Bladder training in patients with spinal cord injury.

Immediately following severe injury to the spinal cord or conus medullaris, there is a stage of flaccid paralysis of the bladder. The smooth muscle of the detrusor and rectum is affected. Drainage of the bladder is very important in the early care of such patients. From August 1989 to August 1990, 55 spinal cord injury patients were studied on admission to our department. The current bladder training method used for these patients is presented. A patient was deemed to have been successfully bladder trained when catheter-free, continent, and able to consistently maintain a residual volume of 100 mL or less with the aid of tapping and compression. On discharge 45 patients (82%) were successfully bladder trained, 8 (15%) employed a regimen of clean intermittent self-catheterization, and 2 went home/institutional care with an indwelling catheter. The material presented is applicable to any type of neurogenic bladder dysfunction.