Mp21-07 Use and Disuse of Catheterizable Channels as the Primary Method of Emptying the Neuropathic Bladder: A Single Institutional Cohort Study

You have accessJournal of UrologyPediatrics II (MP21)1 May 2024MP21-07 USE AND DISUSE OF CATHETERIZABLE CHANNELS AS THE PRIMARY METHOD OF EMPTYING THE NEUROPATHIC BLADDER: A SINGLE INSTITUTIONAL COHORT STUDY Yifan M. Griffin, Rosalia Misseri, Joshua D. Roth, Benjamin M. Whittam, Pankaj Dangle, Shelly King, Jeremy Koehlinger, Kirstan K. Meldrum, Martin Kaefer, Richard C. Rink, and Konrad M. Szymanski Yifan M. GriffinYifan M. Griffin , Rosalia MisseriRosalia Misseri , Joshua D. RothJoshua D. Roth , Benjamin M. WhittamBenjamin M. Whittam , Pankaj DanglePankaj Dangle , Shelly KingShelly King , Jeremy KoehlingerJeremy Koehlinger , Kirstan K. MeldrumKirstan K. Meldrum , Martin KaeferMartin Kaefer , Richard C. RinkRichard C. Rink , and Konrad M. SzymanskiKonrad M. Szymanski View All Author Informationhttps://doi.org/10.1097/01.JU.0001008844.84871.17.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We aimed to assess the use of long-term catheterizable urinary channels and explore potential risk factors for disuse. METHODS: Patients undergoing appendicovesicostomy (APV) and Monti procedures at our institution were retrospectively reviewed (1991-2023). The main outcome was catheterizable channel disuse, defined as no longer intermittently catheterizing channels as the primary method of bladder emptying. Channel disuse was abstracted based on medical records and self-reported clinic questionnaires. Survival analysis and forward selection stepwise Cox regression were used. RESULTS: 561 patients (46% male, 57% shunted, 72% spina bifida SB) met inclusion criteria (244 APV, 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 (14%) patients disused their channels. Most common reasons for disuse were non-mechanical (64%), including low catheterization adherence (17%) and channel removal during cystectomy following multiple bladder perforations (14%). Of the 76 patients, 46% underwent incontinent diversion. After correcting for differential follow-up, 89% of patients still used their channels at 10 years and 81% at 20. Eight of 11 variables screened on univariate analysis were not associated with disuse, including shunt status and SB (p≥0.20). When analyzing all disused channels on multivariate 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) (Table 1). For channels disused due to non-mechanical reasons, catheterization by others, not attending transition clinic, and RLQ stoma were all associated with disuse (p≤0.04). No variables were associated with channel disuse for mechanical reasons (p≥0.22). Similar risk factors for disuse were identified on multivariate analysis restricted to patients with SB. CONCLUSIONS: On long-term follow-up, most patients with urinary channels continued using them. About 1% annually stopped using them. Disuse was primarily due to non-mechanical reasons. Patients 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. No risk factors were associated with disuse for mechanical reasons. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e331 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Yifan M. Griffin More articles by this author Rosalia Misseri More articles by this author Joshua D. Roth More articles by this author Benjamin M. Whittam More articles by this author Pankaj Dangle More articles by this author Shelly King More articles by this author Jeremy Koehlinger More articles by this author Kirstan K. Meldrum More articles by this author Martin Kaefer More articles by this author Richard C. Rink More articles by this author Konrad M. Szymanski More articles by this author Expand All Advertisement PDF downloadLoading ...