Newman & Price 1985
USA
Downs & Black score=15
Pre-Post
N=60

Population: SCI patients with external catheters: Gender: males = 60; Level of injury: paraplegia = 25, tetraplegia = 35; Severity of injury: complete = 47, incomplete = 13. 17 had sphincterotomies, either before or after switching to condom drainage
Treatment: Patients went through a renal function evaluation which included: roentgenographic studies, and golmerular filtration rates. Urine cultures, antibody coated bacteria determinations were done. Patients were interviewed about their bladder emptying habits. Mean time external catheter was used was 48 months.

Outcome Measures: Urine infections, (a positive culture was defined as any organisms growing). Mean time of external catheter use, renal and bladder abnormalities, glomerular filtration rate.

• 53% of patients had positive urine cultures
• Tetraplegic patients were more likely to have positive cultures than paraplegics (61 vs 44%).
• Complete lesions patients were more likely than incomplete lesions patients to have positive urine cultures (60 vs 31%).
• 27 of 34 patients that were previously free of morphologic abnormalities developed changes including positive urine cultures, reflux (4), bladder diverticula (14) and trabeculation (26), urethral diverticula, and urethral dilatation.
• 5 of 26 patients who initially had morphologic defects became free of abnormalities.
• No change in glomerular filtration rate was seen in 77% of patients, while 3% improved and 20% deteriorated.

Perkash et al. 1992
USA
Downs & Black score=7
Case Series
N=79

Population: SCI: Mean age: 41.9 yrs; Level of injury: paraplegia = 37, tetraplegia = 38; cauda equina = 4; Severity of injury: complete = 61, incomplete = 18; Mean time since injury = 8.24 yrs.
Treatment: Follow-up of individuals implanted with a penile implant allowing improved condom placement or sexual penetration.
Outcome Measures: Failures, complications, Quality of Life Satisfaction survey.

• Penile implants in place mean of 7.08 years.
• Overall failure rate was 8% with an infection complication rate of < 2%.
• Prior to implant, 77% of people lost condoms and had accidents with urine leakage > 2 x week, while only 19% reported condom loss 1 – 2x per week after the implant.
• Prior to implant, 18% of people had indwelling catheters, while none had indwelling catheters after.
• 68% of patients expressed satisfaction with sexual intercourse.
• All felt it was easier to keep themselves clean and dry.