Volitional Voiding After Spinal Cord Injury—Who Will and Who Will Not

Abstract

A long-term absence of volitional voiding after spinal cord injury is common. This review serves to highlight predictive models of volitional voiding after spinal cord injury and evaluate current therapies aimed at improving voiding efficiency after injury. In a new predictive model, using data from the European Multicenter Spinal Cord Injury study, lower extremity motor preservation is the most important physical exam finding to predict volitional voiding. Using a simple composite motor score ranging from 0 to 50 for the bilateral levels of L2-S1, an impressive area under the curve of 0.91 is achieved. While our ability to predict volitional voiding after spinal cord injury has improved, the treatment of an inability to void remains lacking. Neuromodulation techniques may provide the best chance of recovery in those that do not spontaneously improve.