SCI-06 · Neurogenic Bladder Management

Neurogenic Bladder Management. Part of the Spinal Cord Injury series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: And we push for CIC because the benefits are just overwhelming. It has the lowest UTI rate, it preserves the urethra, it allows normal fill and empty cycles. — Correct: Clean intermittent catheterization is the preferred method whenever it is feasible and acceptable, and it does preserve the urethra and allow normal fill-and-empty cycling, but a lowest symptomatic-UTI rate among catheterization methods is not established. Comparative symptomatic-infection evidence between methods is mixed and rated low certainty, and the guideline preference for intermittent catheterization rests on the whole complication profile rather than on an infection ranking. The same claim is implied by the closing recap line that CIC is the gold standard. (2) In the audio: And patients on CIC see more than double the rate of bladder control recovery within one year compared to those left on indwelling catheters. — Correct: In a propensity-matched observational cohort of 1,032 adults with traumatic spinal cord injury, bladder-control recovery at one year was 17.1 percent with intermittent catheterization versus 11.6 percent with indwelling drainage, adjusted odds ratio 2.11 (95% CI 1.39 to 3.22) (PMID 40690218). That is higher adjusted odds in an observational design, not a doubled recovery rate, and it does not establish that the catheter choice causes the recovery. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/SCI-06.