Can-SCIP Coach App
  1. Can-SCIP
  2. Recommendations
  3. Guidelines
  4. Section 2 - MANAGEMENT OF SCI COMPLICATIONS

K - BLADDER FUNCTION




Monitor residual urine volume in individuals who are not using a catheterization regimen during treatment with botulinum toxin type A. Monitor for and educate patients on urinary retention as a complication. (Adapted from NICE 2012, p.176; Level A-C)

Before offering an intravesical botulinum toxin type A:

  1. explain to the individual and/or their family members and caregivers that a catheterization regimen is needed in most individuals with neurogenic lower urinary tract dysfunction after treatment
  2. ensure that they are able and willing to manage such a regimen should urinary retention develop after the treatment
(Adapted from NICE 2012, p.176, Level A-C)
Antimuscarinic drugs are the first-line treatment for detrusor overactivity. Botulinum toxin type A injections to the bladder wall should be considered when antimuscarinic drugs have proved to be ineffective or poorly tolerated. (Adapted from NICE 2012, p.175; Level A-C)
Clinicians should monitor individuals with SCI, particularly those with cervical SCI, for the risk of generalized weakness (including respiratory weakness and motor weakness) after the injection of intravesical botulinum toxin type A. (CAN-SCIP 2020; Level B)
For individuals receiving intravesicular botox injections should be offered prompt access to repeat injections when symptoms return. (NICE 2012, p.176; Level A-C)
For individuals receiving multiple indication botox (e.g., spasticity, neurogenic bladder, aesthetic purposes), a coordinated plan amongst care providers is required to minimize the risk of adverse reactions. (CAN-SCIP 2020, Level C)