The usefulness of bladder reconditioning before indwelling urethral catheter removal from stroke patients

The aim of this study was to determine the effects of bladder reconditioning by indwelling urethral catheter (IUC) clamping before IUC removal in stroke patients.

Sixty patients with stroke were randomized to 0-, 1-, and 3-day IUC clamping groups. IUCs were removed without clamping in the 0-day group. In the other two groups, IUCs were clamped for 4 hrs followed by 5 mins of urinary drainage, a cycle repeated over 24 hrs in the 1-day and over 72 hrs in the 3-day clamping groups. Time to first voiding (FV), first voided volume (FV-vol), residual urine volume after FV, mean void volume, and residual urine volume on the third day after IUC removal were measured. We also recorded the voiding method such as self-voiding or intermittent catheterization, incidence of urinary tract infection, subjective complaints, and other complications.

Time to FV, FV-vol, residual urine volume after FV, voiding method, mean voided volume, and residual urine volume on the third day after IUC removal had no significant difference among three groups, nor between the 0-day and the other two clamping groups. We observed a strong negative correlation between age and FV-vol. Of the patients in the 1- and 3-day clamping groups, 3 (7.5%) had symptomatic urinary tract infection and 9 (22.5%) complained of urinary leakage during IUC clamping program.

Bladder reconditioning through IUC clamping has no noticeable benefits in stroke patients and may induce additional problems. These findings suggest that IUC removal without clamping is superior to IUC clamping for bladder reconditioning in stroke patients.