Abstract
Study Design: Study of reusable catheter.
Objective: To investigate whether a silicone cathether reused over years for clean intermittent catheterization (CIC) was safe for spinal cord injured (SCI) men.
Setting: Maharaj Hospital, Chiang Mai, Thailand.
Method: A cross-sectional study was obtained from SCI men who had used CIC with a reusable silicone catheter for more than a year. Demographic data, urological management and urinary tract complications focusing on the radiologic status of the urethra were reviewed and analyzed. In addition, two reused and one new catheters were studied under electron microscope for catheter morphology (surface and lumen) and stiffness.
Results: There were 28 SCI men included in this study. The average duration of CIC use was 4.8 years and the average time of usage for each catheter was 3 years (range 1–7 years). In all, 26 men previously used indwelling catheterization (ID) during the acute phase. In all, 23 men performed self-catheterization. Regarding urinary complications, three reported urethral bleeding, five had episodes of pus per urethra, five had epididymitis, four had passing stones, 18 had occasional foul smelly urine, 10 developed fever and cloudy urine during the past year. Of 17 patients who had ultrasonography done, four had pathologic findings in kidney and one had bladder calculi. Demographic data, urinary management and complications did not have significant relation to the abnormality of the urethrogram or urinary tract infection. However, where the frequency of CIC was higher, the abnormality of the urethra was lower (P<0.05). All had serum Cr level ⩽1.3 mg/dl. Electron microscopic findings of reused catheters for 2 years revealed encrustation but no obstruction in the lumens and 20% increase in stiffness.
Conclusion: The clinical outcome, especially with regard to urethral abnormalities with this reusable silicone catheter is as good as with a disposable one. However, to reuse urinary catheters, one should consider the increasing risk of infection. For SCI patients in developing countries, CIC with a reusable silicone catheter may be a suitable and safe choice if one cleans and applies it properly to reduce infection. In order to answer the question how long a person in a developing country should use the same silicone catheter, further research should be conducted.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Madersbacher H, Wyndaele JJ, Igawa Y, Chancellor M, Chartier-Kastler E, Kovindha A . Conservative management in neuropathic urinary incontinence. In: Abrams P, Cardozo L, Khoury S, Wein A (eds). Incontinence, 2nd edn. Plymouth: Health Publication Ltd 2002, pp 697–754.
Wyndaele JJ, Maes D . Clean intermittent self-catheterisation – a 12-year follow-up. J Urol 1990; 143: 906–908.
Vaidyanathan S, Soni BM, Dundas S, Krishnan KR . Urethral cytology in spinal cord injured patients performing intermittent catheterisation. Paraplegia 1994; 22: 493–500.
Waller L, Jonsson O, Norlen L, Sullivan L . Clean intermittent self-catheterization in spinal cord injury patients: long-term follow-up of a hydrophilic low friction technique. J Urol 1995; 153: 345–348.
Wyndaele JJ, De Ridder D, Everaert K, Heilporn A, Congard-Chassol B . Evaluation of the use of Urocath Gel catheters for intermittent self-catheterization by male patients using conventional catheters for a long time. Spinal Cord 2000; 38: 97–99.
Madersbacher H et al. Conservative management in the neuropathic patient. In: Abrams P, Khoury S, Wein A (eds). Proceeding of the First International Consultation on Incontinence. Plymouth: Health Publication Ltd 1999, pp 775–812.
Guenther M, Loechner-Ernst D, Kramer G, Stoehrer M . Intermittent cathetherisation in neurogenics: no harm to the urethra. In: The Final Program & Abstract Book of the 39th Annual Scientific Meeting of the International Medical Society of Paraplegia 2000, pp 11 (abstract).
Jacobs SC, Kaufman JM . Complications of permanent bladder catheter drainage in spinal cord injury patients. J Urol 1978; 119: 740–741.
Giannantoni A, Di Stasi SM, Scivoletto G, Virgill G, Dolci S, Porena M . Intermittent catheterization with a prelubricated catheter in spinal cord injured patients: a prospective randomized crossover study. J Urol 2001; 166: 130–133.
Bakke A, Vollset S . Risk factors for bacteriuria and clinical urinary tract infection in patients treated with clean intermittent caheterization. J Urol 1993; 149: 527–531.
Diokno AC, Sonda PL, Hollander JB, Lapides J . Fate of patients started on clean intermittent self-catheterization therpay 10 years ago. J Urol 1983; 129: 1120–1122.
Acknowledgements
Thanks to Medical Service Company (Germany) for the electron microscopic examination and supporting this research study.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kovindha, A., Mai, W. & Madersbacher, H. Reused silicone catheter for clean intermittent catheterization (CIC): is it safe for spinal cord-injured (SCI) men?. Spinal Cord 42, 638–642 (2004). https://doi.org/10.1038/sj.sc.3101646
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.sc.3101646
Keywords
This article is cited by
-
Cross-sectional internet survey exploring symptomatic urinary tract infection by type of urinary catheter in persons with spinal cord lesion in Japan
Spinal Cord Series and Cases (2023)
-
The temporal burden of preparing catheters for re-use in adults with spinal cord injury: a cross-sectional study
Spinal Cord Series and Cases (2023)
-
The microbiological and physical properties of catheters for intermittent catheterization: a systematic review on the impact of reuse and cleaning
Spinal Cord (2022)
-
Pulse article: survey of neurogenic bladder management in spinal cord injury patients around the world
Spinal Cord Series and Cases (2021)
-
Disability and sustainability: reusable versus single-use catheters for persons with neurogenic bladder due to spinal cord injury
Spinal Cord Series and Cases (2020)
