Bladder Management


The latest version of the Fiona Stanley Hospital SCI patient care manual for bladder management can be accessed here. Information for Health Service providers can be found here. The Paralyzed Veterans of America website ( provides free PDF downloads of ‘Bladder Management Following SCI’ which details the best evidence-based practice for bladder management at different levels of SCI. A medical practitioner’s version is also available.

What to do if you are having continence issues

  • Leaking/smelly urine/temperature/blood in urine? – Arrange to have a urine sample tested through your GP urgently as you will probably need antibiotic treatment. Do not wait a few days as you may end up in hospital or even cause permanent damage to your kidneys
  • Leaking more than usual but feeling ok? The first step is to check if you have a UTI (urinary tract infection). Arrange to have a urine sample tested through your GP (you may be able to arrange this through your regular GP without making an appointment). Drink extra fluids and take a few Ural sachets to try and flush out any potential bugs. If the results show that you do not have a UTI but you are still leaking then contact the Spinal Urology nurse for further advice. To contact the Spinal Urology nurse please call Fiona Stanley Hospital 6152 2222. If you do have a UTI your GP will arrange antibiotics if necessary
  • Botox no longer working? – If you are starting to leak and think that you may need another botox injection please get a urine sample checked for UTI through your GPIf your urine results are clear but you are still leaking contact the Spinal Urology nurse to discuss the next step.
  • Other problems – If you are having issues with catheters, need some advice on continence products or have other questions about bladder management you can contact the Spinal Outreach Service on 6152 1153 (Mon-Fri office hours). For more information click here.

Need more tips and tricks about continence?  Brought to you by Spinal Cord Injuries Australia, listen to people with a spinal cord injury as well as healthcare professionals talk frankly and openly about continence, from tips and tricks to the more embarrassing situations. In the style of the popular ABC show You Can’t Ask That, listen to their personal stories about how to deal with continence issues whilst travelling, playing sport and going out as well as how to cope with and prevent UTIs and accidents. Click here and watch all four episodes of Stories from the Smallest Room by SCIA.

Annual check ups

Bladder and kidney issues are one of the highest causes of readmission to hospital following SCI. It is essential that you have the following tests once a year:

  • Renal ultrasound – This is to look at your kidneys/ureters/bladder and check that your kidneys are safe with your current bladder management. It is also an opportunity to check how well you are emptying your bladder
  • Urodynamics – This test checks how your bladder reacts when it fills, measures pressures in your bladder to make sure your kidneys are protected and checks how well your bladder medications are working. This test is not necessary for indwelling/suprapubic catheter users who do not use a flipflo valve
  • Urology review – An appointment with a doctor/Spinal Urology nurse to discuss any problems you are having with bladder management

How to arrange a Spinal Urology appointment at Fiona Stanley Hospital

The outpatient staff and Spinal Urology nurse try to ensure that all spinal patients are seen for annual review, but it is important that you take responsibility for making sure that you have a check-up every year. If you have not been seen for over 12 months it is important that you take the initiative!

  • Have you been seen at Fiona Stanley Hospital before, but not in the last 12 months? – You need to call FSH State Rehabilitation Outpatients, Level 1 (6152 7329) who will be able to contact the relevant staff to arrange an appointment for you.
  • Never been seen by Spinal Urology at Fiona Stanley Hospital? – Call FSH State Rehabilitation Outpatients, Level 1 (6152 7329) to find out if they have a current Urology referral for you. If not, you will need a referral from your GP to the Spinal Urology service. Outpatients will then notify you of your appointment date. If you have a current referral but have not been seen for over 12 months please tell the outpatient staff who will take the necessary steps to arrange an appointment for you.