BERKELEY, CA (UroToday.com) - This is a pilot study that used cross-sectional survey design to study various complications, adherence, and health-related quality of life in community dwelling men and women who have been using clean intermittent self-catheterization (CISC) for two months or more. The total number of participants was 44 (with a mean age of approximately 55.6 years); 59% of participants were female, 18% male, and 93% Caucasian. Twenty-five participants (56%) reused their catheters. Twenty participants (45.5%) reported that they do not void at all on their own. The medium duration of performing CIC was sixty months. The most common difficulty associated with self-catheterization -- reported by female participants -- was lack of access to a bathroom (34%) and positioning to insert the catheter (25%). Dexterity issues were reported by patients with multiple sclerosis. At least 84.6% subjects reported compliance with a catheterization schedule consistent with doctor's orders.
There are very few studies on how patients deal with CISC, so this study provides some insight and adds to the literature on CISC in the community. Barriers noted included lack of access to a bathroom for catheterization, dexterity and spasticity which prevented proper insertion of the catheter, and positioning to insert the catheter. Concerning the catheter itself, there were complaints that included wrong size catheter, type and material of the catheter, not comfortable for performing catheterization, lack of proper training, visual problems making it difficult to insert the catheter, time limitations, inability to sense and feel the catheter being inserted, cost of supplies, lack of supplies, and weight issues. Complications associated with IC included urinary tract infections, bleeding, scar tissue, stone formation (11.4%), and prostatitis in male patients.
The main limitation of the study is the very small sample size due to poor recruitment. The authors initially attempted to recruit from the university urology practice, but because of poor enrollment recruitment was expanded to neurology, rehabilitation, and a VA hospital. This study cannot be generalized to all persons performing CISC, but it does identify many of the same problems with CISC reported by others. The study was supported by Hollister and Wound, Ostomy and Continence Nurses Society (WOCN) CCI grants.
Bolinger R, Engberg S
Reference:J Wound Ostomy Continence Nurs. 2013 Jan-Feb;40(1):83-9
doi: 10.1097/WON.0b013e3182750117
PubMed Abstract
PMID: 23222966
Written by Diane K. Newman, DNP, FAAN, BCB-PMD
