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

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:

• Spinal cord injury
• Anticholinergic therapy
• Urodynamics
• Intermittent catheter frequency

Disclaimer statements

Contributors None.

Funding None.

Conflicts of interest The authors declare no conflict of interest.

Ethics approval The approval of the Educational Planning and Coordination Committee of our hospital was obtained for this retrospective study.