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Journal of the Korean Academy of Rehabilitation Medicine 1986;10(2):10.
Effect of Bladder Rehabilitation in the Spinal Injured Patient on the Urologic Infection
Eung Jin Lee, M.D., Eun Yong Lee, M.D. , Yoon Ok Ahn, M.D.*
Department of Rehabilitation Medicine, and *Department of Preventive Medicine, College of Medicine, Seoul National University
척수손상인에 있어 방광훈련과 요로감염과의 관련성에 관한 연구
이응진, 이은용, 안윤옥*
서울대학교 의과대학 재활의학교실, *예방의학교실

The success in the control of neurogenic bladder is very important in management of the spinal cord injured. The Foley cather drainage method had been most prevaled before the intermittent catheter drainage method was introduced. In Korea, there are many spinal cord injured whose management of neurogenic bladder be maintained by the use of the Foley catheter drainage. Also at prsent time, there are considerable hospitals where the Foley catheter drainage are used as a method provided for the control of neurogenic bladder.

But the Foley catheter drainage have incurred many serious complication, such as urinary tract infection, vesicoureteral reflux, pyelonephritis and chronic renal failure.

The source of infection in the Foley cathered was considered as ascending infection through the catheter.

In 1966, Guttman reported the new method for the control of neurogenic bladder, namely intermittent catheterization. The method has shown very remarkable reduction in urinary tract infection and other complication such as vesicoureteral fistula, which appeared frequently in Foley catheter drainage. Also, it provide physiologic drainage of bladder with benefit of the maintaince of bladder wall contractility, which is very important in acquiring the balanced bladder. But in Korea, there are many spinal cord injured who do not know the risk of Foley catheterization and thebenefit of intermittent catheterization.

An attempt to find out the efficacy of intermittent catheterization and to find out the dangerosity of Foley catherization is conducted using 40 bladder trainee with intermittent catheterization and 80 Foley catheterized men.

Comparison of some selected attributes such as age, education, back ground, socioeconomic status and clinical laboratory findings such as urine culture and identification of bacteria is made between bladder-trained group and Foley cathetered group. Also the willingness of bladder training with intermittent catheterization in Foley cathetered group was investigated.

The results and findings obtained were as followed.

1) The bladder trained group showed very significantly lower urinary tract infection rate than Foley cathetered group.

2) In the distribution of organism of the urinary tract, the exogenous bacteria was found much more frequently in Foley cathetered group.

And this finding showed that Foley cathetered is major reason of urinary tract infection.

3) Whether the spinal cord injured receive bladder training or not is totally dependent on the hospital where the patient was admitted.

4) Most of the Foley cathetered spinal cord injured wanted to receive the bladder training. So, bladder training technique must be educated and transmitted rapidly to the non-bladder training hospital and Foley cathetered spinal injured.

Key Words: Bladder training, Spinal cord injury, Urinary tract infection, Neurogenic bladder, Intermittent catheterization


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