To investigate the effect of early application of clean intermittent catheterization( CIC) in infants with neurogenic bladder(NB).

Eighty-seven children with NB diagnosed in our urodynamic center were less than 1 year old when they first came to hospital from January 2007 to January 2010, and CIC was carried out at different age. Sixty-four patients were followed up for a long time and divided into early CIC group(less than 1 year old children) and late CIC group(more than 3 years old children) according to the treatment time. Early CIC group included 29 patients [19 boys and 10 girls with the mean age of (7.5±2.8) months]. And 4 cases were suffering from postoperative spina bifida manifesta; 22 cases with spina bifida occulta; 2 cases with sacral dysplasia; 1 case with meningitis. Late CIC group included 35 patients [20 boys and 15 girls with the mean age of (8.0±2.9) months].2 cases were suffering from postoperative spina bifida manifesta; 28 cases with spina bifida occulta; 4 cases with sacral dysplasia; 1 case with postoperative pelvic surgery. Before the treatment, there were no significant differences of the bladder compliance (BC) , the maximum cystometric capacity (MCC) and the safety bladder capacity (SBC) between two groups. Urodynamic parameters and complications of 64 patients who were successfully followed up for 6 years were compared.

After 3 years follow up, BC , SBC and MCC in early CIC group [(8.5±1.9) ml/cmH₂O, (140±25) ml, (142±29) ml]were significantly higher than those of late CIC group [(7.0±2.2)ml/cmH₂O, (110±31) ml, (120±28) ml; all P<0.05]. After 6 years follow up, BC , SBC and MCC in early CIC group [(12.0±2.5) ml/cmH₂O, (210±26) ml, (230±30) ml]were significantly higher than those of late CIC group [(9.3±2.3) ml/cmH₂O, (192±31) ml, (205±35) ml; all P<0.05], and the vesicoureteral reflux rate[24.1% (7/29)] in early treatment group was significantly less than that in late treatment group [54.3%(19/35), P<0.05]. Increases in BUN and serum creatinine were found in 6 cases (20.7%) in early CIC group and 17 cases (48.6%) in late CIC group, the difference was significant (P<0.05).

For NB patients , the effect of early CIC is better than that of late CIC.

Neurogenic bladder; Clean intermittent catheterization; Early