Complications, barriers, adherence and self-reported health-related quallity of life (HRQoL) in persons using clean intermittent catheterization (CIC)

Background:  Little is known about the QOL of people using CIC to manage chronic urinary retention.

Purpose:  The aims of this pilot study were to examine general HRQOL in individuals using CIC, complications and difficulties associated with self-catheterization, and adherence to the physician-recommended catheterization schedule.

Sample: Community-dwelling men and women who had been using CIC for at least 3 months

Study design: Cross-sectional, survey design

Measures: MOS SF-36, sociodemographic questionnaire and investigator-developed instrument.

Results: The mean age of the sample (n=40) was 56.0 years (SD=16.5 yrs), 60% were women, and 92.5% were Caucasians.  Their mean SF-36 physical component score was 33.7 (SD=12.2) while the mean mental component score was 50.8 (SD=13.4). Eighteen (45%) reported that they did not void at all on their own.  The median duration of CIC was 60 months.  Twenty-three participants (57.5%) reused catheters a median of 14 times.  The most common complication was UTIs (n=34, 85%). The most common difficulties associated with self-catheterization were dexterity (n=9, 22.5%), lack of access to a bathroom (n=12, 30%), and for women, positioning to insert the catheter (n=9, 34.6%). Although most participants reported catheterizing on their own schedule (n=18, 46.2%) or in response to bladder fullness (n=20, 20.5%), 76.9% reported a catheterization schedule consistent with physicians’ order.  Most were completely (n=20, 50%) or somewhat (n=16, 40%) satisfied using CIC to manage their bladder problem.

Conclusion: While the physical component SF-36 score in this sample was lower, the mental health component score was similar to the population norm for the age group.   The most common complication of CIC was UTIs and the most frequent catheterization difficulties were dexterity and lack of access to bathrooms.