Longitudinal cleavage of the penis in chronic spinal cord injury: two case reports

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1179/2045772315Y.0000000036 · Published: May 1, 2016

Spinal Cord Injury Urology Rehabilitation

Simple Explanation

This paper presents two cases of penile cleavage, a rare complication in patients with spinal cord injury (SCI) who use indwelling catheters for bladder management. The first case involved a 25-year-old male with paraplegia who developed a ventral urethral cleavage after using an indwelling catheter for four months. This was complicated by a urinary tract infection and undiagnosed diabetes. The second case was a 15-year-old male with tetraplegia who had a cleavage on the ventral aspect of the penis after using an indwelling catheter for 18 months. Spasticity in the lower limbs was a contributing factor.

Study Duration

Not specified

Participants

Two male patients with chronic spinal cord injury

Evidence Level

Case Report

Key Findings

1
Penile cleavage is a rare but significant complication of long-term indwelling catheter use in SCI patients with neurogenic bladder.
2
Inadequate catheter care, urinary tract infections, diabetes mellitus, and lower limb spasticity can increase the risk of penile cleavage in SCI patients using indwelling catheters.
3
Proper bladder management techniques, regular follow-up, and patient education are crucial in preventing penile cleavage in SCI patients with neurogenic bladder.

Research Summary

The case reports highlight a rare complication of long-term indwelling catheter use in SCI patients, specifically penile cleavage. Contributing factors include poor catheter care, underlying medical conditions like diabetes and spasticity, and lack of patient education and follow-up. The authors emphasize the importance of training patients and caregivers in proper bladder management and the need for regular follow-up to prevent such complications.

Practical Implications

Patient Education

Comprehensive training on proper bladder management techniques and potential complications should be provided to SCI patients and their caregivers.

Regular Follow-up

Regular medical follow-up, including catheter changes, is necessary to monitor and prevent complications associated with long-term indwelling catheter use.

Spasticity Management

Effective management of lower limb spasticity is crucial to reduce traction on the catheter and prevent penile erosions or cleavage.

Study Limitations

1
The study is limited to two case reports, which restricts the generalizability of the findings.
2
Loss to follow-up of both patients limits the ability to assess the long-term outcomes of the recommended treatments.
3
The study does not explore all potential risk factors or preventative measures comprehensively.

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