Intermittent balloon catheterization using a reusable temporary balloon catheter that can be placed and removed by spinal cord injury (SCI) patients themselves was developed in Japan in 1995. There are two types of intermittent balloon catheters (IBCs): reservoir type and syringe type, depending on the method of injecting distilled water. IBCs are convenient and may improve patients' QOL. However, to our knowledge, there are no studies on the QOL of patients managed with reusable IBCs. The purpose of this study is to evaluate the actual practice, complications, and problems regarding the use of reusable IBCs and provide information that will be useful for future practice.

We conducted a questionnaire survey of SCI patients who currently use or have used IBCs in the past. The subjects were 76 SCI patients who visited our hospital between August 2020 and March 2021 and agreed to participate in this study, all of whom had used the reservoir-type IBC. In addition, we surveyed 31 SCI patients who had used both reservoir-type and syringe-type IBCs between July 2023 and December 2024 to determine which type they preferred. 
To test for significant differences between the two groups, the chi-square test was used for nominal variables and the t-test for continuous variables. Multivariate logistic regression analysis was used to analyse prognostic factors. The statistical significance level was set at p < 0.05.

The median age was 49 years (range 15-83 years), the median time from the onset of SCI to the start of IBC use was 186 months (range 16-661 months), and the median duration of IBC use was 48 months (range 1-300 months). QOL scores before and after IBC use showed significant improvement after use. Forty-six of the 76 (61.3%) patients had complications. The independent predictors of the occurrence of complications were male and non-traumatic SCI. The independent predictors of whether to discontinue IBC use were the lack of improvement in QOL score. (Table). 
Furthermore, patients with cervical SCI tended to prefer the reservoir-type IBC (p = 0.052), while patients with incomplete paralysis or those with a short period of IBC use tended to prefer the syringe-type IBC (p < 0.05). All 7 patients with complete paralysis due to cervical SCI chose the reservoir-type IBC.

This study is one of the few reports examining the use of reusable IBCs in patients with SCI [1]. Previous reports have shown that CIC can be performed if the injury level is C5 or lower in men and C6 or lower in women [2], and the SCI level of the patients participating in this study was also C5 or lower in men and C6 or lower in women.
 When using an IBC, patients need to insert the tip of the catheter into the bladder and inflate the balloon. Therefore, it was expected that the number of cases would be limited compared to conventional CIC, but this study showed that it can be used in the same way as conventional CIC depending on the remaining function of the upper limbs. All patients with complete paralysis due to cervical SCI chose a reservoir-type IBC because it was difficult to operate the syringe to inject distilled water. In addition, patients who were accustomed to the reservoir-type IBC tended to continue using the reservoir-type IBC without switching to the syringe-type IBC.

We found that the use of a reusable IBC in combination with a conventional intermittent catheter significantly improved the QOL of SCI patients regarding urinary management. We also found that patients with improved QOL scores tended to continue using IBCs. Patients with complete paralysis due to cervical SCI tended to use reservoir-type IBCs.

Sci Rep 14: 24383, 2024
Spinal Cord 52: 163-71, 2014