Comparative analysis of urethral catheterization versus suprapubic cytostomy in management of neurogenic bladder in spinal injured patients

Abstract

The objective of this study was, to prospectively and retro respectively evaluate urethral catheterization (UC) versus supra-pubic cystostomy (SPC) in prevention of urinary tract infection (UTI) in patients with spinal cord injury lesion. A total of 125 patients with neurogenic bladder and a mean age of 30 years had UC (n=80) and SPC (n=40) at the Jos University Teaching Hospital (JUTH) between January 1984 and June 2005. Episodes of UTI were significantly more; UC 65% versus 14% forS PC (P< O 0 5). Urinary tract infection occurred relatively late in the course of admission, in patient who had SPC. Patients in SPC group were significantly satisfied with this management option; 57% versus 8% for UC. Similarly, mortality at 1 year post admission was significantly less; 9% versus 36% for UC and death due to UTI related septicaemia was 33% versus 18% respectively. It was concluded that SPC was a better management option since it was associated with a low morbidity, better quality of life and a longer life expectancy than UC.