Early clean intermittent catheterization recommended with neurogenic bladder

Early clean intermittent catheterization is recommended to reduce the incidence of recurrent febrile urinary tract infections (FUTIs) in children with neurogenic bladder (NB), according to a study published in the September issue of Neurourology & Urodynamics.

Guanglun Zhou, from Shenzhen Children's Hospital in Guangdong, China, and colleagues sought to identify the clinical and urodynamic risk factors associated with the development of recurrent FUTIs in children with NB. The analysis included data for 321 children with NB receiving clean intermittent catheterization (CIC) prospectively followed for two years.

The researchers found that occasional FUTIs occurred in 223 patients, and 98 patients experienced recurrent FUTIs. Late-initiation and low-frequency CIC, vesicoureteral reflux (VUR), small bladder capacity and low compliance, and detrusor overactivity were associated with an increased risk for recurrent FUTIs. Risk for recurrent FUTIs was higher for children with high-grade VUR (grades IV to V) versus those with low-grade VUR (grades I to III; odds ratio, 26.95 versus 4.78; P < 0.001).

"We recommend early CIC interventions in patients with NB," the authors write.