In patients affected by Neurogenic Bladder Dysfunctions (NBD), infrequent or incomplete voiding, thickness of the bladder wall and increased urethral resistance are risk factors for urinary tract infections as well as continence and urinary tract anomalies (ureteral meatal entrapment, vesico-ureteral reflux). A large majority of patients achieve an alleviation of the NBD symptoms with Clean Intermittent Catheterization (CIC). Physicians and urotherapists, in order to achieve an effective treatment, should obtain a correct diagnostic classification of the vesico-sphincteric dysfunction. Pirstly, it is important to identify whether the problem lies in the filling phase or in the emptying phase of the bladder. Then, it is necessary to select all the possible therapeutic options, which change according to whether the problem is related to the bladder, the urethral resistances, or both. One of the obvious pitfalls of reflex evaluation and treatment is that we might ignore a potentially reversible reason for this dysfunction. The etiology of a particular voiding who an the dysfunction and its potential reversibility should always be considered. © 2006 Springer-Verlag Berlin Heidelberg.

In patients affected by Neurocgenic Bladder Dysfunctions (NBD), infrequent or incomplete voiding, thickness of the bladder wall and increased urethral resistance are risk factors for urinary tract infections as well as continence and urinary tract anomalies. A large majority of patients achieve an alleviation of the NBD symptoms with Clean Intermittent Catheterization (CIC). In order to achieve an effective treatment a correct diagnostic classification of the vescico-sphinteric dysfunction should be obtained. The chapter describes historical evolution of the management of patients with NBD, indications, training and materials required in CIC as well as complementary treatments and complications.