Paralysis is a loss of muscle function in part of the body due to a breakdown of communication between the brain and the nerves that control the muscle. Some major causes of paralysis are stroke, spinal cord injury and multiple sclerosis (MS). The condition can be localised or generalised, partial or complete, and one common effect of paralysis is urinary incontinence which is when the bladder muscles do not respond properly. One effective way of managing bladder dysfunction is with the use of catheters.
If the person’s paralysis is extensive, affecting both lower limbs (paraplegic) or even the entire torso (quadriplegic), it may affect their ability to move or even sit upright. Patients with this condition may be confined to a bed for much of the time, and have limited ability to manipulate things, which has implications for catheter use. In this post, we look at the best bladder management options for patients bed-ridden from paralysis.
Catheters and the risk of infection
Catheters are an effective means of managing bladder dysfunctions, but there are downsides to their use. When the catheter is inserted into the bladder for extended periods of time, there is an increased likelihood of bacteria from the skin and urethra spreading to the bladder, leading to what is called Catheter-Associated Urinary Tract Infection (CAUTI). The catheter itself sometimes also becomes a carrier of infection when bacterial colonies cling on and spread from the catheter to the patient. People who are paralysed are at a high risk of UTIs, and it used to be a leading cause of death until the 1950s.
What catheters should you choose?
A paralysed person confined to their bed is likely to need catheterisation for bladder management. Based on the circumstances and needs of the patient, doctors and caregivers will use the most appropriate catheter. Some common types of catheter include:
- Suprapubic catheter – This method involves passing a tube surgically through the abdominal wall directly into the bladder, without going through the urethra. It is one of the most common ways male and female quadriplegics manage their spinal cord injury bladder problems. The carers usually need to replace a suprapubic catheter every six to eight weeks.
- Indwelling urinary catheter –A catheter is inserted into the bladder through the urethra, with an inflatable balloon end to keep the catheter in position at the bladder, while the outside end of the catheter leads to a drainage bag. An indwelling catheter is another popular option for quadriplegics and it needs to be changed every four to 12 weeks.
- Intermittent catheter – For this method, the user inserts a single-use catheter through the urethra into the bladder to urinate as and when necessary. This requires the user to have full use of their arm and hand. A female patient would also need to be able to get into a position where they can reach their urethra. As such, intermittent catheters are less useful for paralysed patients.
- External catheter – Also known as a condom catheter or male catheter, it consists of a sheath made out of PVC, latex or silicone, with an adhesive to attach it to the penis, and the standard tube coming out of the other end, connected to a drainage bag. This is sometimes favoured over indwelling catheters because no inflated balloon or urethra tube is inserted, reducing bladder irritation and urethral trauma. The catheter needs to be removed and the penis washed at least once a day, and a new catheter should be used every day. While kits are available for women, they are rare. The frequent need for catheter change also calls for the patient to have some degree of mobility or the presence of a caregiver.
How UroShield can help lower risks of CAUTI
While indwelling and suprapubic catheters are great at managing urinary incontinence and help bed-ridden patients to urinate easily, they carry a risk of infection and can lead to Catheter-Associated Urinary Tract Infection (CAUTI). UroSheild can help to lower the risks of CAUTI.
UroShield is a compact external medical device that generates low-frequency, low-intensity ultrasound waves to prevent bacterial biofilm from forming on catheters. The action of the ultrasonic waves run along the full length of the catheter, up into the balloon and down into the bag, both on the outside and inside surfaces of the catheter. The ultrasound gently vibrates the catheter to stop the bacteria from adhering to the catheter and forming the biofilm – preventing infections from developing.
If biofilm is present, UroShield helps to break up the protective layer surrounding the biofilm which is normally impenetrable to antibiotics, allowing it access to the bacteria and curing the infection. The vibrations also prevent catheter encrustation and blockage, caused by crystalline deposits of mineral salts in the urine. UroShield also helps to reduce catheter-associated bladder spasms and pain and is effective for any kind of catheter, both urethral and suprapubic. Click on the link to find out more about how UroShield works. In our clinical studies, patients have reported benefits such as:
- No or reduced infection rates
- No or reduced catheter blockage
- No or reduced catheter-related bladder spasms
- No or reduced catheter-related pain
- Increased quality of life
- More energy and feeling generally better
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