Clean, Intermittent Catheterization of Infants With Neurogenic Bladder

PEDIATRICS ◽  
1989 ◽  
Vol 84 (1) ◽  
pp. 78-82
Author(s):  
David B. Joseph ◽  
Stuart B. Bauer ◽  
Arnold H. Colodny ◽  
James Mandell ◽  
Alan B. Retik
Keyword(s):  
Urinary Tract ◽  
Neurogenic Bladder ◽  
Bladder Dysfunction ◽  
Upper Urinary Tract ◽  
Febrile Episode ◽  
Intermittent Catheterization ◽  
Early Age ◽  
Clean Intermittent Catheterization ◽  
Detrusor Sphincter Dyssynergia ◽  
Tract Infections

Clean, intermittent catheterization was instituted in 38 babies with myelodysplasia who were thought to be at risk for upper urinary tract deterioration because of neurogenic bladder dysfunction. There were 19 patients 2 weeks to 12 months of age, 11 were 1 to 2 years of age, and 8 were older than 2 years. Effectiveness of clean, intermittent catheterization was determined by maintenance of upper urinary tract stability. Upper urinary tracts improved or remained stable in 13 of 16 infants (81%) with reflux and 16 of 18 infants (89%) with detrusor-sphincter dyssynergia. Bacteriuria was present in 16 (42%), with only 2 infants (5%) having a febrile episode; no infant required hospitalization because of urinary tract infections. No further complications were identified in infants who were cleanly and intermittently catheterized. Most families found clean, intermittent catheterization of their infants easy to master and not stressful, and their children adjusted to it at an early age.

Bladder instillation for urinary tract infection prevention in neurogenic bladder patients practicing clean intermittent catheterization: A systematic review

2021 ◽  
pp. 039156032110498
Author(s):  
Talal Ziadeh ◽  
Roy Chebel ◽  
Chris Labaki ◽  
Gebrael Saliba ◽  
Elie El Helou
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Urinary Tract ◽  
Neurogenic Bladder ◽  
Lactobacillus Rhamnosus ◽  
Intermittent Catheterization ◽  
Clean Intermittent Catheterization ◽  
Efficacy And Safety ◽  
Bladder Instillation ◽  
Tract Infections

Objective: To assess the efficacy and safety of different modalities of bladder instillation in patients with neurogenic bladder practicing intermittent catheterization. Methods: A systematic review of the literature were conducted using two databases: Medline via PubMed and Scopus. Articles evaluating bladder instillation in patients with neurogenic bladder, who are practicing intermittent catheterization, were collected and assessed for the efficacy and safety of the studied agent by two different reviewers. Results: Among the 1896 studies, eight involving 346 patients with neurogenic bladder, were included in this systematic review according to the PRISMA protocols. Gentamicin, Hyaluronic acid, and Lactobacillus rhamnosus was found to decrease the incidence of urinary tract infections, the former reduced multidrug-resistant organisms. Kanamycin-colistin, showed a drop in the mean incidence of bacteriuria in males only. Trisdine, the only studied antiseptic, significantly reduced bacteriuria. Neomycin, however, showed no efficacy in term of bacteriuria. Regarding safety, when evaluated, no major adverse events were reported with any of the studied modalities. Conclusion: Bladder instillations of either antibiotics, antiseptics, hyaluronic acid, or Lactobacillus rhamnosus GG are efficient and safe in patients having neurogenic bladder, with recurrent urinary tract infections and practicing clean intermittent catheterization, with gentamicin being the most recommended product among the different studied agents.

scholarly journals Neurogenic Bladder

2012 ◽  
Vol 2012 ◽  
pp. 1-16 ◽  
Author(s):  
Peter T. Dorsher ◽  
Peter M. McIntosh
Keyword(s):  
Urinary Incontinence ◽  
Urinary Tract ◽  
Neurogenic Bladder ◽  
Urinary Tract Infections ◽  
Bladder Dysfunction ◽  
Upper Urinary Tract ◽  
Neurogenic Bladder Dysfunction ◽  
Surgical Interventions ◽  
Bladder Retraining ◽  
Tract Infections

Congenital anomalies such as meningomyelocele and diseases/damage of the central, peripheral, or autonomic nervous systems may produce neurogenic bladder dysfunction, which untreated can result in progressive renal damage, adverse physical effects including decubiti and urinary tract infections, and psychological and social sequelae related to urinary incontinence. A comprehensive bladder-retraining program that incorporates appropriate education, training, medication, and surgical interventions can mitigate the adverse consequences of neurogenic bladder dysfunction and improve both quantity and quality of life. The goals of bladder retraining for neurogenic bladder dysfunction are prevention of urinary incontinence, urinary tract infections, detrusor overdistension, and progressive upper urinary tract damage due to chronic, excessive detrusor pressures. Understanding the physiology and pathophysiology of micturition is essential to select appropriate pharmacologic and surgical interventions to achieve these goals. Future perspectives on potential pharmacological, surgical, and regenerative medicine options for treating neurogenic bladder dysfunction are also presented.

scholarly journals Urinary tract infections in children with myelodysplasia in whom clean intermittent catheterization was administered

2017 ◽  
Vol 49 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Zuhal Albayrak Yildiz ◽  
Cengiz Candan ◽  
Mustafa Arga ◽  
Pinar Turhan ◽  
Pinar Isguven ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Intermittent Catheterization ◽  
Clean Intermittent Catheterization ◽  
Tract Infections

Is baseline routine renal ultrasound indicated for all MS patients?

2019 ◽  
Vol 96 (1134) ◽  
pp. 194-196
Author(s):  
Igor B Títoff ◽  
Victoria Titoff ◽  
Thomas F Scott
Keyword(s):  
Urinary Tract ◽  
Upper Urinary Tract ◽  
Renal Ultrasound ◽  
Red Flags ◽  
Inclusion Criteria ◽  
Detrusor Sphincter Dyssynergia ◽  
History Of ◽  
Bladder Symptoms ◽  
Tract Infections

BackgroundMost patients with multiple sclerosis (MS) develop multiple urological complaints due to hyperactive or hypoactive bladder, and may have detrusor-sphincter dyssynergia. Routine renal ultrasound (RUS) screening has been recommended for both symptomatic and asymptomatic MS patients; however, there is little data to support this practice.MethodsProspectively screened consecutive MS clinic patients in 2016–2017 with functional systems scores (FSS) indicating moderate to severe neurogenic bladder symptoms (FSS bladder ≥2) were sent for RUS. We also screened for history of urinary tract infections.Results872 patients were screened between 3 September 2016 and 13 April 2017. 58 patients met inclusion criteria for RUS. 6 were excluded due to non-compliance with testing or unavailability of results; 52 patients were imaged. Only 3/52 patients were found to have renal pathology requiring follow-up. Of those three, one had known symptomatic nephrolithiasis, and one had subsequently normal findings, leaving one patient newly found to have valid abnormal upper urinary tract (UUT) findings. Multiple incidental findings were also discovered.ConclusionThe minimal yield for significant UUT pathology found in this enriched group of symptomatic MS patients indicates that RUS screening for asymptomatic MS patients without clear risk factors is not indicated. Red flags for high risk of UUT complications should be used as triggers for baseline RUS screening in MS patients.

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