A prior study of a large cohort of veterans with supra-sacral spinal cord injury or disorder (SCI/D) showed, as seen in other cohorts, substantial variation in application of bladder care processes and, specifically in the proportion of patients undergoing cystometrography (CMG). The next step in a systematic evaluation such as this is to assess the association CMG on outcomes related to the urinary system. To assess the association of CMG being performed with changes in bladder management, urinary tract infections, urinary stones, renal deterioration, and dialysis care. The cohort consisted of 49 326 veterans with supra-sacral spinal cord injury or disorder (SCI/D) within the Veterans Affairs (V.A.) healthcare system first seen from fiscal year 1999 to 2024. Multivariable regression models were used to assess factors, including CMG, that affected changes in bladder management (e.g., intermittent catheterization), annual probabilities of urinary tract infections, urinary stones and time to renal deterioration and to dialysis care. Having a CMG was associated with a significantly lowered annual probabilities of febrile urinary tract infections and urinary stones. CMG also was associated with delay in the time to renal deterioration (measured as more than 25% year-to-year drop in estimated glomerular filtration rate; hazard ratio 0.74; 95% CI: 0.70-0.78, p < 0.001), and delay in time to initiation of dialysis for end-stage renal failure (hazard ratio 0.76 (95% CI: 0.60-0.96, p < 0.05). After adjusting for observable confounding factors, a veteran not having a CMG was associated with significantly more adverse urinary system outcomes (urinary tract infection, stone, renal insufficiency). These findings indicate a need to reexamine systemwide policies to increase the use of CMG for this cohort, as recommended in many global guidelines.

Objective: To determine the frequency of postpartum urinary retention (PPUR) and its concomitant factors among women after vaginal delivery at a tertiary care hospital in Pakistan.Study Design: A cross-sectional descriptive study.Place and Duration of Study: The study was conducted at the Department of Obstetrics and Gynecology, Shaikh Zaid Women Hospital, Shaheed Mohtarma Benazir Bhutto Medical University (SMBBMU), Larkana, Karachi, Pakistan, from January 2025 to June 2025.Methods: 231 women were enrolled in this study, aged 18-45 years and at 32-37 weeks' gestation, who underwent vaginal delivery. Women with postpartum hemorrhage, renal disease, Urinary Tract Infections, and other chronic comorbidities were excluded. Postpartum urinary retention is the inability to void urine during the first 6 hours after delivery or post-void residual bladder volume ≥150 mL assessed by ultrasound. Data were analyzed using SPSS 20; Chi-Square tests were applied, with P ≤ 0.05 considered statistically significant.Results: The mean maternal age was 28.08 ± 5.68 years. Overall, 18.6% (43/231) of women developed postpartum urinary retention. Frequency was significantly higher among obese (P=0.0005), hypertensive (P=0.0005), anemic (P=0.0005), pre-eclamptic (P=0.0005), and smoking women (P=0.001). The study findings highlight that maternal comorbidities (obesity, hypertension, pre-eclampsia, anemia, and smoking) were the strongest predictors of PPUR, while sociodemographic variables did not significantly influence its occurrence.Conclusion: Postpartum urinary retention is a clinically relevant problem following vaginal delivery, with obesity, hypertension, anemia, pre-eclampsia, and smoking as significant risk factors. Vigilant bladder care during labor, proactive postpartum monitoring, and early intervention when required can reduce complications and improve maternal outcomes. How to cite this: Soomro K, Ayoub N, Javed S, Yasmin, Parveen A, Abro SH. Postpartum Urinary Retention after Vaginal Delivery:Frequency and Associated Factors from a Tertiary Care Hospital, Larkana, Pakistan. Life and Science. 2026; 7(1): 118-122. doi:http://doi.org/10.37185/LnS.1.1.1021

Objective: To map and synthesize the published literature on the epidemiological burden of urinary tract infections (UTIs) in adults with spinal cord injury (SCI) or multiple sclerosis (MS) using intermittent catheterization (IC). Methods: We conducted a comprehensive literature review following PRISMA guidelines, searching PubMed, Scopus, and Web of Science for studies published since 2014. A total of 30 studies met the inclusion criteria. Results: Reported UTI incidence varied widely from 24% to 93.1%, highlighting significant heterogeneity across the evidence base. Annually, 15-17% of patients experienced 4-6 UTIs, and up to 16.4% required hospitalization for UTI-related complications. A critical evidence gap was exposed, with only one study focusing specifically on the MS population. Conclusions: Despite its clinical benefits, IC remains underutilized and inconsistently supported. Addressing systemic delivery gaps is essential. UTIs in neurogenic bladder care should be recognized as a modifiable public health issue requiring equity-driven interventions and strengthened implementation frameworks. This review underscores the urgent need for methodologically rigorous research to establish clear best practices.

Recovery from general anaesthesia is the last step towards regaining consciousness. When a fatal incident occurs during general anaesthesia, it happens in the recovery phase in 50–80% of dogs and cats. As such, planning and preparation for this often-neglected phase of general anaesthesia is important. Getting the recovery environment right by providing a quiet area where patients can be monitored by a designated member of staff as required is a good starting point. Care should be taken to provide comfort by optimising the analgesia plan, temperature management and general patient management (bladder care, positioning, padding).

We examined the relationship between psychiatric comorbidities-namely depression, anxiety, and combined depression-anxiety-and hospitalization outcomes among patients diagnosed with neurogenic bladder. Using a large, nationally representative database, the study sought to generate evidence for refining clinical guidelines and improving patient management. A retrospective study was performed using National Inpatient Sample (NIS) records from 2010-2019, identifying 676,826 adults with neurogenic bladder. Mental health comorbidities were classified through ICD-9/ICD-10 coding for depression (n = 125,654), anxiety (n = 77,730), and depression with anxiety (n = 34,330). Outcomes assessed included hospital length of stay, total charges, in-hospital mortality, and specific urological complications. Descriptive statistics and logistic regression analyses were applied, with adjustments for demographic and hospital-related variables. Depression, anxiety, and depression-anxiety were found in 13.5%, 6.4%, and 5.1% of cases, respectively, with higher rates among older adults and women. Anxiety was associated with elevated risks of hydronephrosis (OR 1.420), urinary tract infections (OR 1.050), urinary stones (OR 1.511), and acute renal failure (OR 1.246), whereas the odds of cystitis were reduced (OR 0.636). Patients with both depression and anxiety exhibited comparable complication patterns, while depression alone showed no significant associations. Surprisingly, individuals with any of these psychiatric conditions had shorter median hospital stays (5 vs 6days) and lower mortality (1.8-2.4% vs 3.7%). Mental health comorbidities in patients with neurogenic bladder are linked to a nuanced spectrum of outcomes. Anxiety increases the risk of several urological complications yet may confer protective effects regarding mortality. These results underscore the importance of systematic psychological assessment and integrated multidisciplinary management in neurogenic bladder care.

Genitourinary (GU) malignancies remain a global health challenge. While tissue biopsy is the diagnostic gold standard, its invasive nature and inability to fully capture tumour heterogeneity or minimal residual disease (MRD) highlight the need for non-invasive alternatives. Liquid biopsy, analysing tumour-derived material in plasma or urine, has emerged as a promising tool for diagnosis, surveillance and response monitoring. PubMed was searched to identify studies on liquid biopsy in GU cancers. Eligible studies reported diagnostic or prognostic performance of assays using circulating tumour DNA (ctDNA), urinary tumour DNA (utDNA), extracellular vesicles or RNA. Reviews and case reports were excluded. Articles were screened independently by three reviewers using Rayyan.Ai, with evidence synthesised narratively. In bladder cancer, utDNA-based assays-including methylation panels (BladMetrix, Bladder CARE), mutation assays (UroMuTERT) and capture-based sequencing-consistently achieved sensitivities of 80%-94% and specificities of 85%-95%, outperforming urine cytology and enabling detection of tumours years before clinical diagnosis. In upper tract urothelial carcinoma, utDNA methylation and mutation analysis demonstrated sensitivities of 80% and specificities up to 95%. In kidney cancer, ctDNA levels are relatively low; however, cell-free DNA methylation signatures (VHL, RNF185, RASSF1A) and cfMeDIP-Seq approaches have shown strong discriminatory power, with plasma-based assays achieving near 100% sensitivity in small studies. In prostate cancer, urinary RNA (PCA3, TMPRSS2:ERG), miRNA and metabolite-based assays achieved sensitivities and specificities ranging from 70% to 95%, with composite multigene panels (MyProstateScore2, utLIFE-PC) improving risk stratification beyond PSA alone. Liquid biopsy demonstrates strong diagnostic and prognostic potential across GU cancers. While bladder and prostate cancer assays are most advanced, emerging evidence in UTUC and kidney cancer is encouraging. Prospective, longitudinal validation remains essential before widespread clinical adoption.

Retrospective cohort study. To identify clinical and demographic factors associated with functional recovery and length of hospital stay in individuals with spinal cord injury undergoing inpatient rehabilitation. Physical Medicine and Rehabilitation Center at Ankara Bilkent City Hospital, Turkey. Medical records of patients with spinal cord injury admitted for inpatient rehabilitation between January 2020 and September 2023 were retrospectively reviewed. Demographic characteristics, injury-related variables, neurological level, ASIA classification, SCIM III scores, complications, assistive rehabilitation interventions, bladder management, and functional status were collected. Univariate analyses (Mann-Whitney U, Kruskal-Wallis, Chi-square) were performed, followed by multivariate regression to identify independent predictors of functional outcomes. A total of 342 patients were included (mean age 38.9 ± 16.2 years). The mean length of stay was 41.6 ± 20.3 days. Univariate analyses showed that age, time since injury, neurological level, multiple hospitalizations, SCIM III scores, complications, advanced rehabilitation technologies, and bladder catheterization were significantly associated with both functional status and hospitalization duration (p < 0.05). Multivariate regression demonstrated that age (β = -0.24, 95% CI: -0.35 to -0.13, p < 0.001), presence of complications (β = -0.31, 95% CI: -0.46 to -0.17, p < 0.001), and bladder catheterization (β = -0.19, 95% CI: -0.32 to -0.07, p = 0.004) were independent predictors of discharge SCIM III scores. Age, neurological integrity, complications, and bladder management are key determinants of functional outcomes in SCI rehabilitation, while these factors also influence length of stay. Early complication prevention, optimized bladder care, and tailored rehabilitation strategies may enhance recovery and shorten hospitalization. No commercial sponsorship was received for this study.

BackgroundThere is no comprehensive clinical practice guideline (CPG) for multiple sclerosis (MS) rehabilitation and symptom management. This study aimed to identify and appraise the quality and scope of topics covered by existing international CPGs to inform development of a future comprehensive guideline.MethodsElectronic databases and grey literature were systematically searched for existing CPGs for MS. Identified guidelines were screened independently by 3 authors for inclusion criteria. Included guidelines were each appraised by 4 reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool. The AGREE-II comprises 23 items organized into 6 domains assessing the quality and reporting of CPGs. Mean AGREE ratings and ranges were calculated for each quality domain. The intra class correlation coefficient (ICC) assessed inter-rater reliability. Individual recommendations were organized into broad topics.Results15 CPGs published between 1998 and 2020 met the inclusion criteria. These derived from USA (n = 8), UK (n = 3), Canada (n = 2), and Europe (n = 2). Standardized scores (and range) of quality ratings for the six domains were: 1. Scope and purpose = 83.2% (range 53.7 -100%); 2. Stakeholder involvement = 64.2% (range 31.9-100%); 3. Rigour of development = 55.7% (range 12-93.8%); 4. Clarity of presentation = 79.6% (range 56.9-100%); 5. Applicability = 34.9% (range 13.9-78.1%); and 6. Editorial independence = 60% (range 0-100%). The highest scoring domains were for Scope and purpose and Clarity of presentation. Applicability was the lowest scoring domain with 12/15 guidelines scoring low in this domain. There was moderate to excellent inter-rater reliability (0.60-0.96 across the 6 domains). Recommendations from the CPGs covered spasticity, fatigue, bowel, bladder, pregnancy, physical activity, cognition, mood, and/or multi-disciplinary care topics.ConclusionExisting CPGs have well-defined objectives and target populations, yet clinical applicability and rigour of development is lower. A comprehensive up-to-date MS clinical practice guideline that provides implementation support is urgently needed.

Background/Objectives: We here describe the impact of navigated care on utilization patterns of pharmacologic and minimally invasive overactive bladder therapies. Methods: This retrospective observational cohort study used electronic medical record data from the Precision Point Specialty Analytics Portal in the United States. Eligible patients were adults (≥18 years) newly diagnosed and treated for non-neurogenic overactive bladder (1 January 2015 to 31 December 2019). Categorical endpoints were analyzed by chi-square test or Fisher exact test. Of 170,000 eligible patients, 8982 (≈5%) were randomly selected and stratified by navigation status (navigated: 1150 [12.8%]; non-navigated: 7832 [87.2%]). Results: Overall, 60.0% of patients were female, 69.9% were White, and 42.7% had Medicare coverage. Navigated care was more common among women, Black patients, and those covered by Medicaid/Medicare. Initial pharmacologic treatment rates were similar between navigated and non-navigated groups (anticholinergic: 57.0% vs. 57.4%; beta-3 agonist: 43.0% vs. 42.6%). Greater percentages of navigated versus non-navigated patients received minimally invasive therapy (23.8% vs. 10.8%, respectively; p &lt; 0.0001). Discontinuation rates were lower for navigated versus non-navigated patients undergoing pharmacologic treatment (62.5% vs. 71.3%; p &lt; 0.0001). Conclusions: Patient navigation for overactive bladder may help increase access to minimally invasive therapies and may be a tool to address treatment disparities.

IntroductionSpinal cord injury (SCI) individuals undergoing home-based rehabilitation face multiple challenges, including functional impairments, bladder dysfunction, and employment barriers. Poor bladder management impacts autonomy, health, and quality of life, while limited mobility and environmental inaccessibility hinder return-to-work.ObjectiveTo assess rehabilitation priorities and unmet needs among home-based individuals with SCI, focusing on bladder management, functional limitations, and employment reintegration. The study aims to identify personal, medical, and environmental factors affecting rehabilitation outcomes.MethodsA cross-sectional survey was conducted from May to September 2023 by West China Hospital, Sichuan University. A total of 3,055 SCI individuals across mainland China completed an online questionnaire assessing demographics, functional status, rehabilitation goals, and employment challenges. Descriptive statistics, t-tests, ANOVA, Chi-square, and multivariate regression were used for data analysis.ResultsChallenges: Most participants (80.88%) had traumatic SCI. Significant daily life barriers included financial burden (46.0%), unemployment (44.1%), accessibility issues (34.3%), health concerns (29.5% frequent medical visits; 25.7% persistent issues), and stigma (26.8%). Only 2.7% could walk ≥1 km independently. Rehabilitation Goals: Bladder function improvement (49%) was the top priority, followed by restoring mobility (standing 17%; walking 16%) and preventing complications (10%). Notably, 63.3% did not define specific bladder management targets. Predictors: Multivariate analysis showed that thoracic/cervical injury, complete paralysis, and limited mobility were predictors of prioritizing bladder management (p<0.001). Employment reintegration was significantly influenced by mobility level, environmental accessibility, and social factors such as stigma and recurrent illness.ConclusionSCI individuals face intertwined challenges that impact rehabilitation and social participation. Bladder care, mobility, psychosocial stressors, and environmental access are key factors shaping rehabilitation priorities and employment outcomes. Individualized, biopsychosocial approaches are essential to promote recovery and community reintegration.

Neurogenic bladder and lower urinary tract (LUT) dysfunctions encompass a wide variety of urinary disorders resulting from nervous system impairments. Unfortunately, conventional treatments are still limited and can have significant complication rates, especially when stent implantations or other surgical procedures are involved. Therefore, there is a critical need to develop novel therapeutic strategies and pharmacological approaches to address these challenging urological conditions. Recent technological advances offer promising solutions to overcome some of these challenges faced by patients with bladder and LUT dysfunction. This review summarizes recent progress in advanced urotechnologies, focusing on bladder monitoring and neuromodulation approaches, advanced medical instruments and devices, and the latest wireless, battery-free bioelectronic implants for bladder care. These emerging engineered platforms offer the potential for real-time monitoring and improved patient outcomes while minimizing the risks associated with traditional treatments. Outlook and future directions are also discussed, highlighting how technological innovations-enabled by interdisciplinary efforts-can lead to next-generation urotechnologies. These include multimodal closed-loop strategies, artificial intelligence, deep-tissue sensing techniques, and other approaches aimed at addressing a wide variety of complex urological conditions affecting the bladder and beyond.

Nursing management of the neurogenic bladder: Evidence map of quality and recommendations from clinical practice guidelines.

This review evaluates the clinical utility of emerging optical techniques-specifically, near-infrared spectroscopy (NIRS), optical coherence tomography (OCT), photoacoustic imaging (PAI), and fiber-optic sensors (FOSs)-as noninvasive, patient-friendly modalities for diagnosing lower urinary tract dysfunction. We assess their potential integration into wearable systems for personalized urological care and propose a novel clinical pathway for their use. We included published studies employing optical modalities to evaluate bladder function or pathology, focusing on diagnostic accuracy, feasibility, and patient-related outcomes. We also examined technical principles, diagnostic performance metrics (e.g., sensitivity, resolution, penetration), and clinical validation across optical modalities. A total of 40 articles met the final inclusion criteria. NIRS demonstrates >85% sensitivity for detecting detrusor overactivity in small-scale trials, with wearable devices enabling continuous bladder monitoring. OCT has been found to improve the detection of carcinoma in situ by up to 22% compared to white-light cystoscopy, although its shallow penetration (~2 mm) limits evaluation of deeper layers. PAI visualizes microvascular structures to depths of several centimeters, suggesting strong potential for noninvasive bladder tumor diagnosis. FOSs offer continuous intravesical pressure monitoring with reduced discomfort, although semi-invasive placement remains a limitation. Noninvasive optical diagnostics offer a safer, more patient-friendly alternative to conventional cystoscopy and urodynamic studies. However, larger multicenter trials, cost-effectiveness analyses, and regulatory alignment are needed. Integrating these emerging modalities with telemedicine and artificial intelligence could transform bladder care into a continuous, home-based model.

Mechanism to translation: Neural prostheses for the lower urinary tract

PPUR is a common yet underdiagnosed complication of vaginal delivery, especially in low-resource settings. Objective: This study aimed to identify maternal and intrapartum risk factors associated with PPUR. Methods: A case-control study was conducted at Ibn-e-Siena Hospital, Multan, over three months from 22 January 2025 to 22 April 2025. A total of 142 women (71 with PPUR, 71 controls) were assessed for maternal characteristics and intrapartum variables. Statistical analysis included logistic regression to identify independent risk factors. Results: Significant independent risk factors for PPUR included episiotomy (OR 3.90), epidural analgesia (OR 3.88), obesity (OR 2.54), gestational diabetes (OR 3.39), macrosomia (OR 4.75), and longer labor duration (p = 0.003) were noted in this study. Conclusion: Targeted monitoring for women with identified risk factors may reduce the incidence and complications of PPUR. These findings support the integration of routine bladder care into postpartum protocols in Pakistani healthcare settings.

Abstract Introduction Many individuals with spinal cord injury (SCI) face a constellation of sleep disturbances that interfere with sleep initiation and/or continuity. While poor sleep is widely documented post-SCI, sleep management is often deprioritized for clinical attention. Given the potential for reciprocal impacts between sleep disturbances and additive effects on sleep outcomes, we aimed to characterise sleep routines and elucidate relationships between sleep disturbances and sleep outcomes in individuals living with SCI. Methods We conducted an online survey with community partner SCI British Columbia for Canadians (≥19 years old) living with SCI, inclusive of all lesion levels and sensorimotor-completeness. Survey questions pertained to sleep routines, support, and disturbances assessed by frequency, severity, and management. Established questionnaires evaluated poor sleep quality (Pittsburg Sleep Quality Index [PSQI]; score≥5), daytime sleepiness (Epworth Sleepiness Scale [ESS]; score≥10), and fatigue (Fatigue Severity Score [FSS]; score≥36). Results We report responses from 170 individuals with SCI (aged 43.4±13.6 years, 122 male, 14.5±11.8 years injured). Most (74%) participants manage their sleep independently. However, 28.8% use non-prescription substances to support sleep, which may reflect that 67.1% of participants have not reviewed their sleep care with a healthcare provider since initial discharge. In the past 6 months, 73.5% experienced ≥1 regular sleep disturbance, 55.2% of whom reported ≥3 disturbances. These included nociceptive pain (45.6%), anxiety (44.8%), bladder care (40.0%), spasticity (37.6%), turn routines (34.4%), neuropathic pain (30.4%), thermal discomfort (29.6%), autonomic dysreflexia (episodic hypertension; 23.1%), sleep apnea (20.8%), and bowel care (19.2%). Poor quality sleep was reported by 75.3% of respondents (PSQI 8.3±4.1), with 37.7% experiencing high fatigue (FSS 30.4±15.3), and 29.4% experiencing excessive daytime sleepiness (ESS 7.1±4.6). Compared to those without, individuals with ≥1 sleep disturbance reported higher PSQI (OR=14.9, p&amp;lt; 0.001), FSS (OR=6.0, p&amp;lt; 0.001), and ESS (OR=2.0, p&amp;lt; 0.05) scores, with all scores highly correlated with each other, with sleep duration, and the number of sleep disturbances experienced (p&amp;lt; 0.005). Conclusion Sleep disturbances post-SCI are highly prevalent, often occur in combination, and emerge as a determinant of global sleep health. Thus, sleep care presents as a clinical and research target with potential to improve quality of life for those living with SCI. Support (if any)

Globally, stroke is a leading cause of mortality and disability and there are substantial economic costs for post-stroke care. Barriers to the rehabilitation of stroke survivors with disabilities in low- and middle-income countries are many. There are enormous challenges in overcoming the barriers. The socioeconomic impacts of disabilities are high. Developing and delivering cost-effective rehabilitation services to stroke survivors with disabilities are daunting challenges to low- and middle-income countries. The barriers and unmet needs for rehabilitation treatments are high. These challenges are amplified by resource constraints like infrastructural facilities for rehabilitation management, and an inadequately trained healthcare workforce in low- and middle-income countries (LMICs). Multidisciplinary team care management led by physicians, therapists, rehabilitation nurses, and community health workers need to be strengthened. Threats to the outcomes of stroke care in resource-poor settings are the non-availability of cost-effective team care at the hospital and at the community level. Long-term medical and rehabilitation care needs organizational and financial support. The future challenge is to identify what elements of organized stroke care can be implemented to make the largest gain. Simple interventions such as swallowing assessments, bowel and bladder care, mobility assessments, and consistent secondary prevention can prove to be key elements to improving post-discharge morbidity and mortality. Recognition of the importance of stroke rehabilitation by WHO and global health leaders are new opportunities for LIMCs to fight back the stroke-related disabilities. Successful rehabilitation of stroke survivors with disabilities is a paramount challenge in LIMCs. But opportunities are coming up as there is increased awareness about stroke among general people. Task shifting of the rehabilitation health workforce to caregivers at the home or community level can help augment disability-adjusted life years. Proper Caregivers Training is coming out as a good prognostic indicator in stroke survivors in low resource settings. Structured training of caregivers is essentially needed at the low resource outset in developing countries and should be emphasized in stroke rehabilitation protocol. Universal health coverage should be extended to poor stroke survivors with disability. The burden of stroke will further increase until effective stroke prevention strategies are more widely implemented. The objective of this review article is to highlight the elements of health system behavior that affect barriers and opportunities in addressing stroke survivors with disabilities. J Enam Med Col 2022; 12(3): 148−154

&lt;b&gt;Objectives&lt;/b&gt; There is a risk that early neurogenic bladder and bowel dysfunction following acute spinal cord injury (SCI) may not be adequately managed on the acute hospital wards. The aim of this paper was to review optimal assessment and management of patients with neurogenic bladder and/or bowel dysfunction during acute care immediately following SCI. A secondary aim was to translate these findings into an accessible policy for clinical staff involved in the care of acute SCI patients.&lt;br&gt;&lt;b&gt;Methods&lt;/b&gt; A literature review was performed to identify the protocols and research describing the management of bladder and bowel dysfunction after acute SCI. The measures extracted were principles of practice, threshold measures and evaluation tools, and timelines of best care. Key findings relating to assessment, management and identification of the benefits of adhering to a protocol of clinical practice were summarised. Fidelity with evidence identified was evaluated, and practice gaps were recognised.&lt;br&gt;&lt;b&gt;Results&lt;/b&gt; A total of 12 papers and six guidelines for providing excellent care to patients with SCI were identified. Overall, a systematic and comprehensive assessment of bladder and bowel function and neurological impairment should be completed early following SCI. Management is best individualised to both prevent known sequelae and optimise current function and quality of life. Acute SCI bladder and bowel management pathways were developed based on evidence identified.&lt;br&gt;&lt;b&gt;Conclusions&lt;/b&gt; The study has identified that timely assessment and management of patients with spinal cord neurogenic bladder and/or bowel dysfunction during the acute phase is pivotal to optimising continence and mitigating risk of preventable harm prior to discharge to specialised spinal rehabilitation.

&lt;b&gt;Objectives&lt;/b&gt; There is a risk that early neurogenic bladder and bowel dysfunction following acute spinal cord injury (SCI) may not be adequately managed on the acute hospital wards. The aim of this paper was to review optimal assessment and management of patients with neurogenic bladder and/or bowel dysfunction during acute care immediately following SCI. A secondary aim was to translate these findings into an accessible policy for clinical staff involved in the care of acute SCI patients.&lt;br&gt;&lt;b&gt;Methods&lt;/b&gt; A literature review was performed to identify the protocols and research describing the management of bladder and bowel dysfunction after acute SCI. The measures extracted were principles of practice, threshold measures and evaluation tools, and timelines of best care. Key findings relating to assessment, management and identification of the benefits of adhering to a protocol of clinical practice were summarised. Fidelity with evidence identified was evaluated, and practice gaps were recognised.&lt;br&gt;&lt;b&gt;Results&lt;/b&gt; A total of 12 papers and six guidelines for providing excellent care to patients with SCI were identified. Overall, a systematic and comprehensive assessment of bladder and bowel function and neurological impairment should be completed early following SCI. Management is best individualised to both prevent known sequelae and optimise current function and quality of life. Acute SCI bladder and bowel management pathways were developed based on evidence identified.&lt;br&gt;&lt;b&gt;Conclusions&lt;/b&gt; The study has identified that timely assessment and management of patients with spinal cord neurogenic bladder and/or bowel dysfunction during the acute phase is pivotal to optimising continence and mitigating risk of preventable harm prior to discharge to specialised spinal rehabilitation.

The short physical performance battery is associated with activities of daily living impairment at discharge in older patients with acute heart failure.