Intermittent catheterization with a prelubricated catheter in spinal cord injured patients: A prospective randomized crossover study

Purpose: We compared the safety and patient acceptance of a conventional Nelaton and a prelubricated nonhydrophilic catheter in 18 spinal cord injured patients on intermittent catheterization. Materials and Methods: In a prospective crossover study each catheter was used for 7 weeks and the initial course was randomized. Urinalyisis and urine culture were performed at 2, 4 and 7 weeks. Urethral trauma was evaluated by urethral cell count on the surface of each catheter used on the last day of each study period. Patient satisfaction was assessed at the end of the study by a questionnaire using multiple visual analog scales. Results: Urinary tract infection was identified in 12 and 4 patients on a Nelaton and a prelubricated nonhydrophilic catheter (p = 0.03), while asymptomatic bacteruria was identified in 18 and 8 (p = 0.0244), respectively. The mean urethral cell count, plus or minus standard deviation on the catheter surface was 6.7 +/- 2.8 x 10(4) and 15.1 +/- 8.9 x 10(4) for the prelubricated nonhydrophilic and the Nelaton catheter, respectively (p = 0.01). The prelubricated nonhydrophilic catheter resulted in a better mean satisfaction score than the Nelaton catheter (2.33 +/- 1.06 versus 4.72 +/- 2.13, p = 0.022). Urethral bleeding was reported in 2 patients during the study period while using the Nelaton catheter. Conclusions: The prelubricated nonhydrophilic catheter is a safe, effective and comfortable option in spinal cord injured patients on intermittent self-catheterization.