Urinary Symptoms Are Unrelated to Leukocyte Esterase and Nitrite Among Indwelling Catheter Users

• DOI: 10.46292/sci22-00095
• Publication Date: 2023-02-15T22:36:29Z
• Authors: Amanda K. Rounds; Rochelle E. Tract...; Suzanne L. Groah; Jamie K. Frost; Inger H. Ljungberg; Herminio Navia; Cynthia T. Pham
• Keywords: Urinary Bladder; 16. Peace & justice; Spinal Cord Diseases; 3. Good health; 03 medical and health sciences; Catheters, Indwelling; 0302 clinical medicine; Predictive Value of Tests; Urinary Tract Infections; Humans; Prospective Studies; Nitrites; Spinal Cord Injuries

Objectives To explore the association between dipstick results and urinary symptoms.

Method This was a prospective 12-month observational study of real-time self-administered urine dipstick results and symptoms in a community setting that included 52 spinal cord injury/disease (SCI/D) participants with neurogenic lower urinary tract dysfunction (NLUTD) who use an indwelling catheter. Symptoms were collected using the Urinary Symptom Questionnaire for Neurogenic Bladder–Indwelling Catheter (USQNB-IDC). The USQNB-IDC includes actionable (A), bladder (B1), urine quality (B2), and other (C) symptoms; analyses focused on A, B1, and B2 symptoms. Dipstick results include nitrite (NIT +/−), and leukocyte esterase (LE; negative, trace, small, moderate, or large). Dipstick outcomes were defined as strong positive (LE = moderate/large and NIT+), inflammation positive (LE = moderate/large and NIT−), negative (LE = negative/trace and NIT−), and indeterminate (all others).

Results Nitrite positive dipsticks and moderate or large LE positive dipsticks were each observed in over 50% of the sample in every week. Strong positive dipstick results were observed in 35% to 60% of participants in every week. A, B1, or B2 symptoms co-occurred less than 50% of the time with strong positive dipsticks, but they also co-occurred with negative dipsticks. Participants were asymptomatic with a strong positive dipstick an average of 30.2% of the weeks. On average, 73% of the time a person had a negative dipstick, they also had no key symptoms (95% CI, .597-.865).

Conclusion No association was observed between A, B1, and B2 symptoms and positive dipstick. A negative dipstick with the absence of key symptoms may better support clinical decision-making.