Complications of intermittent catheterization: their prevention and treatment

Abstract

Study design: Literature review to evaluate the complications seen in patients on intermittent catheterization (IC) and intermittent self-catheterization (ISC). Objectives: To ®nd the prevalence of most complications seen in patients on IC. To study the prevention and the treatment of these complications. Setting: An international literature review. Methods: Most relevant articles on the subject are reviewed. Conclusion: Urinary tract infection is the most frequent complication in patients performing IC. Catheterization frequency and the avoidance of bladder over®lling are amongst the most important prevention measures. Asymptomatic bacteriuria does not need to be treated with antibiotics. Long-term antibacterial prevention does seem to bear a risk of development of bacterial resistance. Previous treatment with indwelling catheters is a risk factor for chronic infection and urinary sepsis. Prostatitis is more frequently present than often thought. Epididymitis and urethritis are rare. Trauma from catheterization occurs regularly, but lasting eects are more limited. However, the prevalence of urethral strictures and false passages increases with longer use of IC. The use of hydrophilic catheters might be able to lower the urethral complication rate but additional proof through comparative studies is needed. The most important prevention measures are good education of all involved in IC, good patient compliance, the use of a proper material and the application of a good catheterization technique.

Incidence of symptomatic autonomic dysreflexia varies according to the bowel and bladder management techniques in patients with spinal cord injury

“…There is strong argument regarding the safety and efficacy of IC for treatment of neurogenic bladder dysfunction in patients with spinal cord lesions. 23 IC is considered preferable to other forms of bladder emptying in neuropathic patients as it has less complications and associated with a better outcome. 23 We investigated previously changes in BP, pulse rate and classic symptoms of AD before, during and after a bowel program involving manual removal of stool in lateral recumbency in patients with cervical SCI and AIS A or B grade.…”

“…23 IC is considered preferable to other forms of bladder emptying in neuropathic patients as it has less complications and associated with a better outcome. 23 We investigated previously changes in BP, pulse rate and classic symptoms of AD before, during and after a bowel program involving manual removal of stool in lateral recumbency in patients with cervical SCI and AIS A or B grade. 11 The insertion of rectal medication induced a significant increase in systolic BP, which persisted during additional digital rectal stimulation.…”

Influence of bladder management on epididymo-orchitis in patients with spinal cord injury: clean intermittent catheterization is a risk factor for epididymo-orchitis

“…Therefore, it demands specially trained medical resources as well as enough time to give the patients the relevant information and to train them to acquire a proper CIC technique. Wyndaele 19 suggested that the most important measures were a good education of all factors involved in intermittent catheterization, good patient compliance, the use of proper materials, and the application of a good catheterization technique.…”

Reply to Katsumi et al.

“…Doing so, it is evident that intermittent catheterization is superior to indwelling catheters of any kind. [2][3][4] In this case, no misunderstanding about the status of indwelling catheters in the treatment of patients with neurogenic bladder dysfunction due to spinal cord injury would have been possible.…”