Functional recovery of the bladder in patients with spinal cord injury--prognosticating programs of an aseptic intermittent catheterization.

Ninety patients with spinal cord injury were managed by aseptic intermittent catheterization program I (preventing the over-distension of the bladder) and program II (allowing overdistension) in which recovery of bladder function and the clinical effects were comparatively investigated. Using program I, cases with positive BCR restored the automaticity of the bladder on average 8 weeks after injury. When urinary incontinence first occurs during aseptic intermittent catheterization, urinary training may be commenced since the bladder has then recovered from spinal shock. Cases with no BCR do not restore automatic bladder contraction. Program II delayed or weakened the recovery of bladder function considerably. Patients with incomplete lesions and sacral sparing, particularly those with urinary sensation, should be managed by program I which does not impair recovery of the bladder. It is possible to prevent urinary incontinence and infection, if paraplegics with complete lesions are managed by program II. The percentage of urinary infection was 22.6 +/- 16.0% (N = 90) during aseptic intermittent catheterization (non-touch technic) among whom no statistically significant difference between those with trigger voiding (22.2 +/- 17.2%, N = 57) and those with self-catheterization (23.2 +/- 14.0%, N = 33) was found.