Intermittent catheterization practices following spinal cord injury: a national survey

To identify intermittent catheterization (IC) practices and factors associated with urinary tract infection (UTI) in community-dwelling people living with spinal cord injury (SCI) in Canada.

A national survey employing a 36-item self-report questionnaire that was mailed to members of the Canadian Paraplegic Association (CPA).

There were 912 respondents with SCI of either traumatic or nontraumatic etiology. Fifty-five percent of the respondents used IC. The mean age of users (47+/-14 years) was significantly younger than non-users (53+/-13 years) and a greater percentage of males (57%) than females (50%) used IC. Of those who used IC, 26% use hydrophilic catheters either exclusively or sometimes. The mean frequency of UTIs in the past 12 months for IC users was 2.6+/-2.6. Among IC users, females had a significantly greater number of UTIs than males (p=0.003). Linear regression analysis revealed that the variables of sex, number of catheterizations per day, age, and tetraplegia versus paraplegia were individually correlated with infection rate but collectively only explained a small proportion of the variance. Time lost from social activities due to UTIs was associated with compromised quality of life more so than the actual number of UTIs or days lost from work.

The survey identifies existing IC practices and confirms previous reports of UTI rate being dependent on frequency of catheterization and reduced infection rates in individuals using hydrophilic catheters. UTI rates were significantly associated with several clinical and demographic variables but only poorly modeled by the IC practices and lifestyle variables investigated in this study.