Urological problems in the management of quadriplegic women

During the past 25 years enormous progress has been made in the management of the neuropathic bladder, largely as a result of the adoption of intermittent catheterisation, together with improvements in catheter-related techniques, and the judicious use of antibacterial drugs and sphincter surgery. A few quadriplegic women can be trained to do self-intermittent catheterisation, using a special technique. For the majority of these women, however, there is no practical alternative at present to indwelling catheters. Bladder spasms resulting from the mechanical stimulation of the catheter and/or repeated infections may be difficult to control, and illustrative cases demonstrating some problems encountered are presented. There is an obvious need for an external collecting device for these women. The development in the field of such devices are presented and evaluated.