Despite significant advancement in the medical management of the neurogenic bladder, much more needs to be done.
“‘Will he ever walk again?’ is the inevitable first question I have been asked by dozens of family members outside the hospital room of a newly injured spinal cord patient,” says Greg Vigna, MD, JD, and practicing spinal cord injury physician. He adds, “Interestingly, the first question quadriplegics and paraplegics ask me is, ‘Dr. Vigna, will I ever urinate on my own again?’”
It is not surprising that the SCI community reports lower quality of life compared to those who are not disabled, but what is surprising to most is that they would rather regain bowel and bladder function over the ability to walk. In other words, living life dependent on a wheelchair is superior to the current medical management options available for those with a neurogenic bladder caused by a SCI.
Chronically injured paraplegics rank their priorities for attaining function as the following (in order of highest priority): 1) sexual function, 2) continence of bowel and bladder, and 3) walking. Chronically injured quadriplegics rank their priorities for attaining function as the following: 1) use of their upper extremities, 2) sexual function, 4) continence of bowel and bladder, and then 5) walking. Forty years ago, kidney failure and urinary sepsis was the leading cause of death in those with a SCI.
“We want our clients to have the best medical outcome…the attorneys I litigate these cases with are the leading trial attorneys in the country with the experience to obtain the best legal outcome.” – Greg Vigna, MD, JD
Much has changed regarding the medical management of the neurogenic bladder caused by SCI that has preserved kidney function, decreased kidney related complications, and improved the quality of life of those with spinal cord injuries. In fact, every rehabilitation plan of care for an acutely injured spinal cord patient will be tailored to ensure that patients are managed to avoid urinary tract complications. Despite significant advancement in the medical management of the neurogenic bladder, much more needs to be done considering SCI patients would rather be continent of urine over regaining the ability to walk.
Greg Vigna, MD, JD, neurological injury attorney, national pharmaceutical injury attorney, Certified Life Care Planner, and practicing physician represents injured clients with spinal cord injuries and states, “The attorneys with the Vigna Law Group understand all aspects of spinal cord injury because I have provided care for the injured for years. I understand that an injured person has one chance for necessary compensation for the tremendous burden of impairs including mobility, sexual function, bowel and bladder function, psychological distress, and vocational loss. We advocate that our clients obtain the best medical care possible as we prepare the case for trial from day 1 by using the leading physician experts in neurosurgery, physiatry, neurourology, and life care planning to ensure all money damages are developed. Most importantly, my litigation team prepares for trial from Day 1.”
Future care and their costs for the routine urological management of neurogenic bladder must be determined by experts in Physical Medicine and Rehabilitation and neurourologist to capture the value as part of the economic damages. Periodic studies include urodynamics, renal ultrasounds, cystoscopy, urinalysis with culture, and physician follow up. Future complications that are determined by the jury after consideration of testimony by experts that are more likely than not to occur, must be included in the calculation of damages. Potential complications of a neurogenic bladder include bladder stones, urinary tract infections, hydronephrosis, and kidney failure.
Greg Vigna, MD, JD, neurological injury attorney, national pharmaceutical injury attorney, and Certified Life Care Planner states, “The attorneys at the Vigna Law Group understand the profound economic burden caused by neurogenic bladder cause by spinal cord injury over an injured person’s life expectancy and we know how to capture this value for the benefit of our clients.”
Dr. Vigna adds, “From my experience of managing patients with spinal cord injury, it is my opinion that every spinal cord injured person will benefit from routine diagnostic tests and physician follow up for their neurogenic bladder. We want our clients to have the best medical outcome and the attorneys I litigate these cases with are the leading trial attorneys in the country with the experience to obtain the best legal outcome for our clients.”
