Abstract: Clinical Utility of a Portable Ultrasound Device in Intermittent Catheterization

Hubert A. Anton, MD, Keith Chambers, MD, Joanne Clifton, BA, and Jennifer Tasaka, RN. "Clinical Utility of a Portable Ultrasound Device in Intermittent Catheterization." Archives of Physical Medicine and Rehabilitation 79 (February 1998): 172-75.

Objectives:
* To evaluate the effectiveness of a portable ultrasound device (the BladderManager^®) in the management of intermittent catheterization programs for patients with neuropathic bladder. Neuropathic bladder is a condition which often results from spinal cord injury and other neurologic disorders. Its consequences include urinary incontinence, the inability to empty or completely empty the bladder, overdistension of the bladder, urinary tract infection, renal calculi, increased spasticity, and autonomic dysreflexia. In the long-term, neuropathic bladder can lead to upper urinary tract damage, renal failure, and premature death.

Methods:
* Thirty-eight inpatients and outpatients with neuropathic bladder who required intermittent catheterization participated in the study. Participants were randomly assigned to an ultrasound group and a control group. The control group continued their usual intermittent catheterization program. The ultrasound group entered a one week training program, during which they were taught how to use the BladderManager^®.
* A study nurse documented the frequency of catheterization and catheterization volumes for both groups. The nurse also documented episodes of urinary tract infection. Data was collected for one month. Upon completion of the program, patients were asked to complete a Patient Satisfaction Questionnaire.

Results:
* Patients in the ultrasound group had fewer catheterizations per day, on average, than patients in the control group (2.99 vs. 4.12, p = 0.026).
* The number of episodes of overdistension decreased for the ultrasound group.
* Most subjects who participated in the study expressed satisfaction with the BladderManager^®.

Conclusions:
* "Persons requiring long-term intermittent catheterization face a challenging task. Any device that simplifies their routine could improve their quality of life and reduce the frequency of medical complications. In this study, we demonstrated that use of a portable ultrasound device can reduce the frequency of intermittent catheterization and is associated with a high degree of satisfaction in patients with neuropathic bladder who use the device as part of an intermittent catheterization program."

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