Use and disuse of catheterizable channels as the primary method of emptying the neuropathic bladder: a single institutional cohort study

No AccessJournal of UrologyPediatric Article4 Nov 2024Use and disuse of catheterizable channels as the primary method of emptying the neuropathic bladder: a single institutional cohort study Yifan Meng. Griffin, Rosalia Misseri, Joshua D. Roth, Benjamin M. Whittam, Pankaj Dangle, Shelly King, Kirstan K. Meldrum, Martin Kaefer, Mark P. Cain, Richard C. Rink, and Konrad M. Szymanski Yifan Meng. GriffinYifan Meng. Griffin Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Rosalia MisseriRosalia Misseri Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Joshua D. RothJoshua D. Roth Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Benjamin M. WhittamBenjamin M. Whittam Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Pankaj DanglePankaj Dangle Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Shelly KingShelly King Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Kirstan K. MeldrumKirstan K. Meldrum Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Martin KaeferMartin Kaefer Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Mark P. CainMark P. Cain Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , Richard C. RinkRichard C. Rink Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN , and Konrad M. SzymanskiKonrad M. Szymanski Corresponding author: Konrad M. Szymanski, MD MPH Division of Pediatric Urology Riley Hospital for Children at IU Health 705 Riley Hospital Dr., Suite 4230 Indianapolis, IN 46202, USA Tel: (317) 944-7446 Fax: (317) 944-7481 Email: ([email protected]) View All Author Informationhttps://doi.org/10.1097/JU.0000000000004313AboutPDF Cite Export CitationSelect Citation formatNLMAMAIEEEACMAPAChicagoMLAHarvardTips on citation downloadDownload citationCopy citation ToolsAdd to favoritesTrack Citations ShareFacebookLinked InTwitterEmail Abstract Purpose: We aimed to assess long-term use of continent catheterizable urinary channels (CCCs) and explore potential risk factors for disuse. Materials and Methods: People undergoing appendicovesicostomy and Monti procedures at our institution were retrospectively reviewed (1991-2023). The main outcome was CCC disuse (not intermittently catheterizing channels as the primary method of bladder emptying). Cox regression was used. Results: 561 people (46% male, 57% shunted, 72% spina bifida) met inclusion criteria (244 appendicovesicostomy, 317 Monti; 69% right lower quadrant [RLQ]). Channels were created at a median age of 8 years (median follow up: 11 years, 78% self-catheterized). Overall, 76 people disused their channels. Most common reasons for disuse were non-mechanical (64%). After disuse, 46% underwent incontinent diversion. After correcting for differential follow-up, 89% of people still used their channels at 10 and 81% at 20 years, respectively. When analyzing all disused channels in patients reaching adulthood on multivariable analysis, channels catheterized by others had 3.78 times the risk for disuse compared to self-catheterized channels (p<0.001); RLQ channels were 1.06 times more likely to be disused than umbilical channels (p=0.02). For channels disused for non-mechanical reasons, catheterization by others, not attending transition clinic, and RLQ stoma were independently associated with disuse (p≤0.04). No variables were associated with disuse for mechanical reasons (p≥0.22). Conclusions: Most people with CCCs use them on long-term follow-up. 1% stopped using them annually. People who never self-catheterized, never attended transition clinic or had RLQ stomas were at higher risk of channel disuse, particularly due to non-mechanical reasons. © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.KeywordsUrinary bladder, neurogenic / surgeryUrinary catheterizationSurgical StomasRetrospective StudiesSelf-Management / methodsMetrics Author Information Yifan Meng. Griffin Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Rosalia Misseri Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Joshua D. Roth Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Benjamin M. Whittam Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Pankaj Dangle Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Shelly King Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Kirstan K. Meldrum Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Martin Kaefer Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Mark P. Cain Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Richard C. Rink Division of Pediatric Urology, Riley Hospital for Children at IU Health, Indianapolis, IN More articles by this author Konrad M. Szymanski Corresponding author: Konrad M. Szymanski, MD MPH Division of Pediatric Urology Riley Hospital for Children at IU Health 705 Riley Hospital Dr., Suite 4230 Indianapolis, IN 46202, USA Tel: (317) 944-7446 Fax: (317) 944-7481 Email: ([email protected]) More articles by this author Expand All Advertisement PDF downloadLoading ...