Maynard F M, Diokno A C
J Urol. 1982 Sep;128(3):477-80. doi: 10.1016/s0022-5347(17)53003-7.
Charts were reviewed retrospectively for 65 patients with traumatic spinal cord injury discharged from the hospital between 1972 and 1977 on clean intermittent catheterization for management of neurogenic bladders. While 54 patients were still using clean intermittent catheterization 9 had discontinued its use and 2 were lost to followup. Complete urologic followup records were available for 28 long-term clean intermittent catheterization users, with an average followup of 3.7 years. Complications seen in this group included nephrolithiasis-3 cases, cystolithiasis--3, epididymitis--4 and urinary tract infection--12. No patient had hydronephrosis or radiographic pyelonephritis. Clean intermittent catheterization appears to be a safe and satisfactory alternative for long-term management of the neurogenic bladder of selected spinal cord injury patients, since the incidence of serious renal complications is low. Factors that should be considered before long-term clean intermittent catheterization is recommended include type of neurogenic bladder, prognosis for recovery, incontinence despite medication, history of urethral trauma, host resistance, physical independence in self-catheterization, compliance and patient preference.
回顾性查阅了1972年至1977年间因神经源性膀胱管理而采用清洁间歇性导尿术出院的65例创伤性脊髓损伤患者的病历。54例患者仍在使用清洁间歇性导尿术，9例已停止使用，2例失访。有28例长期使用清洁间歇性导尿术患者的完整泌尿外科随访记录，平均随访时间为3.7年。该组出现的并发症包括肾结石3例、膀胱结石3例、附睾炎4例和尿路感染12例。无患者出现肾积水或影像学肾盂肾炎。清洁间歇性导尿术似乎是选定脊髓损伤患者神经源性膀胱长期管理的一种安全且令人满意的替代方法，因为严重肾脏并发症的发生率较低。在建议长期采用清洁间歇性导尿术之前应考虑的因素包括神经源性膀胱类型、恢复预后、药物治疗后仍存在的尿失禁、尿道创伤史、宿主抵抗力、自行导尿时的身体独立性、依从性和患者偏好。
