Intermittent catheterization has reduced the frequency of urinary tract infection(UTI), calculus formation and vesicourethral reflux in spinal cord injured(SCI) patients. Still the residual urine (RU) following catheterization has been suggested as one of the possible causes of UTI.

The purpose of this study was to identify the effect of postures on RU following catheterization, for the rehabilitation of neurogenic bladder in SCI patients. The inclusion criteria were: SCI patients with neurogenic bladder; completion of bladder rehabilitation program; good sitting balance and intact hand function. twelve SCI patients fulfilled the criteria and completed ultrasonographic RU measurement in sitting and supine posture following catherterization, respectively. We also studied the frequency of UTI, the functional type of neurogenic bladder and the postures during bladder evacuation at home.

All patients had ultrasonographical evidence of RU following catheterizations both in sitting and supine postures. Residual urine volume following catheterization was significantly smaller in sitting posture than in supine posture(p<0.05). Frequency of UTI was significantly lower in the patients who performed catheterizations in sitting posture than in supine posture(p<0.05).

In conclusion, bladder training in sitting posture would be better than in supine posture to minimize RU in SCI patients with good sitting balance and intact hand function.

As a standard method for the measurement of post-void residual urine volume, the urethral catheterization is commonly used. However, it is frequently associated with the discomfort of the patients, urethral trauma and urinary tract infection. A noninvasive method of determining the residual urine volume could minimize unnecessary catheterizations and be useful in the management of neurogenic bladder in the patient with spinal cord injury(SCI). This study was undertaken to evaluate the accuracy of a portable ultrasound scanner for measuring bladder volumes in SCI patients undergoing bladder training and to determine the factors affecting its accuracy. Sixty patients with SCI were included in this study. Two investigators performed the ultrasound measurement of the post-void residual urine volume alternately and the same procedures were repeated. After that, the urethral catheterization was done. In comparison of the residual volume measured by two different methods, the correlation coefficient(R²) of the two different methods was 0.996 and the mean value of difference between the residual volume measured by ulltrasound and by catheterization was 21.6 ml. The accuracy of the ultrasound measurements was not affected by gender, types of the neurogenic bladder, shape of the bladder, trabeculation of the bladder and central obesity. The results indicate that the portable ultrasound scanning method is a useful non-invasive method and can be substituted for the urethral catheterization in determination of bladder volumes in patients with SCI.