Q. I’m 28, in my fourth year as a C5-6 quad and have had a suprapubic catheter since rehab. It works well, so I thought it enabled me to dodge taking anticholinergic drugs like Ditropan that control bladder spasms. At a recent SCI support meeting, I heard that long term use of an indwelling catheter causes permanent bladder shrinkage and that bladder spasms makes this worse. The discussion also brought up two equipment options, a “dual-balloon” Foley called the Duette, and a catheter valve called the BioFlo that can help reduce bladder shrinkage. What can you tell me about these two products?
A. According to Paralyzed Veterans of America’s Bladder Management Guidelines for Adults with Spinal Cord Injury, long term bladder management with indwelling catheters — urethral or suprapubic — tends to cause decreased bladder compliance (elasticity and size), which is irreversible and can cause other problems, including formation of stones, reflux and an increase in UTIs