Intermittent Catheterization with Single- or Multiple-Reuse Catheters: Clinical Study on Safety and Impact on Quality of Life - Beyond the Abstract

This was a prospective, multi-center, international (U.S> & Australia) observational real-life safety and satisfaction study of switching patients from reusing urethral catheters for multiple self-catheterizations to using a single hydrophilic catheter (HC). The validated Intermittent Self-Catheterization Questionnaire (ISC-Q) was used to study patient satisfaction and health-related quality of life (QoL). the Intermittent Self-Catheterization Questionnaire (ISC-Q) is a 24 item, validated questionnaire with four categories: ease of use, convenience, discreetness, and psychological well-being, assessing patient satisfaction with ISC.

Reused catheters were collected and studied with regard to contamination. The study included 39 patients with neurogenic lower urinary tract dysfunction (spinal cord injury 46%, spinal cord/brain disease 15%, neural tube defects 5%, other 33%) with a mean age of 55 years (69% men, 31% women). Patients had practiced IC for an average of 10 years, six times daily. At inclusion, all patients reused catheters for a mean of 21 days per catheter. A total of 36 patients completed the prospective test period and the ISC-Q score increased from 62.66 to 74.65 when patients switched to the single-use HC catheters. This corresponds to a 20% increase in health-related QoL. Not surprisingly, all collected reused catheters (100%) were contaminated by debris and 74% were contaminated by bacteria, (Staphylococcus, Enterococcus, and Pseudomonas). At the end of the study, 83% of patients preferred to continue using single-use HC catheters.

An unexpected challenge encountered was the overuse of antibiotics in the reuse population. Patients who were reusing catheters were found in the research sites but many were excluded from enrolling in the study because of having received antibiotic treatment within four weeks prior to study enrollment. There were many patients who had been treated because of symptomatic infections. Many believe that reusing catheters for multiple catheterizations placed the patient at an increased risk of a catheter-associated UTI.

Written by: Diane K. Newman, DNP, ANP-BC, FAAN, Adjunct Professor of Urology in Surgery, Research Investigator Senior, Perelman School of Medicine, Co-Director, Penn Center for Continence and Pelvic Health, Division of Urology, University of Pennsylvania, Philadelphia, Pennsylvania

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