Proportion of complications in patients practicing clean intermittent self-catheterization (CISC) vs indwelling...

To compare the complications especially infection in two groups; group-A: those performing clean intermittent self-catheterization (CISC) and group-B: patients with indwelling catheters.

Comparative study, conducted at Department of Urology, Jinnah Postgraduate Medical Centre, Karachi. A total of 80 patients with ages between 15 - 80 years were studied. There were 40 patients in each group comprising of 35 males and 5 females in group-A and 38 males and 2 females in group-B. Group-A patients were mainly those with neurogenic bladder (n = 25) and postoperative cases of stricture. While in indwelling group 35 patients had neurogenic bladder with the remaining (n = 5) having benign prostatic hypertrophy. Group-A performed CISC 1-4 times/24 hours depending on the primary disease while in group-B fortnightly catheter change was done under aseptic conditions. Symptomatic infections were taken into consideration in both the groups proven by urine C/S.

Symptomatic infections as pyelonephritis, epididymorchitis and urosepsis occurred in both groups. In group-A 2 (5%) patients developed pyelonephritis as compared to 10 (25%) in group-B (P value 0.01). Epididymorchitis and urosepsis occurred in 1 (2.5%) and 0 patients in group-A while 3 (7%) and 2 (5%) patients in group-B. Statistically significant infection (pyelonephritis) occurred in group-B.

CISC is much safer practice with less complications and infection rate than indwelling catheters.