Effect of Chlorhexidine Gluconate Bladder Instillations During Suprapubic Catheter Exchange on Unplanned Healthcare Visits and Quality of Life in Patients with Neurogenic Bladder

What this Trial Is About

Researchers are evaluating the use of 0.05% Chlorhexidine Gluconate (CHG) bladder instillations to reduce unplanned healthcare visits and improve quality of life in patients with neurogenic bladder and chronic suprapubic catheters who have a history of recurrent urinary tract infections. This trial explores whether applying CHG directly into the bladder during routine catheter exchanges is feasible and tolerable in an outpatient setting. The study addresses challenges with antibiotic resistance and side effects by testing a non-antibiotic antimicrobial approach. Participants will receive bladder instillations through their suprapubic catheters as part of their usual catheter exchange visits. The treatment includes three months of normal saline instillations followed by six months of 0.05% Chlorhexidine Gluconate instillations. After the nine-month instillation period, there will be an additional six months of observation with catheter exchanges without any instillations. This protocol is designed to maximize bladder exposure to the therapeutic agent while minimizing systemic absorption and side effects. During the study, participants will undergo monthly assessments for bacteriuria, symptomatic urinary tract infections, and changes in bladder microbiome and catheter biofilm flora. Researchers will also monitor the tolerability and feasibility of the instillations, the impact on unplanned healthcare visits, and patient quality of life and satisfaction. The total study duration is 15 months, during which patients will participate in treatment and observation phases with regular follow-up evaluations.

Effect of Chlorhexidine Gluconate Bladder Instillations in Patients With Chronic Suprapubic Catheters on Unplanned Healthcare Encounters and Quality of Life