Analysis of Urological Complications according to the Voiding Method for Spinal Cord Injury Patients

Lee, Kwang Yeom; Jung, Tae Young; Shim, Hong Bang

Abstract

PURPOSE
Our study was designed to compare the incidence of urological complications for patients with spinal cord injury in relation to their voiding method, and then we wished to suggest a proper voiding method.
MATERIALS AND METHODS
Based on their medical records, questionnaires and upper tract imaging, a total of 301 male spinal cord injury patients were retrospectively analyzed for the outcomes of their voiding method. Our study was performed on 50 patients with urethral Foley catheterization, 106 patients with clean intermittent catheterization, 67 patients with suprapubic catheterization, 51 patients within self voiding and 27 patients with condom catheters. Urological complications such as urinary infection, stone disease, urethral complications, vesicoureteral reflux, radiographic upper tract abnormality and bladder tumor were recorded for each patient.
RESULTS
Of the 262 complications that were recorded, 89 developed in 24 (48.0%) patients having urethral Foley catheterization, 41 in 23 (21.7%) patients having clean interemittent catheterization, 72 in 26 (38.8%) patients having suprapubic catheterization. 36 in 15 (39.4%) patients with self voiding and 24 in 9 (33.3%) patients having condom catheters. The urethral Foley catheterization group had the highest complication rates relative to all other voiding methods, and the clean intermittent catheterization group had significantly lower complication rates except for having the highest rate of urethral stricture.
CONCLUSIONS
Our study shows that clean intermittent catheterization for spinal cord injury patients significantly reduces the incidence of urological complications and it may be the optimal voiding method.