Background: Management of the lower urinary tract is crucially important in patients with spinal cord injuries in order to prevent damage to the upper urinary tract and to preserve renal function.
Aim: This study was designed to compare the use of standard polyvinyl chloride (PVC), hydrophilic-coated, and gel-lubricated non-hydrophilic catheters with regard to urethral micro trauma, urinary system infection, and patient satisfaction in patients with spinal cord injuries. Study design. Randomized, controlled study.
Setting: University hospital, inpatient clinic.
Population: Twenty-five male patients with spinal cord injuries.
Methods: The patients were asked to use 3 different types of catheters. The selection of catheter order was determined randomly, and all 3 catheters were used for 6 weeks consecutively. All patients were assessed at the beginning of treatment and at weeks 6, 12, and 18, in terms of urethral cytology, urinalysis, urine culture, and patient satisfaction (Visual Analog Scale, VAS).
Results: Ten patients completed the study. Regarding the urethral trauma evaluation, urethral cell counts were reduced with gel-lubricated non-hydrophilic catheter use (P<0.05), increased with PVC catheter use (P<0.05), and showed no change with hydrophilic-coated catheter use (P>0.05). The number of leucocytes in the urine sediment was significantly reduced after gel-lubricated catheter use (P<0.05). There was significantly less microhematuria with hydrophilic-coated and gel-lubricated non-hydrophilic catheter use compared with PVC catheter use (P<0.05). There were no significant differences among catheters with respect to symptomatic urinary tract infection and microbiological analysis of urine culture (P>0.05). The mean VAS was better with the gel-lubricated non-hydrophilic catheter than with the other two catheter types (P<0.05).
Conclusion: The hydrophilic-coated catheter and especially the gel-lubricated non-hydrophilic catheter reduce trauma to the urethral surfaces and enable easy and comfortable catheterization.
Clinical rehabilitation impact: The hydrophilic and gel-lubricated catheters represent an attractive alternative to standard PVC catheters for urological rehabilitation in patients with spinal cord injuries.