Success rates of patients with poor emptying on clean intermittent catheterization

Clean intermittent catheterization (CIC) theoretically reduces incontinence, urinary tract infections (UTIs) and lower urinary tract symptoms (LUTS) in the face of poor emptying. It is unclear whether all patients realize these benefits or if CIC is only helpful for some.

A retrospective review of 321 patients all of whom underwent urodynamic study prior to starting CIC for impaired emptying. Success was considered to be no incontinence, no UTIs, and no LUTS while performing CIC. Patients who did not meet these criteria or who stopped CIC for whatever reason were classified as failures.

The mean duration of follow up was 4.3 years (+/- 4.4 years). Overall 51% of the cohort was classified as a success. Among those patients started on CIC to treat incontinence, recurrent UTIs or LUTS the success rate was 43%. We identified the comorbidity of diabetes mellitus, the use of anticholinergic medications, the need for a homecare nurse to perform the CIC, and a post-void residual (PVR) of <300 cc at initial urodynamics to be independently associated with failure on CIC.

CIC resolved incontinence, recurrent UTIs, and LUTS in some but not all patients with impaired emptying. We identified characteristics associated with failure on CIC. Our study has provided some direction as to those individuals most and least likely to benefit from adopting this mode of bladder management for poor emptying.