Greenstein et al. 1992 USA
Downs & Black score=8
Case Series
N=5

Population: SCI: Age: 29-58yrs; Gender: males = 5; Level of injury: paraplegia; Severity of injury: complete = 1, incomplete = 4; Time since injury = 2.5-34 yrs.
Treatment: Voiding by Valsalva or Crede maneuver.
Outcome Measures: Urodynamics: bladder pressure at end of filling and during voiding, external sphincter activity, renal function/anatomy, and UTI’s.

• The Valsalva procedure enabled bladder emptying in 4 and the Crede procedure in 1 people.
• Max. intravesical pressure during voiding ranged from 95 – 160 cmH2O
• 2 of 5 people developed significant vesicoureteral reflux. 1 also had impaired renal function and hydronephrosis which resolved when switched to IC
• 3 had symptomatic UTIs and 1 had an asymptomatic UTI.