical issue as it can lead to significant morbidity and mortality. Complications such as urinary tract infection, bladder/renal stones, social embarrassment from incontinence and renal damage are some complications related to neurogenic bladder if managed inadequately. In India, the average annual incidence of SCI is 15,000 with a prevalence of 0.15 million. Most of these are illiterate, belonging to a low-income group with poor living conditions. Incontinence, social withdrawal and infection can pose a major impediment to vocational rehabilitation, community integration and living an independent life. The goals of the management of neurogenic bladder are to prevent incontinence, allow adequate storage till emptying of the bladder at an appropriate time and prevent infection and upper tract damage. In recent times, various pharmacological, non-pharmacological and surgical options have come up. While some are feasible in the Indian scenario, some are still not. Furthermore, there is a dearth of data related to SCI. The purpose of this review is to present the recent literature on the management of neurogenic bladder with a special focus on patients with traumatic SCI.