Editing CUA: Neurogenic Lower Urinary Tract Dysfunction (2019) (section)

=== Assisted bladder drainage ===
*'''<span style="color:#ff0000">CIC or condom-catheter preferred'''
*# '''<span style="color:#ff0000">Non-catheter mechanisms'''
*#* Rely on involuntary emptying that is either induced or spontaneous
*#* '''Some bladder methods (reflex triggering and Valsalva or Credé manoeuvres) should be strongly discouraged due their associated risk of upper tract injury.'''
*#** The '''Crede manoeuvre''' (external pressure on the bladder) '''and Valsalva''' voiding induces bladder drainage via an increase in abdominal pressure that can overcome the external urethral sphincter. It can be '''inefficient and risk high pressures and cause hemorrhoids, hernias, and VUR.'''
*#* '''Condom catheter drainage''' is often used to collect urine in these non-catheter methods
*# '''<span style="color:#ff0000">Catheter mechanisms'''
*#* '''<span style="color:#ff0000">Options (3): CIC (preferred), indwelling urethral and suprapubic catheter'''
*#** '''<span style="color:#ff0000">CIC associated with reduced risk of infection, reduced risk of stones, and preservation of bladder compliance compared with indwelling urethral or SP catheter'''
*#* Until evidence can confidently demonstrate that multiple use is as safe as single-use catheters, healthcare providers should advocate a single use of catheters in individuals with SCI.