非無菌的問歇的自己導尿法の経験

Abstract

Nineteen cases (7 males and 12 females) primarily with neurogenic bladder were treated in our department with non-aseptic intermittent self-catheterization during a period of approximately ten years and were followed for three months or more. The follow-up period was three years or more in eleven cases with a maximum of about ten years in one case. At present, this therapy is being continued in 13 cases and there were no cases in which this mode of therapy was discontinued because of undesirable effects. Dysuria improved in six cases, suggesting the effectiveness of this therapy in the management of the incompetent detrusor. Renal function remained almost unchanged and IVP findings improved in four of eight cases, suggesting the favorable effect of this therapy on the upper portion of the urinary tract. Although no serious complication occurred, 45.3% of the cases were complicated by UTIs. However, these infections could be controlled by antibacterial drugs. Antibacterial drugs were administered in all cases but the total dose was unexpectedly high. In view of the possible untoward effects associated with such high dose chemotherapy, we thought we should avoid the prophylactic use of antibacterial agents wherever possible.