Prevalence and Cost of Catheters to Manage Neurogenic Bladder

Abstract

In this review, we examine the current literature to address the epidemiology of catheters for managing neurogenic bladder. We will address the epidemiology of conditions associated with neurogenic bladder, including multiple sclerosis, spinal cord injury, Parkinson’s disease, stroke, and spina bifida. Rates of utilization of various catheter strategies, including indwelling urethral catheter, suprapubic catheter, and intermittent catheterization rates will be reviewed. Lastly, we examine the cost considerations between and within each type of strategy. Management strategies for neurogenic bladder have evolved overtime. Costs between catheter strategies are largely driven by complications. The highest cost variation within each strategy is related to the technique and type of intermittent catheter. Recently, there has been an increase in costlier single-use intermittent catheter strategies. However, the short- and long-term benefits of these strategies remained understudied. Without comparative studies highlighting improvements in complication rates and compliance, the benefits of single-use catheters for intermittent catheterization are largely theoretical. Until such studies are performed, providers should strongly consider managing neurogenic bladder patients with reusable intermittent catheters in order to provide the most cost-conscious care.