Open Access

ARTICLE

Intermittent catheterization and urinary tract infection in multiple sclerosis patients

Lauren E. Corona¹, Nadia R. Sion², Anne P. Cameron¹, Paholo G. Barboglio Romo¹, John T. Stoffel¹

1 Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
2 Central Michigan University, School of Medicine, Mount Pleasant, Michigan, USA
Address correspondence to Dr. Lauren E Corona, Department of Urology, The University of Michigan, A. Alfred Taubman Center, 1500 E Medical Center Dr, SPC 5330, Ann Arbor, MI 48109 USA

Canadian Journal of Urology 2020, 27(4), 10294-10299.

Abstract

Introduction: We sought to investigate whether starting clean intermittent catheterization (CIC) for multiple sclerosis (MS) patients with lower urinary tract symptoms (LUTS) and elevated post-void residual (PVR) would improve urinary quality of life (QoL) and decrease risk of urinary tract infection (UTI).
Materials and methods: We retrospectively reviewed an institutional database for MS patients with PVR > 100 mL and obstructive LUTS. Patients were categorized by subsequent choice of treatment: CIC versus medical treatment. Outcomes compared over 1-year follow up included incidence of UTI, urinary QoL, emergency room visits, and adherence to therapy.
Results: Between 2014 and 2017, 37 patients met inclusion criteria. Nineteen patients started daily CIC, while 18 patients had pharmacologic therapy. At 1-year follow up, the CIC group had less improvement in urinary symptoms (26% improvement from baseline versus 72%, p = 0.02) and 7 times greater odds of having minimum one UTI within 1 year (OR 6.8, p = 0.01). The CIC group was also more likely to start an additional treatment for LUTS, and to visit the ED (all p < 0.05).
Conclusions: In this group of MS patients with LUTS and elevated PVR, initiation of CIC was associated with increased incidence of UTI and less improvement in urinary symptoms over the subsequent year compared to pharmacologic treatment.

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Keywords

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