The urologic care of the spinal cord injury patient.

From 1974 to 1979, 141 acute spinal cord injury patients in the acute phase were managed by sterile, intermittent catheterization without complication. Of these patients 101 have been followed to the present. We used urodynamic criteria to determine whether these patients should be in retention on intermittent self-catheterization, or voiding with or without an appliance. When compared to a matched control group managed by indwelling catheterization in the acute phase and conventional criteria in the rehabilitation phase, 1 of 10 complications and 1 of 7 infections occurred in the study group. This analysis confirms that intermittent catheterization in the acute and rehabilitation phases, and the use of urodynamic criteria to follow lower tract management to achieve a low pressure voiding system represent major advances in the care of the urinary tract in patients with acute spinal cord injury.