Clean intermittent catheterization--physical and psychological complications

Area of Science:

• Urology
• Infectious Diseases
• Patient Safety

Background:

• Clean intermittent catheterization (CIC) is a common treatment for bladder emptying.
• Understanding complications associated with CIC is crucial for patient management.
• Previous studies have highlighted potential risks, but a comprehensive follow-up is needed.

Purpose of the Study:

• To prospectively evaluate physical and psychological complications in patients undergoing CIC.
• To identify the prevalence and risk factors of bacteriuria and symptomatic urinary tract infections (UTIs).
• To analyze complications related to the catheterization procedure itself.

Main Methods:

• A one-year prospective follow-up study of 407 patients (206 men, 201 women) treated with CIC.
• Patients were categorized into five groups based on underlying diagnoses.
• Urine samples were analyzed for bacteriuria, and clinical UTIs were monitored.

Main Results:

• Significant bacteriuria was found in 50.6% of samples, with E. coli dominant.
• Symptomatic UTIs occurred in 11.9%–17.4% of patients, more frequently in females and those using antibiotics.
• Predictive factors for clinical UTIs included low age and high catheterization volume in women, and low age, neurogenic bladder, and non-self-catheterization in men.
• Bacteriuria was a significant risk factor for future clinical infections.

Conclusions:

• Clean intermittent catheterization is associated with a notable risk of bacteriuria and symptomatic UTIs, particularly in female patients.
• Identifying predictive factors for UTIs and bacteriuria is essential for targeted prevention strategies.
• While bleeding during catheterization occurred, other major physical complications were infrequent.