Variables associated with an inability to learn clean intermittent self-catheterization after urogynecologic surgery

Area of Science:

• Urology
• Gynecology
• Pelvic Surgery

Background:

• Post-operative urinary retention is common after pelvic reconstructive surgery.
• Clean intermittent self-catheterization (CISC) is a crucial skill for managing retention.
• Identifying barriers to learning CISC is important for patient outcomes.

Purpose of the Study:

• To explore factors associated with the inability to learn CISC after a failed post-operative retrograde voiding trial (RGVT).
• To identify predictors of successful CISC learning in women experiencing post-operative urinary retention.

Main Methods:

• Retrospective case-control study of women undergoing pelvic organ prolapse or urinary incontinence surgery (2016-2018).
• Comparison of women who learned CISC versus those discharged with an indwelling catheter (IC).
• Statistical analyses included Fisher's exact test, Mann-Whitney U, Chi-squared, t-tests, and logistic regression.

Main Results:

• Of 202 women who failed RGVT, 66.3% learned CISC, while 33.7% did not.
• Inability to learn CISC was associated with older age, urinary incontinence, diabetes, and colpectomy/colpocleisis.
• Multivariate analysis identified increasing age as the sole significant risk factor for failing to learn CISC (aOR 1.036).

Conclusions:

• Increasing age is a significant risk factor for failure to learn CISC post-operatively.
• Further research is needed to elucidate specific barriers to post-operative self-catheterization learning.
• Understanding these barriers can improve patient management and reduce reliance on indwelling catheters.