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Urethral strictures in men with neurogenic lower urinary tract dysfunction using intermittent catheterization for
Spinal Cord
|February 4, 2015
Summary
Men using intermittent catheterization (IC) have a significantly higher risk of developing urethral strictures. Approximately 25% of men using IC may develop strictures, though only a third may require surgery.
Area of Science:
- Urology
- Nephrology
- Rehabilitation Medicine
Background:
- Neurogenic lower urinary tract dysfunction (NLUTD) affects bladder management.
- Intermittent catheterization (IC) is a common bladder evacuation method for NLUTD.
- Urethral strictures are a potential complication of bladder management.
Purpose of the Study:
- To investigate the incidence, characteristics, and clinical outcomes of urethral strictures in men with NLUTD.
- To compare urethral stricture rates between intermittent catheterization (IC) and other bladder evacuation methods.
- To analyze factors influencing stricture development and the need for surgical intervention.
Main Methods:
- Retrospective investigation of a patient database from a spinal cord injury rehabilitation center.
- Screening of men with NLUTD undergoing video-urodynamic investigation (2008-2012).
- Data collection included patient characteristics, bladder diaries, stricture occurrence, and urethrotomy procedures, with strictures classified using a modified Wiegand scoring system.
Main Results:
- Urethral stricture occurrence was significantly higher in men using IC (25%) compared to other methods (14%) (P=0.0001).
- Strictures developed after a median of 5.9 years of IC use, with no significant effect of tetraplegia or catheter type.
- One-third of affected men underwent internal urethrotomies, and operated men had a 100% recurrence rate after a median of 14 years.
Conclusions:
- Intermittent catheterization (IC) is associated with a significantly higher incidence of urethral strictures in men with NLUTD.
- A substantial proportion of men using IC (up to 25%) may develop urethral strictures.
- While strictures are common, surgical intervention is required in only about one-third of cases, with high recurrence rates post-surgery.
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