Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep;48(5):835-841.
doi: 10.1080/10790268.2024.2352931. Epub 2024 May 31.

Adherence of spinal cord injury patients in the community to self-clean intermittent catheterization (CIC) within 12 months of discharge following rehabilitation: A telephone survey

Saumya Susan Zacharia  1 , Raji Thomas  1 , Jacob George  1
Affiliations

Adherence of spinal cord injury patients in the community to self-clean intermittent catheterization (CIC) within 12 months of discharge following rehabilitation: A telephone survey

Saumya Susan Zacharia et al. J Spinal Cord Med. 2025 Sep.

Abstract

Context: Spinal cord injury often results in neurogenic bladder affecting storage or emptying functions of the bladder. Clean intermittent catheterization (CIC) is considered the gold standard for patients with neurogenic bladder dysfunction. Our study aims to assess the adherence of patients to CIC following discharge from rehabilitation.

Objective: PRIMARY: To assess the adherence of patients with spinal cord injury in the community to self-CIC within 12 months of discharge. SECONDARY: To study the reasons and analyze the factors associated with discontinuation of CIC and to assess the perception of patients regarding CIC.

Methods: Prospective follow-up of a retrospective cohort in 121 individuals with paraplegia who were trained to do CIC for bladder management. After obtaining telephonic consent, a questionnaire-based interview was conducted.

Results: Out of 121 patients, 97 (80.2%) were males and 24 (19.8%) were females. The mean age was 35.8 ± 11.6 years. About 89 (73.6%) patients were continuing CIC as the primary mode of bladder management after discharge. However, only 18 (15%) patients were fully compliant with the CIC technique, 71 (59%) were partially compliant and 32 (26%) patients discontinued CIC. Reasons for the discontinuation of CIC included medical complications (78%), including leaks, recurrent UTI, hematuria, ulcers, back pain, and spasticity, and other factors like difficulty in following the timing of CIC (12.5%), issues with positioning (3.1%), and difficulty in restricting fluid intake (6.3%).

Conclusion: This study highlights the need for regular follow-up as well as education of patients regarding CIC technique, complications, care, and hygiene while doing CIC which can result in improved adherence to CIC.

Keywords: Adherence; Clean intermittent catheterization; Paraplegia; Spinal cord injury; UTI.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Bladder emptying methods at admission, at discharge, and at follow-up.
Figure 2
Figure 2
Adherence to CIC.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Dev K, Das R, Vyas A.. Occurrence of urinary tract infection in reference to bladder-emptying method and etiological agents among spinal cord injury patients: a cross-sectional study. Indian J Phys Med Rehabil 2019 Mar 1;30(1):12–16.
    1. Lapides J, Diokno AC, Silber SJ, Lowe BS.. Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol 1972 Mar;107(3):458–461. - PubMed
    1. Wyndaele J. Complications of intermittent catheterization: their prevention and treatment. Spinal Cord 2002 Oct;40(10):536–541. - PubMed
    1. Weld KJ, Dmochowski RR.. Effect of bladder management on urological complications in spinal cord injured patients. J Urol 2000 Mar;163(3):768–772. - PubMed
    1. Afsar SI, Yemisci OU, Cosar SNS, Cetin N.. Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study. Spinal Cord 2013 Aug;51(8):645–649. - PubMed

LinkOut - more resources