Management of the Neuropathic Bladder by Suprapubic Catheterisation

Barnes, Douglas G.; Shaw, Peter J.; Timoney, Anthony G.; Tsokos, Nicolas

doi:10.1111/j.1464-410x.1993.tb00681.x

Cited by 32 publications

(13 citation statements)

References 6 publications

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“…On the contrary, some other articles reported that chronic urinary management with catheterization including SPC did not show any significant difference in urinary complications and renal deterioration compared with CIC or catheter–free urinary management [14, 15, 16]. Our study also showed good results during follow–up and no significant difference between SPC and CIC except for bladder stones, which resulted from appropriate management to maintain low vesical pressure from the early stage of SCI after trauma.…”

Section: Discussionsupporting

confidence: 59%

Is Suprapubic Cystostomy an Optimal Urinary Management in High Quadriplegics?

Mitsui

Minami²,

Furuno³

et al. 2000

European Urology

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Section: Discussionsupporting

confidence: 59%

Is Suprapubic Cystostomy an Optimal Urinary Management in High Quadriplegics?

Mitsui

Minami²,

Furuno³

et al. 2000

European Urology

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“…6 Recurrent catheter blockage remains the commonest complaint with a higher incidence than that reported by Stower and his colleagues. 11 Two major di erences may account for this discrepancy.…”

Section: Discussionmentioning

confidence: 96%

“…5 This unit ®rst introduced a policy of suprapubic catheter management consisting of anti-cholinergic therapy in the presence of signi®cant detrusor hyperre¯exia to suppress detrusor function, daily catheter clamping for 2 h to maintain the reservoir capacity of the bladder, and a catheter change every 6 weeks. 6 By these means it was hoped to avoid the development of upper urinary tract abnormalities in the long-term. The demand for this convenient form of bladder management has continued to increase and therefore further assessment of its clinical implications and acceptance in long-term use is required.…”

Section: Introductionmentioning

confidence: 99%

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

et al. 1998

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We report on the clinical outcome and satisfaction survey of long-term suprapubic catheterisation in patients with neuropathic bladder dysfunction. Between early 1988 and later 1995, 185 suprapubic catheters were inserted under direct cystoscopic vision. Anticholinergic therapy was given to all patients with signi®cant detrusor hyper-re¯exia; the catheters clamped daily for two hours and changed every six weeks. Ultrasonography and assessment of the serum creatinine were used to assess the upper renal tracts, and the results of the pre-and post-catheter video-cystometrography was used to evaluate bladder morphology, cystometric capacity, maximum detrusor pressure and the presence of vesico-ureteric re¯ux. There were equivalent numbers of males and females. The follow-up ranges from 3 ± 68 months. Following catheterisation, there was a 50% reduction in the average maximum detrusor pressure, bladder morphology improved in 85% of the cases; the bladder capacity and upper renal tracts remained unchanged. Vesico-ureteric re¯ux was abolished in 33% of the cases. Complaints were common consisting of recurrent catheter blockage, persistent urinary leakage and recurrent urinary tract infections. There was a 2.7% incidence of small bowel injury with one fatality. However, the general level of satisfaction was high. It is concluded that suprapubic catheterisation is an e ective and well tolerated method of management in selected patients with neuropathic bladder dysfunction for whom only major surgery would otherwise provide a solution to incontinence. We are encouraged to ®nd preservation of renal function with maintained bladder volumes and reduced maximum detrusor pressures thus justifying the policy of catheter clamping and anti-cholinergic therapy in the presence of signi®cant detrusor hyper-re¯exia. However, even in expert hands this procedure is not without hazards.

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“…The di erence in this series is due to persistence of incontinence refractory to anticholinergic suppression. 12,15 During long-term follow-up, we observed that some of the female patients who needed to be catheterised by someone else started to perceive the procedure as a sexual assault. Usually this occurred after the ®rst 2 years during which they thought that catheterisation would be temporary, and that they were again going to urinate by themselves one day.…”

Section: Discussionmentioning

confidence: 99%

Compliance with bladder management in spinal cord injury patients

et al. 2000

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Study design: Retrospective analysis of medical records on spinal cord injury (SCI) patients with neuropathic bladder. Objective: To determine SCI patients' compliance with the method of bladder management they used on discharge from inpatient rehabilitation. Setting: Ankara University Medical School, Department of Physical Medicine and Rehabilitation, Spinal Cord Injury Unit, which treats patients referred from throughout Turkey. Methods: The bladder management method of 50 new SCI patients was noted at admission, discharge and follow-up. Reasons for changing the initial method were documented. For analysis, patients were grouped by gender, level and completeness of injury. Compliance with bladder management method was compared between these groups by chi-square test. Results: The method of bladder management at admission was indwelling catheter (IC) for 86% of the patients. Most were switched to clean intermittent catheterisation (CIC) by rehabilitation discharge. Of 38 patients (76%) on CIC at discharge, 20 (52%) discontinued this method and reverted to IC during follow-up. Compliance with CIC was lower for women, for tetraplegics, and for those with complete injury. Dependence on care givers, severe spasticity interfering with catheterisation, incontinence despite anticholinergic agents, and lack of availability of external collective devices for female patients were the main reasons for low compliance with CIC. Conclusion: The bladder management method of SCI patients should be selected so as to be suitable to the patients' life style. Besides reducing morbidity, it also has to enhance the quality of life. Spinal Cord (2000) 38, 762 ± 765

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Management of the Neuropathic Bladder by Suprapubic Catheterisation

Cited by 32 publications

References 6 publications

Is Suprapubic Cystostomy an Optimal Urinary Management in High Quadriplegics?

Is Suprapubic Cystostomy an Optimal Urinary Management in High Quadriplegics?

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

Compliance with bladder management in spinal cord injury patients

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