Validity of a disposable catheter to drain urine overnight in neurogenic bladder

• Published in: Pediatrics International Vol. 61; no. 7; pp. 706 - 711
• Main Authors: Furukawa, Hiromi, Ishikawa, Ken, Tsuchiya, Shigekuni, Nishimi, Saeko, Sasaki, Makoto, Onodera, Chinatsu, Takada, Akira, Oyama, Kotaro, Chida, Shoichi
• Format: Journal Article
• Language: English
• Published: Australia Wiley 01.07.2019; Blackwell Publishing Ltd
• Subjects: Analgesia; Animals; Bacteria; Bladder; Catheterization; Catheters; check valve; Contamination; Cross-Over Studies; Disposable Equipment; Disposable Equipment - microbiology; disposable silicone no‐balloon catheter; Drainage; Drainage - adverse effects; Drainage - instrumentation; Drainage - methods; Growth rate; In Vitro Techniques; Male; neurogenic bladder; overnight catheter drainage; Pain perception; Pediatrics; Rabbits; Random Allocation; retrograde bacterial contamination; Silicones; Swine; Urinary Bladder, Neurogenic; Urinary Bladder, Neurogenic - therapy; Urinary Catheterization; Urinary Catheterization - adverse effects; Urinary Catheterization - instrumentation; Urinary Catheterization - methods; Urinary Catheters; Urinary Catheters - adverse effects; Urinary Catheters - microbiology; Urinary Tract Infections; Urinary Tract Infections - etiology; Urinary Tract Infections - prevention & control; Urine; Wound drainage; overnight catheter drainage; neurogenic bladder; retrograde bacterial contamination; check valve; disposable silicone no-balloon catheter
• ISSN: 1328-8067; 1442-200X; 1442-200X
• DOI: 10.1111/ped.13806

Background Overnight catheter drainage (OCD) is introduced to avoid overdistention of the bladder at night‐time when clean intermittent catheterization proves ineffective for daytime management of neurogenic bladder. We adopted OCD using disposable silicone no‐balloon (DSnB) catheters, with the distal end outside the body opening into diapers. OCD using DSnB catheter, however, had risks of retrograde bacterial contamination. Therefore, in this study, the validity of equipping DSnB catheters with check valves to prevent retrograde bacterial contamination was examined. Methods For the in vitro study, excised saline‐filled swine bladders were drained using DSnB catheters with or without check valves, and the time required for intravesical pressure to reach 5 cmH2O was measured. For the in vivo study, in cross‐over experiments comparing DSnB catheters with and without check valves, OCD using DSnB catheters for 10 h was performed in rabbits under analgesia. Bacterial growth from urine samples before and after OCD and residual urine volume were examined. Results For the in vitro experiment, the median drainage time was 368.2 s (range, 88–1,085 s) and 344.7 s (range, 28–840 s) with and without check valves, respectively (n = 6), which was not significantly different. For the in vivo experiment, in cross‐over experiments (n = 8) new bacterial growth rates after OCD did not differ, and median residual urine volume was 17.1 mL (range, 0–75 mL) and 1.2 mL (range, 0–5 mL) with and without check valves, respectively (P = 0.055). Conclusions Installing a check valve in the DSnB catheter did not decrease new bacterial growth, while tending to increase residual urine volume. DSnB catheters without check valves appear to be better for continuous drainage of urine from bladder.