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Intermittent catheterisation for neuropathic urinary incontinence
M N de la Hunt1, S Deegan, J E Scott
1Department of Paediatric Surgery, Royal Victoria Infirmary, Newcastle upon Tyne.
Insights
Clean intermittent catheterisation (CIC) effectively manages neuropathic urinary incontinence in children, with most patients achieving dryness. This long-term study shows CIC is safe and well-tolerated, remaining a preferred treatment option.
Area of Science:
- Pediatric Urology
- Neurology
- Nephrology
Background:
- Neuropathic urinary incontinence significantly impacts children's quality of life.
- Long-term management strategies are crucial for this patient population.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of clean intermittent catheterisation (CIC) in children with neuropathic urinary incontinence.
- To assess complication rates and patient tolerance of CIC over an extended period.
Main Methods:
- Retrospective review of 86 children with neuropathic urinary incontinence treated with CIC for over five years.
- Analysis of continence status, reasons for abandoning CIC, infection rates, and urological complications.
Main Results:
- 84% of patients achieved dryness or only minor stress incontinence during the day.
- Only 32 patients developed occasional symptomatic infections; serious complications were infrequent.
- No new upper urinary tract dilatation occurred in previously normal renal systems during CIC.
Conclusions:
- Clean intermittent catheterisation is a highly successful and well-tolerated treatment for neuropathic urinary incontinence in children.
- CIC demonstrates a favorable safety profile with few serious complications, making it the preferred management option.
Abstract:
Eighty six children with neuropathic urinary incontinence who had been treated by clean intermittent catheterisation for more than five years were reviewed. Eighty five had congenital lesions, and one traumatic paraplegia. During the day, 72 (84%) patients were dry or had minor stress incontinence only, 11 were damp but controlled with pads, and only three were continuously wet. Eleven abandoned clean intermittent catheterisation, five because of poor control, four by choice despite good control, and only two because of deterioration of upper urinary tract disease. Most of them usually had bacteriuria, but only 32 developed occasional symptomatic infections. Urinary calculi occurred in six, epididymitis in three, and urethral problems in four. Upper urinary tract dilatation did not arise in a previously normal renal system in any patient during clean intermittent catheterisation. Clean intermittent catheterisation was successful in controlling wetting with few serious complications, and was well tolerated. It remains the method of choice for the management of neuropathic urinary incontinence in such children.