How are indwelling catheters maintained in the treatment of neurogenic bladder?

Updated: Dec 24, 2020
  • Author: Bradley C Gill, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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The usual practice is to replace indwelling catheters and collection bags at least once monthly. However, catheters that develop encrustations and problems with urine drainage must be changed more frequently. All indwelling catheters that remain in the urinary bladder for more than 2 weeks become colonized with bacteria. Bacterial colonization does not mean the patient has clinical bladder infection. Symptoms of bladder infection include foul odor, purulent urine, and hematuria. Fever with flank pain often is present if upper tracts are involved. If bladder infection occurs, change the entire catheter and the drainage system. The urinary drainage bag does not need to be disinfected to prevent infection.

Routine irrigation of catheters is not required. However, some authors favor the use of 0.25% acetic acid irrigation because it is bacteriostatic, minimizes catheter encrustation, and diminishes the odor. When this method is used, 30 mL is instilled into the bladder and allowed to freely drain on a twice-daily basis.

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