Bridget Lang Findlay, MD, discusses patient-centered bladder management in SCI care

In this video, Bridget Lang Findlay, MD, a reconstructive urologist at Mayo Clinic in Phoenix, Arizona, discussed key findings from her study on bladder management strategies (BMS) in female patients with spinal cord injuries. Although the study sought to evaluate quality of life (QoL) associated with different BMS, Findlay noted a significant limitation: The QoL data collected were not specific to neurogenic bladder issues but rather addressed general health perception and life satisfaction. Consequently, the study did not reveal statistically significant differences in QoL outcomes among patients using various BMS, such as urinary diversion vs other strategies. She acknowledged that other studies using neurogenic bladder-specific QoL metrics have shown such differences, though her team was unable to assess this due to dataset limitations.

Findlay emphasized the importance of clinical awareness regarding long-term BMS, particularly the high and sustained use of indwelling urethral catheters among women with spinal cord injury. She identified a need for health care professionals to reconsider this practice in light of better alternatives, such as suprapubic catheters, and to recognize anatomical and practical challenges faced by women performing clean intermittent catheterization, especially those in wheelchairs.

She advocated for comprehensive patient counseling that includes the full range of BMS options, not just those available within a provider’s immediate practice. When more invasive interventions like urinary diversion are considered, referrals to centers of excellence are crucial for ensuring patient-centered care.

Findlay concluded with a key message for practicing urologists: Bladder management should be individualized, taking into account patient mobility, level of bladder dysfunction, and personal goals of care. Since patient needs and physical abilities evolve over time, BMS decisions should be revisited regularly to ensure optimal function, satisfaction, and quality of life throughout a patient’s care journey.

REFERENCE

1. Findlay BL, Fadel A, Dash M, Kemble J, Viers BR, Anderson KT. Long-term trends in bladder management strategies in females following spinal cord injury. Urology. 2025 Jun 15:S0090-4295(25)00597-7. doi:10.1016/j.urology.2025.06.026