Patterns of Use, Compliance, and Reasons for Cessation of Clean Intermittent Catheterization in Neurogenic Bladder Patients: a 4-Year Experience

Abstract

Clean intermittent catheterization (CIC) is the gold standard for bladder management in patients with neurogenic bladder (NB). Although CIC remains the preferred method for bladder management in NB, long-term compliance is a complex, multifactorial issue. Thus, this study aimed to evaluate real-world CIC compliance, catheter preference, and reasons for discontinuation in a patient population initiated on CIC. We retrospectively reviewed 310 patients between March 2019 and May 2023. When starting CIC for the first time, we provide patients with three types of catheter samples. During follow-up, patients were interviewed about: current catheter preference, continuation or discontinuation of CIC, duration of CIC use prior to cessation, reasons for discontinuation, number and frequency of treated urinary tract infections (UTIs) during CIC use. Among the 310 new CIC patients (mean age: 72 years), 186 patients (60.0%) eventually discontinued CIC. Discontinuation was more frequent in males (122 cases, 66.0%), and the median duration of CIC use prior to cessation was 3.5 months. The most common reasons of CIC cessation were symptoms improvement, pain or discomfort during catheterization, recurrent UTI, declining general condition, and death due to unrelated causes. The CIC is a reliable method. Increasing the convenience of catheter use and reducing the rate of side effects are ways to improve adherence to this method, and hydrophilic-coated catheter products are most suitable for this purpose. And education of patients on catheterization technique and periodic follow-up is necessary to maintain patient compliance.