Catheter selection for Quadriplegics
In article about bladder management, we discussed in detail about different types of catheter and their pros and cons.
In this article, we will discuss about suitability of various catheter for quadriplegics. When selecting quadriplegic catheter for bladder management, quadriplegics should look at two aspects:
- First is catheter’s medical complications
- second is the independence and ease with which they can manage bladder .
Uro-dynamic reports, in medical point of view, can help a lot in looking at the suitability of a catheter .
As we have discussed earlier, that the best way to manage bladder is through clean intermittent catheter. Because bladder empties completely through this way and it’s capacity stays intact.
But as quadriplegics have impaired hands functions so there are certain limitations preventing them adopting this method.
They have to depend on caregivers ,several times a day, for passing catheter into bladder and emptying it.
A tenodesis splint, catheter tools or tendon transfer surgery can help quadriplegics getting independence with this method.
Also called Condom catheter, it can not only create medical complications for quadriplegics but can compromise their independence as well.
An overactive bladder (which majority of quadriplegics have) can damage kidneys due to a phenomenon known as Dystruser Sphincter Dyssenergia. Bladder stones may be formed in case the bladder does not empty completely. Putting it on requires good hands dexterity and thus doesn’t help with independence as well.
Indwelling urethral catheter can help quadriplegics get some independence, as it needs changing after few weeks. With an internal object always in body, chances of infection are always there. Long term use can cause irritation of urethra and it is also kind of an obstruction for married individuals.
Superapubic pubic catheter is also a kind of indwelling catheter, carrying chances of infections. But in many ways, it can be a good option for quadriplegics. It helps a lot with independence. The stoma is easily accessible so it can be cleaned and catheter can be changed easily. It is also good option for married individuals. The bladder shrinking disadvantage associated with it can be decreased by regularly clamping the catheter.
To sum up the discussion, Superapubic catheter is the best option among quadriplegic catheter available. It provides you a lot of independence and can help you live a quality active life.
I being a C6 quadriplegic, use Superapubic catheter and very much satisfied with it. A lot of quadriplegics friends of mine who had been using other methods for bladder management for years took a sigh of relief after they changed to Superapubic catheter.
Read also : My tendon transfer surgery experience