Use of a Diurnal Indwelling Urethral Catheter to Improve Quality of Life

Inclusion Criteria: 1. Age 10 to 21 years at study entry 2. Primary diagnosis of Spina Bifida or Spinal Cord Injury with neurogenic bladder and established patients of a pediatric urologist in the Shriners Hospitals for Children multidisciplinary spina bifida clinic. 3. History of compliance with a CIC regimen. 4. Ability to understand and the willingness to sign a written informed consent document on the part of both the subject and guardian. A signed assent will be required, on the part of the subject, for all youth aged 10 to 17 years at the onset of study participation. In these cases, a parent or legal guardian must additionally sign a provision of informed consent. For subjects 18 years of age and older at the onset of study participation, only the subject must sign a provision of informed consent and HIPAA compliant research authorization. Exclusion Criteria: 1. Age less than10 years and greater than 21 years at study entry 2. Greater than 2 diagnosed UTIs within last 12 months or symptomatic UTI at trial onset (UTI defined as the presence or ≥104 cfu/ml of a single bacterial strain in the presence of identified symptoms including but not limited to fever, flank or abdominal pain, change in urinary pattern or dysuria). Potential screened subjects with a symptomatic UTI at time of screening may be included after treatment of the UTI, followed by verification of symptom resolution and a negative culture result. 3. History of bladder augmentation 4. History of prior urethral surgery 5. History of urinary tract calculi 6. Diagnosis of high volume vesicoureteral reflux (grade 3 to 5) or moderate to severe (grade 3-4) hydronephrosis on pre-study imaging within 6 months of trial onset. 7. Diagnosis on urodynamics of \>40mmHg detrusor end fill pressure (consistent with a poorly compliant bladder) on pre-study urodynamics within 6 months of trial onset. 8. Diminished renal function (GFR \<60, consistent with CKD III) on pre-study laboratory assessment within 4 weeks prior to study onset. 9. Lack of a 5th grade minimum reading/writing level by the subject (and parent or guardian providing informed consent of \<18 years of age at time of study onset) 10. Demonstrated lack of compliance with follow-up, with \>2 missed urologic appointments in past year and/or lack of compliance with clean intermittent catheterization. 11. Pregnant women (all female participants must have a negative pregnancy test within 4 weeks prior to study onset). 12. Prisoners, institutionalized individuals or wards of the state.