Profile of patients practicing clean intermittent catheterization and associated resource consumption. Multicenter study in Spain

Abstract

Introduction: Clean intermittent catheterization (CIC) is a technique used for bladder emptying in patients with neurogenic or non-neurogenic lower urinary tract dysfunction. CIC is considered the best option for most patients with dysfunctional voiding, as it improves their quality of life with a low complication rate. However, there is considerable variability in the management of CIC across regions and countries, as well as a lack of standardized guidelines. This study aims to determine the patient profile, associated complications and resource utilization related to the procedure.

Methods: This descriptive, multicenter, cross-sectional study was conducted in the functional urology and urodynamics units of 23 hospitals across Spain between April 2019 and April 2021. Patient characteristics were collected and stored in the Multicenter Studies Research Platform of the Spanish Urology Association.

Results: This study included 573 CIC users, with a mean age of 54.1 years (SD: 19.1). Of the participants, 78.6% lived in urban areas, and 53.9% had additional comorbidities. The primary indication for CIC was spinal cord injury (29.5%), followed by hypocontractile neurogenic bladder (20.8%). Most patients performed one clean intermittent catheterization per day (87.3%), with a median of three. The most common complication observed was urinary tract infection (51.8%). Additionally, 95.3% of patients attended at least one urology consultation in the past year.

Conclusions: CIC is mostly indicated for neurological pathologies, and urinary tract infection is the most common associated complication. CIC is a fundamental procedure in functional urology units and is linked to significant healthcare resource consumption. Knowledge on the patient profile and the characteristics associated with CIC is crucial for comprehensive patient management, as it helps reduce and prevent potential complications while also informing healthcare strategies for more efficient resource management.

Keywords: Autocateterismo; Cateterismo intermitente limpio; Catheter; Catéter; Clean intermittent catheterization; España; Patient profile; Patient registry; Perfil de pacientes; Registro de pacientes; Self-catheterization; Spain; Unidades de urología; Urology units.