Open Access

ARTICLE

Success rates of patients with poor emptying on clean intermittent catheterization

Andrew A. Di Pierdomenico, Sidney B. Radomski

Department of Surgery (Division of Urology), Toronto Western Hospital (University Health Network), University of Toronto, Toronto, Ontario Canada Address correspondence to Dr. Sidney B. Radomski, Department of Urology, Toronto Western Hospital, Main Pavilion: 8^th Floor Room 304, 399 Bathurst Street, Toronto, ON M5T 2S8 Canada

Canadian Journal of Urology 2014, 21(2), 7188-7193.

Abstract

Introduction: Clean intermittent catheterization (CIC) theoretically reduces incontinence, urinary tract infections (UTIs) and lower urinary tract symptoms (LUTS) in the face of poor emptying. It is unclear whether all patients realize these benefits or if CIC is only helpful for some.
Materials and methods: A retrospective review of 321 patients all of whom underwent urodynamic study prior to starting CIC for impaired emptying. Success was considered to be no incontinence, no UTIs, and no LUTS while performing CIC. Patients who did not meet these criteria or who stopped CIC for whatever reason were classified as failures.
Results: The mean duration of follow up was 4.3 years (±4.4 years). Overall 51% of the cohort was classified as a success. Among those patients started on CIC to treat incontinence, recurrent UTIs or LUTS the success rate was 43%. We identified the comorbidity of diabetes mellitus, the use of anticholinergic medications, the need for a homecare nurse to perform the CIC, and a post-void residual (PVR) of <300 cc at initial urodynamics to be independently associated with failure on CIC.
Conclusions: CIC resolved incontinence, recurrent UTIs, and LUTS in some but not all patients with impaired emptying. We identified characteristics associated with failure on CIC. Our study has provided some direction as to those individuals most and least likely to benefit from adopting this mode of bladder management for poor emptying.

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