Clinical Guidelines of Patient-Centered Bladder Management of Neurogenic Lower Urinary Tract Dysfunction due to Chronic Spinal Cord Injury – Part 4: Patient Risk, Bladder Management, and Active Surveillance

Abstract Urological complications are common in patients with chronic spinal cord injury (SCI). Inappropriate bladder management may result in high voiding pressure, low bladder compliance, large postvoid residual urine volume, and recurrent urinary tract infections. Thus, long-term surveillance of high-risk patients with SCI is required to avoid urological complications and improve the quality of life. Herein, the current evidence and expert opinions on patient-centered bladder management of neurogenic lower urinary tract dysfunction (NLUTD) in patients with chronic SCI in Taiwan are presented. Regular physical and urological examinations should be performed in patients with SCI depending on their risk of upper urinary tract deterioration. For patient with SCI who have received different bladder management and surgical intervention, education on proper bladder emptying and regular surveillance are mandatory. It is critical to identify high-risk patients to prevent renal functional deterioration in those with chronic SCI-induced NLUTD. Thus, annual active surveillance of bladder and renal function is required, particularly in high-risk patients with SCI.