[Normalization of bladder emptying in patients on clean intermittent catheterization]

Area of Science:

• Urology
• Nephrology
• Internal Medicine

Context:

• Clean intermittent catheterization (CIC) is a standard treatment for lower urinary tract (UT) dysfunction.
• Previous reports on successful CIC termination due to restored spontaneous bladder emptying were anecdotal.
• A large-scale study was needed to evaluate the feasibility of discontinuing CIC.

Purpose:

• To determine the rate at which patients can terminate clean intermittent catheterization (CIC) due to restored spontaneous bladder emptying.
• To identify patient subgroups with higher likelihoods of achieving normal bladder function after CIC.
• To explore potential mechanisms behind CIC's efficacy in improving bladder emptying.

Summary:

• Data from 1,702 patients undergoing CIC were analyzed.
• 13.2% of patients successfully stopped CIC due to normalized spontaneous bladder emptying.
• Improved outcomes were more frequent in patients with lower UT lesions and unknown bladder dysfunction etiology (18.4%) compared to upper UT lesions (8.8%).
• Improvement typically occurred within the first year and was more common in women.
• No difference in catheterization frequency was observed between groups who terminated CIC and those who continued.

Impact:

• Demonstrates that CIC can lead to sustained restoration of bladder function in a significant patient cohort.
• Highlights the potential for treatment de-escalation in lower urinary tract dysfunction.
• Suggests that reducing bladder over-distension may be a key mechanism for CIC-induced functional recovery.