Use of a Closed Diurnal Indwelling Catheter for Patients with Spinal Cord Disorders: A Pilot Study.

OBJECTIVES: To evaluate an alternative to clean intermittent catheterization (CIC) for individuals with neurogenic bladder for its effects on independence, privacy and convenience. This prospective cohort study provides an initial assessment of quality of life, safety and efficacy of closed diurnal indwelling catheterization (CDIC). METHODS: Individuals with spinal cord disorders using CIC were prospectively screened at multidisciplinary clinic appointments. During the 24-week intervention, a foley was placed each morning and capped between scheduled bladder drainage each 3 to 4 hours. After a maximum of eight hours of CDIC use, CIC was resumed. Quality of life outcome measures (SF-36, KHQ and PedsQL questionnaires), clinic evaluations, labs, imaging and urodynamics were obtained at specified interval visits planned after 4-, 12- and 24-weeks of study participation and compared to baseline. RESULTS: A total of 11 subjects enrolled; 8 completed the 24-week intervention. No significant difference with CDIC was observed in SF-36 or PedsQL summary scores as compared to baseline. For the KHQ, physical limitations secondary to bladder function decreased significantly from baseline to the 4-week and 12-week (p=.02) but not 24-week visits. All eight subjects who completed the 24-week intervention requested continued use. Early discontinuation occurred in three male participants due to urethral trauma (1) and incontinence (2). No increase in bacteriuria, urinary tract infections or renal anatomic changes was observed. CONCLUSIONS: This prospective study demonstrates that CDIC may be safe and effective for short-term use. This alternative to CIC for scheduled daytime bladder drainage for neurogenic bladder warrants further consideration.