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For children with neurogenic bladder, self-catheterization is associated with lower adherence to clean intermittent catheterization (CIC), according to a study recently published in the Journal of Pediatric Urology.

Simran K. Sidhu, from Kuala Lumpur Hospital in Malaysia, and colleagues identified factors that could affect CIC compliance and examined the association between CIC compliance and short-term urological outcomes in children with neurogenic bladder due to spina bifida and caudal regression syndrome.

The validated Intermittent Catheterization Adherence Scale was used to assess patient compliance with CIC among 50 patients aged 2 to 18 years. The validated Intermittent Catheterization Difficulty Questionnaire (ICDQ) was used to assess CIC difficulties.

The researchers found that 60 percent of the participants showed strong adherence to CIC. Most (78 percent) were able to catheterize with no or minor difficulties; the main difficulties encountered were pain, transient blocking sensation, and urinary incontinence (12, 12, and 6 percent, respectively).

Adherence was improved with CIC performed by caregiver versus patient self-catheterization. Patients who purchased their own CIC catheters also had strong adherence. The likelihood of being compliant with CIC was higher for patients with a lower ICDQ score. Patient’s age, gender, comorbidity, mobility, caregiver factors, socioeconomic factors, and age at initiation of CIC did not affect CIC adherence.

No significant association was seen between CIC adherence and febrile urinary tract infections, upper tract deterioration, and bladder stones at a follow-up of six months.

“Our study provides insights on facilitators and barriers to instituting CIC that will improve care and counseling provided to patients,” the authors write.

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