What is intermittent catheterization for the treatment of neurogenic bladder?

Updated: Dec 06, 2018
  • Author: Bradley C Gill, MD, MS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Answer

Intermittent catheterization or self-catheterization is a mode of draining the bladder at timed intervals, as opposed to continuous bladder drainage. A prerequisite for self-catheterization is patients' ability to use their hands and arms; however, in a situation in which a patient is physically or mentally impaired, a caregiver or health professional can perform intermittent catheterization for the patient. Of all 3 possible options (ie, urethral catheter, suprapubic tube, intermittent catheterization), intermittent catheterization is the best solution for bladder decompression of motivated individuals who can physically and cognitively participate in their care.

Many studies of young patients with spinal cord injuries have shown that intermittent catheterization is preferable to indwelling catheters (ie, urethral catheter, suprapubic tube) for both men and women. Intermittent catheterization has become a healthy alternative to indwelling catheters for individuals with chronic urinary retention due to an obstructed, weak, or nonfunctioning bladder. Young children with myelomeningocele have also benefited from the use of intermittent catheterization.

For those children, antibiotic prophylaxis (low-dose chemoprophylaxis) has commonly been prescribed for urinary tract infections. A study by Zegers et al found that this practice can be safely discontinued, especially in boys, patients with low urinary tract infection rates, and patients without vesicoureteral reflux. [7]


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