INTERMITTENT CATHETERIZATION TO OBTAIN CATHETER-FREE BLADDER FUNCTION IN SPINAL-CORD INJURY

  • 1 January 1978
    • journal article
    • research article
    • Vol. 59  (1) , 4-8
Abstract
The intermittent bladder catheterization technique has been proposed as an effective way of eliminating the need for an inlying Foley catheter in patients with neurovesical dysfunction following spinal cord injury. A group of 41 male patients with spinal cord injuries achieved a catheter-free state with this method. Of these 41 patients, 19 have been followed for 1 yr. The patient''s fluid intake was restricted to 2000 ml daily. A detrusor reflex was triggered by lower abdominal percussion followed by a Crede maneuver. A 6-h catheterization schedule was used unless autonomic dysreflexia required more frequent catheterizations. Ascorbic acid, methenamine mandelate and nitrofurantoin were routinely administered and specific antibiotics were also given following trial off-catheter, depending on the results of urine cultures and sensitivity studies. All patients achieved a catheter-free state in an average time of 17.1 days; no late failures have occurred. Two patients developed vesicoureteral reflex, but no evidence of hydronephrosis was observed. At 1 yr only 16% of the patients were found to have infected urine, as compared to 100% at initiation of the trial off-catheter.

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