Urological management of the traumatic cord bladder

Time and patience are the two prerequisites for treatment of the traumatic cord bladder. The experienced physician knows when early intervention is necessary. Intermittent catheterization from onset of injury is as of today the accepted method of treatment in most large centers over the world. "Lack of personnel" is the usual answer where this procedure is not being carried out. Administrative people do not realize that with this method the patients can be discharged more quickly and have less complications; complications lead to a great variety of surgery, which is costly to any institution. And above all, what is best for the patient should always be our goal. Medicine travels fast these days; therefore, physicians must keep an "open mind" for the newer developments. The ileal conduit and the cutaneous vesicostomy have their place in the armamentarium of the treatment of the traumatic cord bladder: the proponents should make a greater effort to create more spedific indications. It will be interesting to see what the results of suprapubic needling will produce. Electrical stimulation is still in a research stage. The latter two methods have a noble goal, i.e., prevention of infection. Experience with chronic bladder infection over the past 28 years suggests that the majority of our patients possibly may survive because of "local tissue immunity." The ultimate solution is a presently unknown preventative method of treatment of chronic urinary tract infection.