Factors Affecting Difficulties Faced by Women During their First Year of Clean Intermittent Self-Catheterization

Clean intermittent self-catheterization represents a cornerstone in the management of lower urinary tract dysfunction in women. Patients may be confronted with many difficulties during their early experience of self-catheterization, which may lead to discontinuation. The purpose was to identify the factors affecting difficulties that women with lower urinary tract dysfunction face during their first year of clean intermittent self-catheterization.

Females older than 18 years who were on clean intermittent self-catheterization for less than 1 year responded to the Intermittent Catheterization Difficulty Questionnaire and Patient Clean Intermittent Catheterization-Quality of Life questionnaire. Statistical associations between their responses and factors expected to affect the difficulty of self-catheterization were tested.

The study included 42 patients with a median (range) age of 25 (18-51) years and median (range) duration of self-catheterization of 4 (3-10) months. The median (range) Intermittent Catheterization Difficulty Questionnaire score was 43 (26-59). For the Patient Clean Intermittent Catheterization-Quality of Life questionnaire, poor responses were reported regarding difficulty, pain and interest in continuing with self-catheterization for life in 20 (47.6%), 22 (52.4%), and 31 (73.8%) patients respectively. The factors that had statistically significant associations with Intermittent Catheterization Difficulty Questionnaire score were the occurrence of complications (p < 0.001), position during self-catheterization (p < 0.001), duration of self-catheterization (p = 0.007), and daily frequency of self-catheterization (p < 0.001). The previously mentioned four factors also had statistically significant associations with patients' responses to all domains of the Patient Clean Intermittent Catheterization-Quality of Life questionnaire.

In women during their first year of clean intermittent self-catheterization, the factors associated with fewer difficulties are absence of complications, commode sitting position, longer duration, and increased daily frequency of self-catheterization.