Chronic suprapubic catheterization in the management of patients with spinal cord injuries: analysis of upper and lower urinary tract complications.
OBJECTIVE
To assess whether chronic suprapubic catheterization (SPC) in patients with spinal cord injury (SCI) is associated with a higher incidence of significant urinary tract complications than in patients whose urinary tracts are managed by other methods.


METHODS
Our experience suggested that the incidence of complications in patients with SCI and SPC was acceptable and relatively low. Between 1988 and 2001, 1018 patients were admitted to our unit after SCI; 149 were managed by SPC and we retrospectively reviewed them, with a mean follow-up of 6 years. There were no complications in 49% of patients. Most complications were minor (urinary tract infection 27%, bladder stones 22%) and were easily managed. Only 20 patients had upper tract complications. Nine patients had renal scarring and 14, all quadriplegic, had upper tract calculi. One patient developed well-differentiated superficial transitional cell bladder cancer.


CONCLUSIONS
Patients with SCI often prefer SPC than other methods offered to them, because of quality-of-life issues. The incidence of significant complications might not be as high as previously reported, and with a commitment to careful follow-up, SPC can be a safe option for carefully selected patients if adequate surveillance can be ensured.
Sugimura
Takayuki
T
Department of Urology, Christchurch Hospital, Christchurch, New Zealand.
Arnold
Edwin
E
English
Sharon
S
Moore
James
J
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000601:surgery*; D016896:Treatment Outcome; D001744:Urinary Bladder Calculi / Q000209:etiology; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D014546:Urinary Catheterization / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000209:etiology