Management of the neuropathic bladder by suprapubic catheterisation

Forty out-patients with neuropathic bladders managed by suprapubic catheterisation have been reviewed. Management included anticholinergic therapy and daily clamping of the catheter to maintain a compliant bladder of good capacity. Twenty-three females and 17 males (mean age 45 years) were studied. Failed intermittent catheterisation and the replacement of long-term urethral catheters were the main indications for suprapubic catheterisation. Catheter-related problems were common, with only 5 patients reporting none. Acceptance by patients was high (84%). No evidence could be found of accelerated renal deterioration in patients followed up for more than 2 years. A policy for the management of suprapubic catheters is recommended.