EFFECT OF CLEAN INTERMITTENT CATHETERIZATION ON LOWER URINARY TRACT: AN EXPERIMENTAL STUDY

Abstract

Objective To investigate the effect of clean intermittent catheterization (CIC) on the lower urinary tract in experimental animals. Patients and Methods Eight male spinalized cats were subjected to CIC for a period of 6 – 9 weeks. A urine specimen for culture was obtained weekly. A pathological examination of the proximal and distal urethra and the bladder was performed. Results Urinary tract infection was detected in all cats starting from the second week. It responded to antibiotics but recurrence occurred after discontinuing the treatment. One animal died in the 4th week from fibrinopurulent peritonitis caused by necrotizeng ulcerative cystitis. False passage occurred in another cat at the end of the 6th week. It was managed by fixation of a urethral catheter for a week, and CIC was then continued for another two weeks. Pathological examination showed a thickening of the urethral wall that progressed with the duration of CIC. Microscopic examination of the urethra showed epithelial hyperaemia, ulceration and an inflammatory reaction with oedema as well as an inflammatory reaction of the lamina propria. The muscular layer showed progressive hypertrophy with continuing CIC. The bladder wall showed epithelial ulceration, Brunn nests and squamous metaplasia with islands of degenerated cells. Conclusion Recurrent urinary tract infection, local traumatic reactions of the urethral and bladder wall, especially epithelial damage of the mucosa, and false passages are common complications occurring with CIC in the experimental animal. Although the situation in the experimental animal has no relevance in humans, yet, it may throw light on some aspects of possible complications of long-term CIC.



Since this article was accepted on a very short notice, the translation will be published in vol. 9, No 2.


African Journal of Urology Vol.9(1) 2003: 18-23