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

Overnight catheter drainage (OCD) is introduced to avoid overdistension of the bladder nighttime when clean intermittent catheterization proves ineffective for daytime management of neurogenic bladder. We adopted OCD using disposable silicone no-balloon (DSnB) catheters, with the distal end outside the body opening into diapers. However, the OCD using DSnB catheter had risks of retrograde bacterial contamination. Therefore, in this study, the validity of equipping DSnB catheters with check valves to prevent retrograde bacterial contamination was examined.

In vitro: Excised saline-filled swine bladders were drained using DSnB catheters with or without check valves, and the time required for intravesical pressure to reach 5 cmH2 O was measured. In vivo: In crossover experiments comparing DSnB catheters with and without check valves, OCD using DSnB 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.

In vitro: Median (range) drainage time were 368.2 (88-1085) s and 344.7 (28-840) s with and without check valves respectively (n=6), which wasn't different. In vivo: In crossover experiments (n=8) new bacterial growth rates after OCD did not differ, and median (range) residual urine volumes were 17.1 (range, 0-75) mL and 1.2 (0-5) mL with and without check valves, respectively (p=0.055).

Installing a check valve in the DSnB catheter did not decrease new bacterial growth, while tending to increase residual urine volume. DSnB catheters without check valves appear to be better for continuous drainage of urine from bladder. This article is protected by copyright. All rights reserved.

Pediatrics international : official journal of the Japan Pediatric Society. 2019 Feb 19 [Epub ahead of print]

Hiromi Furukawa, Ken Ishikawa, Shigekuni Tsuchiya, Saeko Nishimi, Makoto Sasaki, Chinatsu Onodera, Akira Takada, Kotaro Oyama, Shoichi Chida

Department of Pediatrics, Iwate Medical University, School of Medicine, 19-1 Uchimaru, Morioka, 020-8505, Japan.