Experience with non-sterile intermittent self-catheterization.

Although a patient subjected to intermittent self-catheterization must carry a catheter and catheterize himself under a non-sterile technique at regular intervals this method is considered the best one available for patients who lead an active social life. When family cooperation is available intermittent catheterization is a cleaner procedure, causes less complications and is easier to manage for a patient confined to bed than the indwelling catheter, cystostomy or other urinary diversion procedures. The technique is also useful for patients with spinal cord injuries, promoting the early return of bladder activity and a life free of the catheter. It is an ideal method for children with meningomyelocele, after the upper tract has been maintained carefully by an indwelling catheter or cystostomy until the child is able to catheterize himself. In these cases a small capacity bladder may be enlarged using the colon and urinary incontinence may be corrected by other operative procedures. We have treated 26 patients with this technique, including 1 with a 17-year followup. The upper urinary tract has not deteriorated in any case and the urine has remained sterile in 39 per cent of the cases.