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USE OF A DIURNAL INDWELLING CATHETER TO IMPROVE QUALITY OF LIFE
FOR PATIENTS WITH SPINAL CORD DISORDERS
Renea STURM
1
, Jennifer YANG
1
, Blythe DURBIN-JOHNSON
2
and Eric KURZROCK
1
1) University of California Davis Medical Center, Urology, Sacramento, USA - 2) University of California Davis Medical
Center, Division of Biostatistics, Davis, USA
PURPOSE
As children with neurogenic bladder managed by CIC transition to adulthood, an option is needed to increase
independence and privacy. We hypothesized that placement of an indwelling urethral catheter during the daytime that is
emptied on a regular schedule would be a safe alternative leading to improved quality of life.
MATERIAL AND METHODS
Ten to twenty-one year olds with spina bifida or spinal cord injury using CIC were screened prospectively at clinic
appointments. Exclusion criteria included frequent UTIs, urologic surgery, urolithiasis, reflux, hydronephrosis or poor
bladder compliance. During the 24-week intervention, a foley was placed each morning and plugged between bladder
drainages. After eight hours maximum, CIC was resumed. Evaluations at baseline, 4-, 12-, 24-weeks and post-
intervention crossover included scheduled SF-36, KHQ, PedsQL questionnaires, labs, imaging and urodynamics.
RESULTS
Twelve patients have enrolled. All five who completed the 24-week intervention to date have requested continued
use. Early discontinuation occurred due to urethral trauma, incontinence and spinal cord retethering. There has been no
increase in UTI frequency. The SF-36 demonstrated improvement in 24-week physical role (p=0.04) and general health
(p=0.02) scores. The physical role finding remained significant when girls but not boys were evaluated. PedsQL 4-week
parental assessment of school functioning (p=0.05) improved and KHQ 12-week bladder/continence scores (p=0.08)
approached significant improvement.
CONCLUSIONS
This prospective interventional study demonstrated that combining CIC and a closed, indwelling catheter for daytime
use is safe and may improve quality of life. The diurnal indwelling catheter is a novel alternative in the management of
neurogenic bladder.