Role of Intermittent Self Catheterization after Cauda Equina Syndrome Surgery.
Background: To determine the effectiveness and
safety of intermittent self catheterization in cauda
equina patients who have lost the bladder control.
Methods : In this prospective study patients with
symptoms and signs of cauda equina syndrome, due
to lumbar disc herniation confirmed by relevant
MRI ,were included. Emergency surgery was
performed and post operatively these patients were
taught the technique of intermittent self
catheterization. After full aseptic measures patients
were asked to sit on the chair and identify the
meatus. Catheter was slowly inserted into the
bladder,uptil the urine output was obtained.
Pressure on the lower abdomen was applied to help
in emptying the bladder. Nelton catheter was
removed and was kept in a bottle of clean water.
After couple of attempts patients learnt to pass the
catheter. Patient was asked and helped to do this
activity 3 to 4 times a day. The patient was
discharged from the hospital only when he/she was
confident enough to catheterize himself/herself.
Initially patients were kept on biweekly follow up
and later on monthly basis.
Results : Majority (86%) continued to undergo
intermittent self catheterization, but 14% , elderly
patients, experienced insertion difficulty and
discontinued intermittent self catheterization. Ten
patients (24%) had bacteriuria during the procedure.
Epididymitis was seen in 2%. There were no urethral
complications suggesting that the self-lubricating
Nelton catheters are safe and less traumatic.
Conclusion: Intermittent self catheterization is a
safe, effective treatment and is associated with
improved quality of life in cauda equina syndrome