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KMID : 0361419860100020154
Journal of Korean Academy of Rehabilitation Medicine
1986 Volume.10 No. 2 p.154 ~ p.163
Effect of Bladder Rehabilitation in the Spinal Injured Patient on the Urologic Infection



Abstract
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 present 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, suchas 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
willingness of bladder training gTOUp and Foley cathetered group. Also the training with intermittent catheteterization 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 xate 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 train
ing. So, bladder training technique must be educated and transmitted rapidly to the non-bladder trainining
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