Abstract
Study design:
Retrospective review of medical notes.
Objective:
To evaluate spinal cord injury (SCI) patients’ compliance with bladder emptying method at long-term period after discharge and determine the frequency of urinary tract infections (UTIs).
Setting:
Inpatient rehabilitation unit of tertiary research hospital.
Methods:
Bladder management method of 164 new spinal cord injured patients were noted at discharge from rehabilitation center and follow-up. Patients were questioned whether they continued the initial bladder emtying method at follow-up, reasons for discontinuation and the history of treated UTIs.
Results:
The most common bladder management method at discharge from inpatient rehabilitation center was clean intermittent catheterization (CIC) (63.4%). At follow-up 42% of the patients who used CIC changed their bladder emptying method. Rate of reverting to urethral indwelling catheter (IC) was 21.4%. Reasons for the patients who switched to IC application were recurrent UTIs, incontinence, nephrolithiasis, dependence on care givers and urethral strictures. For all patients, the frequency of treated UTI in 1 year was 38.8%. The number of UTIs were highest in patients using IC.
Conclusion:
Many factors, including urological complications, patient’s preference, living environment, life-style and level of injury should be considered in deciding the method of bladder management in SCI patients. The CIC is a reliable and effective method in selected SCI patients. Despite changes in bladder emptying method, CIC was the most preferred method at long-term follow-up. Education of patients on catheterization technique and periodic follow-up is necessary to maintain patient compliance.
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References
Hansen RB, Biering-Sørensen F, Kristensen JK . Bladder emptying over a period of 10-45 years after a traumatic spinal cord injury. Spinal Cord 2004; 42: 631–637.
Linsenmeyer TA, Bodner DR, Creasey GH, Green BG, Groah SL, Joseph A et al. Bladder management for adults with spinal cord injury: a clinical practice guideline for health care providers. J Spinal Cord Med 2006; 29: 527–573.
Perkash I, Giroux J . Clean intermittent catheterization in spinal cord injury patients: a follow up study. J Urol 1993; 149: 1068–1071.
Yavuzer G, Gök H, Tuncer S, Soygur T, Arikan N, Arasil T . Compliance with bladder management in spinal cord injury patients. Spinal Cord 2000; 38: 762–765.
Granger CV . Quality and outcome measures for medical rehabilitation. In Braddom RL, (ed). Physical Medicine and Rehabilitation 2nd edn. Saunders Elsevier: Philadelphia, pp 151–164 2000.
Darouiche RO . Infections in patients with spinal cord injury. In: Mandell GL, Bennett JE, Dolin R, eds.. Principles and Practice of İnfections Diseases 6th edn. Elsevier Churchill Livingstone: Philadelphia, pp 3512–3517 2005.
Weld KJ, Dmochowski RR . Effect of bladder management on urological complications in spinal cord injured patients. J Urol 2000; 163: 768–772.
Dahlberg A, Perttilä I, Wuokko E, Ala-Opas M . Bladder management in persons with spinal cord lesion. Spinal Cord 2004; 42: 694–698.
Cameron AP, Wallner PL, Tate DG . Bladder management after spinal cord injury in the United States 1972 to 2005. J Urol 2010; 184: 213–217.
Ku Ja Hyeon . The management of neurogenic bladder and quality of life in spinal cord injury. BJU Int 2006; 98: 739–745.
Timoney AG, Shaw PJR . Urological outcome in female patients with spinal cord injury: the effectiveness of intermittent catheterisation. Paraplegia 1990; 9: 556–563.
Chai T, Chung AK, Belville WD, Faerber GJ . Compliance and complications of clean intermittent catheterization in the spinal cord injured patient. Paraplegia 1995; 33: 161–163.
Hill VB, Davies WE . A swing to intermittent clean self catheterization as a preferred mode of management of the neuropathic bladder fort he dextrous spinal cord patient. Paraplegia 1988; 26: 405–412.
Maynard FM, Glass J . Management of the neuropathic bladder by clean intermittent catheterization: 5 year outcomes. Paraplegia 1987; 25: 106–110.
Gallien P, Nicolas B, Robineau S, Le Bot MP, Durufle A, Brissot R . Influence of urinary management on urologic complication in a cohort of spinal cord injury patients. Arch Phys Med Rehabil 1998; 79: 1206–1209.
Mizuno K, Tsuji T, Kimura A, Liu M, Masakado Y, Chino N . Twenty-seven years of complication-free life with clean intermittent self-catheterization in a patient with clean intermittent self-catheterization in patient with spinal cord injury: a case report. Arch Phys Med Rehabil 2004; 85: 1705–1707.
Siroky MB . Pathogenesis of bacteriuria and infection in the spinal cord injured patient. Am J Med 2002; 113: 67S–79S.
Waites KB, Canupp KC, DeVivo MJ . Epidemiology and risk factors for urinary tract infection following spinal cord injury. Arch Phys Med Rehabil 1993; 74: 691–695.
Chartier-Kastler E, Denys P . Intermittent catheterization with hydrodhilic catheters as a treatment of chronic neurogenic urinary retention. Neurourol Urodyn 2011; 30: 21–31.
Li L, Ye W, Ruan H, Yang B, Zhang S . Impact of hydrophilic catheters on urinary tract infections in peoples with spinal cord injury: systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil 2013; 94: 782–787.
Heard L, Buhrer R . How do we prevent UTI in people who perform intermittent catheterization? Rehabil Nurs 2005; 30: 44–45.
Newman DK, Willson MM . Review of intermittent catheterization and current best practices. Urol Nurs 2011; 31: 12–28.
Preminger GM, Tiselius HG, Assimos DG, Alken P, Buck AC, Gallucci M et al. EAU/AUA Nephrolithiasis Guideline Panel. 2007 guideline for the management of ureteral calculi. J Urol 2007; 178: 2418–2434.
Vaidyanathan S, Soni BM, Singh G, Oo T, Hughes PL . Barriers to implementing intermittent catheterisation in spinal cord injury patients in Northwest Regional Spinal Injuries Centre, Southport, U.K. ScientificWorldJournal 2011; 11: 77–85.
Akkoç Y, Ersöz M, Yıldız N, Erhan B, Alaca R, Gök H et alfor Neurogenic Bladder Turkish Research Group. Effects of different bladder management methods on the quality of life in patients with traumatic spinal cord injury. Spinal Cord 2013; 51: 226–231.
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Afsar, S., Yemisci, O., Cosar, S. et al. Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study. Spinal Cord 51, 645–649 (2013). https://doi.org/10.1038/sc.2013.46
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DOI: https://doi.org/10.1038/sc.2013.46
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