The use of SUBY G irriagion system in patients with neurogenic lower urinary tract dysfunction and longterm indwelling catheter
Abstract
Aim: Despite of advanced treatment of neurogenic lower urinary tract dysfunction there is a not inconsiderable group of patients reliant on long-term or permanent urinary diversion using indweling urinary catheter (IC). IC increase the risk of urinary tract infection and infections with ureasplitting strains can cause catheter encrustation and catheter blockage.
Preventive measures include frequent changes of IC, treatment of urinary infections and acidification of urine. Methods: In this prospective study, we randomized 43 patients.
The first group had inserted a IC with standard care. In the second group the bladder was washed out twice weekly using URO TAINER(R) Suby G solution for 10 minutes.
The catheter was changed in both groups after 21 days. The period of study was 9 weeks and the endpoint was the number of catheter encrustations caused by Proteus mirabilis, Pseudomonas aeruginosa, Klebsiela pnemumoniae and Providencia species and the incidence of symptomatic urinary tract infection.
Results: In the group with catheter washout, we recorded significantly fewer episodes of catheter encrustation (p-value = 0.009). Also the number of symptomatic urinary tract infections in the group with wash-out was significantly lower.
Two patients in the wash-out group did not complete the study due to adverse events. Conclusion: Preventive catheter wash-out in the group of patients with neurogenic lower urinary tract dysfunction led to significant reductions in episodes of catheter encrustation and significant reductions in the rate of symptomatic urinary tract infection.