Role of Residual Urine and Asymptomatic Prostatitis in the Development of Urinary Tract Infections in Spinal Cord Injury

Study Overview
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Brief Summary
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The purpose of this prospective study is to investigate the association between the amount of residual urine and asymptomatic bacterial prostate infection with the occurrence of recurrent (>2 /year) symptomatic urinary tract infections in patients suffering from chronic (> 1 year) spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction performing intermittent catheterization. The following hypotheses will be tested: The amount of residual urine after intermittent catheterization is significantly greater in SCI patients suffering from frequent (>2 /year) urinary tract infections compared to those without. The incidence of asymptomatic bacterial prostate infections is significantly higher in SCI patients suffering from frequent (>2 /year) urinary tract infections compared to those without.

Detailed Description
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To investigate the association between the amount of residual urine and asymptomatic bacterial prostate infection with the occurrence of recurrent (>2 /year) symptomatic urinary tract infections in patients suffering from chronic (> 1 year) spinal cord injury (SCI) and neurogenic lower urinary tract dysfunction performing intermittent catheterization, patients perform self-catheterization twice (before and after urodynamic testing. After each catheterization, residual urine is assessed by ultrasound. Prior to urodynamic testing, prostate massage is performed, bacterial cultures of the fluid and the urine are initiated and the results of these cultures will be analysed .

Official Title
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Role of Residual Urine and Asymptomatic Prostatitis in the Development of Lower Urinary Tract Infections in Spinal Cord Injury Patients - a Prospective Study

Conditions
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Urinary Tract Infection

Intervention / Treatment
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* Other: sonographic assessment of residual urine, urine culture


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: male patients with chronic (> 1 year) spinal cord injury bladder management by intermittent catheterization Exclusion Criteria: symptomatic urinary tract infection prostate pathology immunodeficiency antibiotic therapy missing informed consent

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| urinary tract infection<br>urinary tract infection in male patients with neurogenic bladder dysfunction due to spinal cord injury managed by intermittent catheterization | Other: sonographic assessment of residual urine, urine culture<br>* residual urinary volume assessed by ultrasound after bladder catheterization urinary cultures taken before and after prostate massage<br>* Other names: intermittent catheterization;|
| control group<br>less than three urinary tract infections / year | Other: sonographic assessment of residual urine, urine culture<br>* residual urinary volume assessed by ultrasound after bladder catheterization urinary cultures taken before and after prostate massage<br>* Other names: intermittent catheterization;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| amount of residual urine | determined by ultrasound | change from self-catheterization 10 minutes before and 10 minutes after urodynamic assessment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| bacterial prostate infection | urinary culture | 5-10 minutes before and after prostate massage | 
| bacteriuria | urine dip stick | 5-10 minutes before and after prostate massage | 
| number of leucocytes in urine | urine dip stick | 5-10 minutes before and after prostate massage | 
| number of erythrocytes in urine | urine dip stick | 5-10 minutes before and after prostate massage | 
| patient characteristics | age | day 0 | 
| type of neurogenic bladder dysfunction |  | day 0 | 
| type of catheter used for intermittent catheterization |  | day 0 | 
| annual rate of symptomatic urinary tract infections |  | day 0 | 
| patient characteristics | sex | day 0 | 
| patient characteristics | time since spinal cord injury | day 0 | 
| patient characteristics | level and degree of spinal cord injury (ASIA impairment score) | day 0 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Urinary Tract Infection, Bacteriuria, Pyuria, Prostatitis, Intermittent Catheterization, Spinal Cord Injuries, Residual Urine