Suprapubic catheterisation after spinal cord injury: a follow-up report

Peatfield, Richard; Burt, A A; Smith, Philip H.

doi:10.1038/sc.1983.35

Cited by 17 publications

(10 citation statements)

References 9 publications

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“…In this study just fewer than 50% of the patients were females with a similar outcome. Suprapubic catheters have been used with success in the early management of traumatic spinal cord lesions 9 and compared by prospective study with CISC for this use 10 with no reported di erence between the two methods of management, although SPC was found to be a cheaper alternative.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

et al. 1998

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“…6 SPC has also been successfully used in the early treatment of spinal cord lesions. 7 Despite purported benefits and convenience of SPC, early studies demonstrating accelerated renal deterioration [8][9][10][11] relegated it to a second-line management option. Long-term complications associated with indwelling urinary catheters are well reported elsewhere, 12 with studies demonstrating proportionately more renal and other urologic complications with long-term (>10 years) than short-term (removed just after injury).…”

Section: Suprapubic Cystostomy For the Neuropathic Bladdermentioning

confidence: 99%

Contemporary Role of Suprapubic Cystostomy in Treatment of Neuropathic Bladder Dysfunction in Spinal Cord Injured Patients

Feifer

Corcos

2008

Neurourology and Urodynamics

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Early studies reported accelerated renal deterioration and lower urinary tract complications, including stones, recurrent infections and blocked catheters. Procedural complications were generally rare. In contrast, recent investigations, in which patients were managed with anti-cholinergics, frequent catheter changes and bladder washing, and volume maintenance procedures demonstrated similar morbidity profiles to CIC.

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“…On the other hand, continuous suprapubic cystostomy may cause various but not fatal ill effects [2]. We analyzed the long-term outcome of these patients including their backgrounds and complications.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Analysis of Suprapubic Cystostomy Drainage in Patients with Neurogenic Bladder

Nomura

Teranishi

et al. 2000

Urol Int

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Objective: We assessed the roles of suprapubic cystostomy in patients with neurogenic bladder and analyzed the complications and their courses. Patients and Methods: We reviewed 118 patients with neurogenic bladder managed with suprapubic cystostomy. The original diseases were spinal cord injury in 90, degenerative disease of the central nervous system in 15, spina bifida in 6, cerebral palsy in 3, pontine bleeding in 1, Parkinson’s disease in 1, brain tumor in 1, and dysgenesis of the external sphincter in 1. Fifty-six (62.2%) of spinal cord-injured patients demonstrated cervical damage. Renal function, urinary pH and white blood cell values were measured and evaluated after insertion. The stone-free rate after insertion was estimated by the Kaplan-Meier method. Results: Indications for cystostomy were failure of clean intermittent catheterization in 62 (52.5%) and Credé’s maneuver in 2, severe urethral damage in 30 (25.4%), replacement of urethral catheter in 3, worsening of the original disease in 15 (12.7%), deterioration of the general condition in 2, mental retardation in 2, and traumatic vesical rupture in 1. Frequent complications were formation of the bladder calculi in 30 (25%) and urinary leakage through the urethra in 11 (10%). No fatal complications occurred. The stone-free rates 5 and 10 years after insertion were 77 and 64%, respectively. The urinary pH of the stone-forming group was significantly higher than that of the stone-free group. The high urinary pH group (>7.24) had a higher risk of stone formation. Conclusions: Although continuous cystostomy drainage is not considered to be ideal management for bladder emptying, some patients with neurogenic bladder may benefit from this procedure.

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Suprapubic catheterisation after spinal cord injury: a follow-up report

Cited by 17 publications

References 9 publications

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

Long-term suprapubic catheterisation: clinical outcome and satisfaction survey

Contemporary Role of Suprapubic Cystostomy in Treatment of Neuropathic Bladder Dysfunction in Spinal Cord Injured Patients

Long-Term Analysis of Suprapubic Cystostomy Drainage in Patients with Neurogenic Bladder

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