Abstract
BackgroundCondom catheters are indicated in spinal cord injury patients in whom intravesical pressures during storage and voiding are safe. Unmonitored use of penile sheath drainage can lead to serious complications.Case reportA 32-year old, male person, sustained complete paraplegia at T-11 level in 1985. He had been using condom catheter. Eleven years after sustaining spinal injury, intravenous urography showed no radio-opaque calculus, normal appearances of kidneys, ureters and bladder. Blood urea and Creatinine were within reference range. A year later, urodynamics revealed detrusor pressure of 100 cm water when detrusor contraction was initiated by suprapubic tapping. This patient was advised intermittent catheterisation and take anti-cholinergic drug orally; but, he wished to continue penile sheath drainage. Nine years later, this patient developed bilateral hydronephrosis and renal failure. Indwelling urethral catheter drainage was established. Five months later, ultrasound examination of urinary tract revealed normal kidneys with no evidence of hydronephrosis.ConclusionSpinal cord injury patients with high intravesical pressure should not have penile sheath drainage as these patients are at risk for developing hydronephrosis and renal failure. Intermittent catheterisation along with antimuscarinic drug should be the preferred option for managing neuropathic bladder.
Highlights
Condom catheters are indicated in spinal cord injury patients in whom intravesical pressures during storage and voiding are safe
Spinal cord injury patients with high intravesical pressure should not have penile sheath drainage as these patients are at risk for developing hydronephrosis and renal failure
Intermittent catheterisation along with antimuscarinic drug should be the preferred option for managing neuropathic bladder
Summary
Condom catheters should be used only in those spinal cord injury patients in whom intravesical pressures during storage and voiding are safe. This case illustrates that penile sheath drainage in a spinal cord injury patient with high intravesical pressure can lead to bilateral hydronephrosis and renal failure. Consent Written informed consent was obtained from the patient for publication of this Case report and accompanying images. We have started providing written information to spinal cord injury patients regarding possible complications of unmonitored penile sheath drainage and long-term indwelling catheter drainage (urethral as well as suprapubic catheter). The Internet has the potential to provide user-friendly health information to people living with disabilities. All authors contributed to and approved the final version of the manuscript
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