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Recurrent Urinary Tract Infection in Intermittently Catheterized Spinal Cord Injury Patients
Leonard U Edokpolo, Karen B Stavris, Harris E Foster, Jr
Yale University School of Medicine, New Haven, CT

Introduction: Clean intermittent catheterization (CIC) is widely accepted for neurogenic bladder management in spinal cord injury (SCI). We studied our population of SCI patients for the association of recurrent urinary tract infections (UTI) with the long-term use of CIC for neurogenic bladder management.

Materials & Methods: Retrospective study of 61 SCI subjects. Subjects were selected from patients followed by one physician at our institution between 2000 and 2010. 930 records were generated with diagnosis codes for “neurogenic bladder” and “spinal cord injury.” Initial review of these records identified 210 SCI patients. 51 males and 10 females followed for at least one year were included. Patients with urinary diversion or those not using CIC were excluded. Subjects experiencing recurrent symptomatic UTI's were identified by their use of medical UTI prophylaxis (PRx) with either oral antibiotics or methenamine/vitamin C.

Results: 41 (67%) subjects required medical PRx for recurrent symptomatic UTI's (8 (80%) females and 33 (65%) males). There was no statistically significant difference between percentage of males and females requiring PRx. Date of initial PRx use was noted in 39 of 41 subjects and the Results demonstrate 28 (72%) required PRx within 2 years after initiation of CIC.

Conclusions: Although CIC is believed to have the fewest complications compared with other Methods, most SCI patients managed with long-term CIC will require medical PRx for prevention of symptomatic UTI within 2 years after its initiation. This highlights the continued need for advances in bladder management to improve quality of life in SCI patients.

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