Spinal cord lesionsTrauma to the spineHerniated discMyelomeningocele
Peripheral nerve lesionsGuillian-Barry syndromeSever herpes in in genitoanal areaPernicious anaemiaNeurosyphilis
Flaccid or Atonic Bladder Spastic or Reflex Bladder Uninhibited Bladder Sensorimotor Paralytic Bladder
Occurs after acute spinal cord injury.The bladder fails to contract resulting in urinary retention
Occurs when there is a spinal cord injury abovethe level of S2-S4.It results in frequent uncontrolled voiding due tobladder spasms and a lack of sensation.
Urinary frequency and urgency resultingfrom changes in the brain.This may be caused by conditions such asstroke, head injury or Multiple Sclerosis.
Inability to empty the bladder because of damage to the peripheral nervous system.It can be caused by conditions such as diabetes mellitus or extensive pelvic surgery.
Follow a regular schedule Empty your bladder completely each time Prevention of UTI
Intermittent catheterizationIndwelling catheterExternal condom catheter for menSuprapubic catheterization
Clean Technique-Clean technique doesnot require the use of sterile catheters or gloves.wash your hands and genital area beforeinserting a new catheter
Aseptic TechniqueUse a sterile catheter and it will remain sterilethroughout the catheterizationInsert the catheter through aprotective sleeve or use sterile gloves
Sterile TechniqueTo achieve a sterile technique, you will use acompletely sterile setting.This includes sterile gloves, forceps, gown andmask.
This type of catheter is held in the bladderby an inflatable balloon and it providescontinuous drainage.Long term indwelling catheters aretypically replaced by a healthcareprofessional every 10-12 weeks.
Short term Long term (14-28 days) (12 weeks) All-siliconPolyvinyl chlorideLatex Silicon elastometer coated Hydrogel coatedTeflon
Complications of indwelling catheters may include urinary tract or kidney infections, blood infections (septicemia), urethral injury, skin breakdown, bladder stones, and/or hematuria.
A suprapubic catheter is an indwellingcatheter that is placed directly into thebladder through the skin above the pubicbone.The insertion site (opening on the skin), andthe tube, must be cleansed daily with soapand water
No risk of urethral damageNo risk of prostatitis and epididymo-orchitisCan be clamped intermittently to see if voidingoccurs.
Less chances of UTIMay require distal urethralsphincterectomy
These stimulates the anterior nerve rootsof S2,S3 and S4 nerves and helps invoiding the bladder.
Few patients train themselves to initiatethe voiding reflex by stroking or pinchingon medial side of the thigh and initiate thereflex
UTIRenal failureBladder stonesUrine leakage or incontinenceBladder cancer
Keep skin cleanUse proper techniques closed system cathetersDrink plenty of fluids Indwelling Catheter – 15 glasses of water Condom and Intermittent Catheterization – 8-10 glasses of waterEmpty bladder on a regular schedule
Have a regular urologic check-upRenal scan or ultrasound X ray-KUBKnow the warning signs of infection cloudy urine bad smelling urine (foul odor); and blood in the urine (pink or red urine).