Disclosures: Rachel K. Teranishi, MD: No financial relationships or conflicts of interest

Objective: To understand the burden of and possible risk factors for indwelling urinary catheter (IDC) blockage in people with spinal cord injury (SCI).

Design: We conducted a cross-sectional cohort study on a convenience sample of veterans with SCI. We compared survey results and urine samples between “blockers” and “non-blockers,” with “blockers” defined as those who experience IDC blockage at least once every two months. Univariate comparisons were done using Fisher Exact and unpaired t-test. Setting : Veterans Affairs SCI Center. Participants : Veterans with SCI who use IDC for bladder management.

Interventions: Not applicable.

Main Outcome Measures: History of IDC blockage, urologic history, and urine characteristics.

Results: 15/24 (63%) reported any frequency of IDC blockage while eight individuals (33%) experienced catheter blockage at least every two months. Foley and suprapubic catheter users were equally likely to experience blockage (p= 0.4). 7/8 blockers noticed daily urinary sediment versus 3/16 of non-blockers (p=0.002). 5/8 blockers had a history of at least one bladder or renal stone requiring surgical removal compared to 2/16 non-blockers (p=0.02). Blockers appeared less mobile compared to non-blockers, but differences were not statistically significant. There were no distinct patterns of urine bacterial colonization and no differences in specific gravity or spot urine mineral concentrations. 6/13 (46%) participants who experience autonomic dysreflexia (AD) reported AD induced by catheter blockage. Blockers spent more time on average performing catheter flushes than non-blockers (20 min v. 12 min, p = 0.2). Conclusions: Between 20-50% of people with SCI use IDC for bladder management and many of these struggle with recurrent catheter blockage. Those who experience catheter blockage have more urinary sediment and a history of urinary tract stone disease. IDC blockage can cause AD and takes significant time to manage. Further study is needed to better understand the risk factors and effective management strategies for recurrent blockage of indwelling catheters in individuals with SCI.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/indwelling-urinary-catheter-blockage-after-spinal-cord-injury/