Intermittent catheterization in women with spinal cord injury-three decades of experience

Removal of an indwelling catheter and the initiation of intermittent catheterization (IC) has become a standard urological goal over the past decades. While realistic for men it is more difficult for women, mainly due to their anatomical differences and lack of development of a satisfactory external collection device. Thus, the evaluation for IC as a bladder management method must involve a different approach for women with spinal cord injury (SCI) than their male counterparts. Key components of the evaluation include the woman's functional abilities, attendant care, motivation, neurological bladder type (i.e., reflexive versus areflexive) along with maintenance of social continence and stable renal function. It has been shown that women tend to have less urological complications and renal deterioration than men, no matter what method of bladder management they we. Advances in urological pharmacology, diversionary surgeries and neural blocks have greatly contributed to successful bladder manipulation for self-IC.