[Vescical catheter management in patients with vertebro-medullary pathologies: a rating instrument for removal]

About 35-40% of hospital infections arise from the urinary tract and 75-80% of these are attributable to vesical catheterization. In patients operated for vertebro-medullary pathologies, removal of the catheter represents a delicate moment, due to the possibility of neurological bladder . To date, no rating method exists to determine when the catheter should be removed. The aim of this study was to test a system for determining catheter removal in such patients, to reduce the incidence of urinary infections and the need for further catheterization. A case-control study was performed on 139 patients surgically treated for vertebro-medullary pathologies in the Neurosurgical Division of Rome "Sapienza" University Hospital between May 2008 and February 2009, collecting and monitoring data for all patients and creating an assessment scale for the study group comprising 4 variables influencing minction: sensory perception, mobility, pain, pre-existing sphincter disturbances.

In the experimental group, catheterization times were shorter in comparison to the control group and the incidence of both urinary retention and permanent catheterization after removal were lower.. There was a complete absence of urinary infections in the experimental group compared to 6.52% in the control group.