Evaluation of 3 methods of bladder irrigation to treat bacteriuria in persons with neurogenic bladder.
J Spinal Cord Med
; 29(3): 217-26, 2006.
Article
in En
| MEDLINE
| ID: mdl-16859225
ABSTRACT
BACKGROUND/OBJECTIVE:
We conducted a randomized, double-blind comparison of twice daily bladder irrigation using 1 of 3 different solutions in community-residing persons with neurogenic bladder who used indwelling catheters to evaluate efficacy in treatment of bacteriuria.METHODS:
Eighty-nine persons with bacteriuria were randomized to irrigate their bladders twice daily for 8 weeks with 30 mL of (a) sterile saline, (b) acetic acid, or (c) neomycin-polymyxin solution. Urinalysis, cultures, and antimicrobial susceptibility tests were performed at baseline and weeks 2, 4, and 8 to determine the extent to which each of the solutions affected numbers and types of bacteria, urinary pH, urinary leukocytes, and generation of antimicrobial-resistant organisms.RESULTS:
Bladder irrigation was well tolerated with the exception of 3 participants who had bladder spasms. None of the 3 irrigants had a detectable effect on the degree of bacteriuria or pyuria in 52 persons who completed the study protocol. A significant increase in urinary pH occurred in all 3 groups. No significant development of resistance to oral antimicrobials beyond what was observed at baseline was detected.CONCLUSIONS:
Bladder irrigation was generally well tolerated for 8 weeks. No advantages were detected for neomycin-polymyxin or acetic acid over saline in terms of reducing the urinary bacterial load and inflammation. We cannot recommend bladder irrigation as a means of treatment for bacteriuria in persons with neurogenic bladder.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Cord Injuries
/
Bacteriuria
/
Urinary Bladder, Neurogenic
/
Therapeutic Irrigation
Type of study:
Clinical_trials
/
Etiology_studies
/
Guideline
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Spinal Cord Med
Journal subject:
NEUROLOGIA
/
REABILITACAO
Year:
2006
Document type:
Article
Affiliation country:
United States