Related Experiment Video
Updated: Sep 16, 2025
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
Practice of clean intermittent catheterisation in children with spina bifida: A scoping review
Denis Nono1,2, Andrew S Ssemata1,2, Femke Bannink Mbazzi1,2,3
1Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, United Kingdom.
Insights
Clean Intermittent Catheterization (CIC) management for spina bifida in low-income countries faces barriers like pain and lack of supplies. Facilitators include early initiation, healthcare support, and family involvement.
Area of Science:
- Pediatric Urology
- Rehabilitation Medicine
- Global Health
Background:
- Spina bifida is a congenital neural tube defect impacting bladder function and causing urinary incontinence.
- Clean Intermittent Catheterization (CIC) is a primary management strategy for bladder and bowel dysfunction in affected children.
- Understanding challenges in CIC practice is crucial for improving care in resource-limited settings.
Purpose of the Study:
- To systematically review existing evidence on facilitators and barriers to Clean Intermittent Catheterization (CIC) usage in children with spina bifida.
- To identify factors influencing the successful implementation and practice of CIC in low-income countries.
- To inform future interventions and research aimed at optimizing CIC management for this population.
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Web of Science, SCOPUS).
- Study selection followed PRISMA-ScR guidelines, focusing on articles related to spina bifida, continence management, CIC, barriers, and low-income countries.
- Ten relevant English-language articles published between 2004 and 2023 were included after rigorous screening and eligibility assessment.
Main Results:
- Key barriers to CIC practice include pain during catheter insertion, social stigma, lack of accessible toilets, and difficulties in obtaining supplies and training.
- Facilitators identified are early initiation of CIC in infancy, consistent follow-up by healthcare providers, and strong family and community support.
- Effective training, utilization of lubricants, and the reuse of catheters and low-cost materials also emerged as important facilitators.
Conclusions:
- Effective management of CIC in low-income countries requires addressing identified barriers and leveraging identified facilitators.
- Future research should prioritize the involvement of family members and community-based rehabilitation workers to enhance CIC practices.
- This review provides critical insights into optimizing CIC for children with spina bifida in resource-constrained environments.
Background:
Spina bifida is a congenital neural tube defect, where there is incomplete formation of the spinal cord and vertebrae, resulting in abnormal development of the neural tube. This affects bladder function and urinary incontinence. Clean Intermittent Catheterization (CIC) is used to manage bladder and bowel management.
Objectives:
This study aims to scope evidence on the facilitators and barriers to usage and practice of CIC in children with spina bifida in low-income countries.
Method:
We searched databases including PubMed, Web of Science and SCOPUS, and screened articles for inclusion following the PRISMA-ScR guidelines. The search terms included 'Spina Bifida ([continence management] AND [clean intermittent catheterisation]) AND ([barriers to Clean Intermittent Catheterisation] OR [Low Income Countries]) OR (myelomeningocele)'. Full-text assessment for eligibility excluded 202 articles. Twenty-two articles were reviewed and twelve full-text articles were excluded because of limited content. Ten articles published in English between 2004 and 2023 were selected for review.
Results:
Barriers in practicing CIC include pain and discomfort in catheter insertion, stigma and fears; inaccessibility of public toilets, unavailability of appropriate catheters, difficulty in positioning, limited quality of teaching and challenges with accessing supplies. Facilitators include starting CIC in infancy, follow-up by healthcare providers, support from family and community members, quality of training, continuous practice of CIC, utilisation of lubricants, reuse of catheters and other low-cost materials.
Conclusion:
Our review summarises facilitators and barriers to CIC and provides recommendations for further research, which includes the involvement of family members and community-based rehabilitation workers.
Contribution:
This article contributes to a better understanding of CIC use in low-income countries.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:28Urologic Endoscopic Procedure: Cystoscopic Examination