Shifting to 4 × 1 intermittent catheterization without an early follow-up urodynamic study is possible in most patients with subacute spinal cord injury

J Spinal Cord Med. 2016 May;39(3):307-10. doi: 10.1179/2045772315Y.0000000065. Epub 2016 Apr 1.

Abstract

Objectives: We retrospectively evaluated the frequency of changing to 4/day intermittent catheterization (IC) in patients with subacute spinal cord injury (SCI) who had been initiated on IC 6 times a day and started oral anticholinergic treatment following urodynamic investigation for decreased maximum cystometric capacity and undergone a follow-up urodynamic study within 45 days. The goal of the study was to see if the second urodynamic study was necessary.

Methods: The frequency of shifting to 4/day IC was investigated retrospectively in 27 patients with subacute SCI who were prescribed 6/day IC.

Results: In 25 of 27 patients a bladder capacity of 400 ml or more was reached in urodynamic study carried out in the following 45 days and the patients were shifted to 4/day IC. There was a significant difference between the anticholinergic pre-treatment (293 ± 39 ml) and post-treatment (531 ± 81 ml) capacities (P < 0.001). The mean increase in bladder capacity in all patients was 237.6 ± 79.5 ml (83.5 ± 32.1%).

Conclusion: Patients with subacute SCI who were prescribed 6/day IC and were given an oral anticholinergic drug can be shifted to 4/day IC after 45 days without performing an early control urodynamic study if the patients use the drug properly. However in the long-run, periodic follow-up urodynamic studies should be carried out at appropriate intervals, according to the patients' clinical findings.

Keywords: Anticholinergic therapy; Intermittent catheter frequency; Spinal cord injury; Urodynamics.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Intermittent Urethral Catheterization / adverse effects
  • Intermittent Urethral Catheterization / methods*
  • Male
  • Middle Aged
  • Spinal Cord Injuries / complications*
  • Urinary Bladder, Neurogenic / diagnosis
  • Urinary Bladder, Neurogenic / etiology
  • Urinary Bladder, Neurogenic / therapy*
  • Urodynamics