Suprapubic catheter insertion in people with multiple sclerosis: long-term complications and survival in a retrospective cohort study

Authors

  • Lisa Grandidge Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
  • Amin Mohamed Abu Baker Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Department of Neurosciences, the University of Sheffield, United Kingdom https://orcid.org/0000-0003-3757-5433
  • Steven Kennish Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
  • Krishnan Padmakumari Sivaraman Nair Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom; Department of Neurosciences, the University of Sheffield, United Kingdom

DOI:

https://doi.org/10.2340/jrm.v58.45600

Keywords:

catheterization, Multiple Sclerosis, Neurogenic Urinary Bladder, neuropathic lower urinary tract dysfunction, survival analysis., Suprapubic Catheterization

Abstract

Objective: To evaluate complications and survival following radiologically guided suprapubic catheter insertion in people with multiple sclerosis.

Design: Retrospective cohort study.

Subjects/Patients: All patients with multiple sclerosis who underwent radiologically guided suprapubic catheter insertion at a tertiary regional multiple sclerosis centre in the United Kingdom between 2014 and 2020.

Methods: Clinical and demographic data were obtained from medical records. Immediate complications occurring within 30 days and delayed complications occurring after 30 days were recorded. Kaplan–Meier and Cox regression analyses were performed to assess survival predictors.

Results: Fifty-five patients underwent suprapubic catheter insertion. At the time of insertion, mean age was 62 years (standard deviation 11) and median duration of multiple sclerosis was 17.5 years (1st quartile = 12.0; 3rd quartile = 25.8). Immediate and delayed complication rates were 16% (9) and 27% (15), respectively. Five-year survival was 73%. Older age, higher disability scores, longer disease duration, and discharge to residential care were associated with poorer survival. Complications, sex, and mobility status were not associated with mortality.

Conclusion: Radiologically guided suprapubic catheter insertion was associated with moderate complication rates and long-term survival in people with multiple sclerosis. These findings may allow better understanding of the potential complications of suprapubic catheterization in advanced multiple sclerosis.

Downloads

Download data is not yet available.

References

Panicker JN, Fanciulli A, Skoric MK, Kaplan T, Aleksovska K, Adamec I, et al. European Academy of Neurology (EAN)/European Federation of Autonomic Societies (EFAS)/International Neuro-Urology Society (INUS) Guidelines for practising neurologists on the assessment and treatment of neurogenic lower urinary tract dysfunction. Eur J Neurol 2025; 32. DOI: https://doi.org/10.1111/ene.70205

Asemota AO, Schneider EB, Mowry EM, Venkatesan A. Common comorbid and secondary conditions leading to hospitalization in multiple sclerosis patients in the United States. Clin Neurol Neurosurg 2023; 232: 107851. DOI: https://doi.org/10.1016/j.clineuro.2023.107851

Monti Bragadin M, Motta R, Messmer Uccelli M, Tacchino A, Ponzio M, Podda J, et al. Lower urinary tract dysfunction in patients with multiple sclerosis: a post-void residual analysis of 501 cases. Mult Scler Relat Disord 2020; 45: 102378. DOI: https://doi.org/10.1016/j.msard.2020.102378

Vitkova M, Rosenberger J, Krokavcova M, Szilasiova J, Gdovinova Z, Groothoff JW, et al. Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction. Disabil Rehabil 2014; 36: 987–992. DOI: https://doi.org/10.3109/09638288.2013.825332

Panicker JN, Fowler CJ, Kessler TM. Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. Lancet Neurol 2015; 14: 720–732. DOI: https://doi.org/10.1016/S1474-4422(15)00070-8

Medina-Polo J, Adot JM, Allué M, Arlandis S, Blasco P, Casanova B, et al. Consensus document on the multidisciplinary management of neurogenic lower urinary tract dysfunction in patients with multiple sclerosis. Neurourol Urodyn 2020; 39: 762–770. DOI: https://doi.org/10.1002/nau.24276

Truzzi JC, Almeida FGD, Sacomani CA, Reis J, Rocha FET. Neurogenic bladder: concepts and treatment recommendations. Int Braz J Urol 2022; 48: 220–243. DOI: https://doi.org/10.1590/s1677-5538.ibju.2021.0098

Kavanagh A, Baverstock R, Campeau L, Carlson K, Cox A, Hickling D, et al. Canadian Urological Association guideline: Diagnosis, management, and surveillance of neurogenic lower urinary tract dysfunction – Full text. Can Urol Assoc J 2019; 13. DOI: https://doi.org/10.5489/cuaj.5912

Sekido N, Igawa Y, Kakizaki H, Kitta T, Sengoku A, Takahashi S, et al. Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury. Int J Urol 2020; 27: 276–288. DOI: https://doi.org/10.1111/iju.14186

Ghezzi A, Carone R, Del Popolo G, Amato MP, Bertolotto A, Comola M, et al. Recommendations for the management of urinary disorders in multiple sclerosis: a consensus of the Italian Multiple Sclerosis Study Group. Neurol Sci 2011; 32: 1223–1231. DOI: https://doi.org/10.1007/s10072-011-0794-y

Perez D, Shapiro DS, Bohm D, Zeldin A, Chertin B, Kafka IZ. Comparative outcomes of indwelling urethral versus suprapubic catheters in elderly patients: a retrospective within-subject study. Neurourol Urodyn 2025; 44: 1689–1694. DOI: https://doi.org/10.1002/nau.70133

Hunter KF, Bharmal A, Moore KN. Long-term bladder drainage: suprapubic catheter versus other methods: a scoping review. Neurourol Urodyn 2013; 32: 944–951. DOI: https://doi.org/10.1002/nau.22356

Phé V, Chartier-Kastler E, Panicker JN. Management of neurogenic bladder in patients with multiple sclerosis. Nature Rev Urol 2016; 13: 275–288. DOI: https://doi.org/10.1038/nrurol.2016.53

Lavelle RS, Coskun B, Bacsu CD, Gliga LA, Christie AL, Lemack GE. Quality of life after suprapubic catheter placement in patients with neurogenic bladder conditions. Neurourol Urodyn 2016; 35: 831–835. DOI: https://doi.org/10.1002/nau.22812

Mahajan ST, Frasure HE, Marrie RA. The prevalence of urinary catheterization in women and men with multiple sclerosis. J Spinal Cord Med 2013; 36: 632–637. DOI: https://doi.org/10.1179/2045772312Y.0000000084

Smith H, Santiago JE, McAchran SE, Lin FC. Managing neurogenic bladder with a suprapubic catheter vs urethral Foley: which is best? Curr Bladder Dysfunct Rep 2025; 20. DOI: https://doi.org/10.1007/s11884-025-00781-x

Elm E von, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The STROBE reporting checklist. In: Harwood J, Albury C, Beyer J de, Schlüssel M, Collins G, editors. The EQUATOR network reporting guideline platform [Internet]. The UK EQUATOR Centre; 2025. Available from: https:/resources.equator-network.org/reporting-guidelines/strobe/strobe-checklist.docx

IBM Corp. IBM SPSS Statistics for Windows, Version 28.0. Armonk, NY: IBM Corp; 2021.

JASP Team. JASP (Version 0.18.3) [Computer software]. Amsterdam: University of Amsterdam; 2024. Available from: https://jasp-stats.org

Kang H. The prevention and handling of the missing data. Korean J Anesthesiol 2013; 64: 402–406. DOI: https://doi.org/10.4097/kjae.2013.64.5.402

Peduzzi P, Concato J, Feinstein AR, Holford TR. Importance of events per independent variable in proportional hazards regression analysis II: accuracy and precision of regression estimates. J Clin Epidemiol 1995; 48: 1503–1510. DOI: https://doi.org/10.1016/0895-4356(95)00048-8

Krebs J, Wöllner J, Pannek J. Bladder management in individuals with chronic neurogenic lower urinary tract dysfunction. Spinal Cord 2016; 54: 609–613. DOI: https://doi.org/10.1038/sc.2015.196

Hennessey DB, Kinnear N, MacLellan L, Byrne C, Gani J, Nunn AK. The effect of appropriate bladder management on urinary tract infection rate in patients with a new spinal cord injury: a prospective observational study. World J Urol 2019; 37: 2183–2188. DOI: https://doi.org/10.1007/s00345-018-02620-7

Ahluwalia R, Johal N, Kouriefs C, Kooiman G, Montgomery BS, Plail R. The surgical risk of suprapubic catheter insertion and long-term sequelae. Ann R Coll Surg Engl 2006; 88: 210–213. DOI: https://doi.org/10.1308/003588406X95101

Sheriff M, Foley S, McFarlane J, Nauth-Misir R, Craggs M, Shah P. Long-term suprapubic catheterisation: clinical outcome and satisfaction survey. Spinal Cord 1998; 36: 171–176. DOI: https://doi.org/10.1038/sj.sc.3100536

Hobbs C, Howles S, Derry F, Reynard J. Suprapubic catheterisation: a study of 1000 elective procedures. BJU Int 2022; 129: 760–767. DOI: https://doi.org/10.1111/bju.15727

Cronin CG, Prakash P, Gervais DA, Hahn PF, Arellano R, Guimares A, et al. Imaging-guided suprapubic bladder tube insertion: experience in the care of 549 patients. Am J Roentgenol 2011; 196: 182–188. DOI: https://doi.org/10.2214/AJR.10.4520

Sugimura T, Arnold E, English S, Moore J. Chronic suprapubic catheterization in the management of patients with spinal cord injuries: analysis of upper and lower urinary tract complications. BJU Int 2008; 101: 1396–1400. DOI: https://doi.org/10.1111/j.1464-410X.2007.07404.x

Stickler D. Clinical complications of urinary catheters caused by crystalline biofilms: something needs to be done. J Intern Med 2014; 276: 120–129. DOI: https://doi.org/10.1111/joim.12220

Grandidge L, Chotiyarnwong C, White S, Denning J, Nair KPS. Survival following the placement of gastrostomy tube in patients with multiple sclerosis. Mult Scler J Exp Transl Clin 2020; 6: 2055217319900907. DOI: https://doi.org/10.1177/2055217319900907

Stritt K, Lucca I, Roth B, Grilo N. Is EDSS enough to predict risk of upper urinary tract damage in patients with multiple sclerosis? Biomedicines 2022; 10: 3001. DOI: https://doi.org/10.3390/biomedicines10123001

Office for National Statistics. Life expectancy in care homes, England and Wales: 2011–2012. London: ONS; 2014. Available from: https://www.ons.gov.uk

Harding K, Zhu F, Alotaibi M, Duggan T, Tremlett H, Kingwell E. Multiple cause of death analysis in multiple sclerosis: a population-based study. Neurology 2020; 94: e820–e829. DOI: https://doi.org/10.1212/WNL.0000000000008907

Oud L, Garza J. Association of multiple sclerosis with mortality in sepsis: a population-level analysis. J Intensive Care 2022; 10: 36 DOI: https://doi.org/10.1186/s40560-022-00628-1

Office for National Statistics. Updated estimates of coronavirus (COVID-19) related deaths by disability status, England: 24 January 2020 to 9 March 2022. London: ONS; 2022. Available from: https://www.ons.gov.uk

Published

2026-06-04

How to Cite

Grandidge, L., Mohamed Abu Baker, A., Kennish, S., & Nair, K. P. S. (2026). Suprapubic catheter insertion in people with multiple sclerosis: long-term complications and survival in a retrospective cohort study. Journal of Rehabilitation Medicine, 58, jrm45600. https://doi.org/10.2340/jrm.v58.45600

Issue

Section

Original Report

Categories