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urinay infections and foley vs suprapubic catheters

Posted by Jerry Brenner on June 06, 1999 at 18:59:22
I am a quad who lost the use of my limbs about 3 years ago.....I use a foley catheter, and suffer from bladder infections at least once a month.  My normal outflow in a day is about 3000 to 4000 cc's, and I am considering getting a suprapubic catheter to try to stop or help the infections.....will this be of any use?
any info would be most appreciated....
Jerry Brenner

Posted by HFHS M.D.-CK on June 09, 1999 at 09:41:17

Dear Jerry,
A neurogenic bladder does not function normally in that it does not fill at nice low pressures nor empty completely at a desired time.  Our goal in treatment is to limit detrimental effects of the bladder function abnormalities on your kidney function, prevent urinary tract infections, and to prevent incontinence of urine.
A foley catheter prevents incontinence, but it does not prevent loss of kidney function or prevent infections.  Ideally we would your bladder pressures down (if they are elevated) with medicines or surgical bladder augmentation, and then have a caregiver perform clean intermittent catheterization.  A surgical approach with an ileal vesicostomy is also an option.
A urodynamic study to measure your current bladder and voiding function is necessary to make treatment choices.  A creatinine blood test and kidney ultrasound should be used to evaluate your kidney function.  A suprapubic catheter has the advantage of decreased infection of the testicles and epididymis when compared to a transurethral foley catheter, otherwise the long term use of a indwelling catheter may prove harmful.
This information is provided for general medical information purposes only. Please consult  your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital  and its suburban locations (I-800-653-6568).
  * Keyword: neurogenic bladder

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