Intermittent Catheterization in Paraplegic Patients

1. Intermittent catheterization was done on 36 patients, 34 with traumatic and 2 with medical cord lesions; 28 (77.7%) patients became catheter free. 2. Intermittent catheterization was performed at first at 4 hours interval, which was extended to 6, 8, 12, 24, 48 and 72 hours depending on the progress recorded in a special chart. 3. Medication consisted of Methenamine mandelate, Ascorbic Acid and when not contraindicated, Betanechol. 4. Of the 28 catheter-free patients, 16 (57%) had a sterile urine. 5. Of 12 patients with sterile urine, 6 (50%) retained a sterile urine; the urine became sterile in 10 of 24 patients who had urinary infection on admission. 6. The majority, namely 21 of the 28 patients became catheter free within 60 days of intermittent catheterization; 10 of the 21 patients became catheter free within 30 days. Intermittent catheterization may be done for up to 3 months. 7. The shorter the period of preceding indwelling catheterization, the quicker is recovery of bladder function; however, long lasting preceding indwelling catheterization does not necessarily militate against a trial with intermittent catheterization; in spite of urinary infection, it may result in recovery of bladder function and sterile urine. 8. Bladder function seemed to respond more readily in patients with incomplete than with complete lesions, and in patients with lower motor neuron than upper motor neuron lesions. 9. The age of the patient did not seem to play a role for recovery of bladder function. 10. The urinary flora ranged from A. aerogenes, Pseudomonas aeroginosa, Proteus, E. Coli, Paracolon to non-hemolytic staph. aureus and diphtheroids, in the order of frequency on admission; changes of the flora occurred without and with medication. 11. The results are discussed in the light of the literature. 12. A plea is made to use this method for patients with cord lesion from the very start and to avoid indwelling catheterization.