title: Results of clean intermittent catheterization for children with neurogenic bladders.
abstract: Forty-nine patients were placed on a regimen of clean intermittent catheterization one to four years prior to this review. The children were intermittently catheterized, and a silver nitrate solution 1:1000 was instilled after each catheterization. Nurse practitioners, and community and school personnel contributed to the management. Twenty-one patients were continent with anticholinergics, and 18 also required alpha-adrenergic agents. Eighty-eight per cent were essentially bacteriuria-free, 65 per cent were essentially infection-free, and forty-nine per cent were totally continent. The remaining 25 had mild incontinence. Eleven had clearances below 85 mm/min with 8 reverting to normal on therapy. Nine had reflux prior to the study and one improved. In 8 patients reflux developed during therapy; 4 had severe reflux which required ureteral reimplantation. The results demonstrated that a clean intermittent catheterization program is feasible in a rural setting and that a genitourinary irrigant does decrease bacteriuria.
mesh_terms: D001437:Bacteriuria / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007484:Iowa; D008297:Male; D010349:Patient Compliance; D012424:Rural Population; D012648:Self Care; D012835:Silver Nitrate / Q000008:administration & dosage; D007507:Therapeutic Irrigation; D001750:Urinary Bladder, Neurogenic / Q000628:therapy*; D014546:Urinary Catheterization; D014549:Urinary Incontinence / Q000517:prevention & control
chemical_list: D012835:Silver Nitrate