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Clean intermittent self-catheterization in persons with multiple sclerosis: the influence of cognitive dysfunction
L Vahter1, I Zopp, M Kreegipuu
1Estonian MS Centre, West-Tallinn Central Hospital, Tallinn University, Tallinn, Estonia. liina.vahter@ltkh.ee
Multiple Sclerosis (Houndmills, Basingstoke, England)
|November 7, 2008
Summary
Most persons with multiple sclerosis (PwMS) can learn clean intermittent self-catheterization (CISC), improving their quality of life. Physical disability impacts learning, but cognitive decline does not.
Area of Science:
- Neurology
- Urology
- Rehabilitation Medicine
Background:
- Bladder dysfunction is a prevalent issue for individuals with multiple sclerosis (MS).
- Clean intermittent self-catheterization (CISC) is a crucial management strategy for bladder problems.
Purpose of the Study:
- To evaluate the capacity of persons with multiple sclerosis (PwMS) to acquire and perform clean intermittent self-catheterization (CISC).
- To identify factors influencing the learning and adherence to CISC in PwMS.
Main Methods:
- Twenty-three PwMS underwent assessment of physical disability (Expanded Disability Status Scale - EDSS) and cognitive function (Brief Repeatable Battery of Neuropsychological Tests - BRB-N).
- CISC training was provided by a single continence advisor, blinded to cognitive test results.
- Learning ability was assessed immediately post-training and at a 3-month follow-up.
Main Results:
- 87% (20/23) of PwMS successfully learned CISC.
- The number of lessons required for CISC acquisition was significantly correlated with physical disability (EDSS), but not with cognitive decline.
- After 3 months, 30% (6/20) of PwMS discontinued CISC; no significant correlations were found between cognitive scores, EDSS, disease course, and CISC learning or adherence.
Conclusions:
- The majority of PwMS can successfully learn CISC, even with cognitive impairments, leading to improved quality of life.
- Physical disability is a key factor affecting the learning curve for CISC in PwMS.
- While initial learning is achievable for most, long-term adherence to CISC requires further investigation.
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