Presentation Authors: Katsumi Shigemura*, Koichi Kitagawa, Masashi Nomi, Masato Fujisawa, Kobe, Japan
Introduction: The patients with neurogenic bladder (NB) often have febrile genito-urinary tract infection (GUTI) but no obvious study was seen in the risk factors for the occurrence. The purpose of this study is to investigate the risk factors for febrile GUTI in spinal cord injury-associated neurogenic bladder (NB) patients who perform routine clean intermittent catheterization (CIC) studied by urodynamic study (UDS) and cystography.
Methods: Over a 3-years period we retrospectively assessed risk factors for febrile UTI in 141 spinal cord injury patients diagnosed as NB and performing routine CIC, regarding gender, UDS findings such as bladder compliance, maximum cystometric capacity, pDetMax, PMP (pre micturition pressure), voided volume, residual urine, residual urine rate, detrusor sphincter dyssynergia: DSD, detrusor overactivity: DO, sensory disturbance and presence of normal desire to urinate, and cystography.
Results: A total of 41 patients had febrile GUTI in the follow-up period as along with 32 cases of pyelonephritis, 10 cases of epididymitis, and 1 case of prostatitis, including patients with multiple infectious diseases. Statistical analysis showed that male gender (male, p=0.018), ASIA impairment scale (AIS) C or worse (p=0.031), the number of CIC (p=0.034), use of quinolones (p < 0.001) and severe bladder deformity (deformity grade: DG2 or worse, p=0.004) were significantly associated with febrile GUTI occurrence in NB patients employing routine CIC. No UDS findings correlated with febrile UTI occurrence.
Conclusions: Our data demonstrated that male gender, severe bladder deformity (deformity grade: DG 2 or worse), ASIA impairment scale (AIS) C or worse, the number of CIC, and use of quinolones were significantly associated with febrile GUTI occurrence in NB patients employing routine CIC. Further prospective studies are necessary to define the full spectrum of possible risk factors for febrile GUTI in the NB patients with CIC performance.