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.
Written by:
Afsar SI, Yemisci OU, Cosar SN, Cetin N. Are you the author?
Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey.
Reference: Spinal Cord. 2013 Aug;51(8):645-9.
doi: 10.1038/sc.2013.46
PubMed Abstract
PMID: 23752262
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