Validity of a disposable catheter to drain urine overnight in neurogenic bladder

摘要

Abstract Background Overnight catheter drainage ( OCD ) is introduced to avoid overdistention of the bladder at night‐time when clean intermittent catheterization proves ineffective for daytime management of neurogenic bladder. We adopted OCD using disposable silicone no‐balloon ( DS nB) catheters, with the distal end outside the body opening into diapers. OCD using DS nB catheter, however, had risks of retrograde bacterial contamination. Therefore, in this study, the validity of equipping DS nB catheters with check valves to prevent retrograde bacterial contamination was examined. Methods For the in?vitro study, excised saline‐filled swine bladders were drained using DS nB catheters with or without check valves, and the time required for intravesical pressure to reach 5?cmH 2 O was measured. For the in?vivo study, in cross‐over experiments comparing DS nB catheters with and without check valves, OCD using DS nB catheters for 10?h was performed in rabbits under analgesia. Bacterial growth from urine samples before and after OCD and residual urine volume were examined. Results For the in?vitro experiment, the median drainage time was 368.2?s (range, 88–1,085?s) and 344.7?s (range, 28–840?s) with and without check valves, respectively ( n = 6), which was not significantly different. For the in?vivo experiment, in cross‐over experiments ( n = 8) new bacterial growth rates after OCD did not differ, and median residual urine volume was 17.1? mL (range, 0–75? mL ) and 1.2? mL (range, 0–5? mL ) with and without check valves, respectively ( P = 0.055). Conclusions Installing a check valve in the DS nB catheter did not decrease new bacterial growth, while tending to increase residual urine volume. DS nB catheters without check valves appear to be better for continuous drainage of urine from bladder.