Feasibility and outcome of clean intermittent catheterization for children with sensate urethra

Abstract

Clean intermittent catheterization (CIC) is an important asset in managing children with noncompliant bladders. We review the feasibility and late outcomes of patients with normal urethral sensation who began CIC. We reviewed all patients with posterior urethral valve (PUV) or non-neuropathic bladder sphincter dysfunction (NNBSD) who began on CIC, and had at least 2 years of follow-up. We considered their age, indication, acceptance and compliance with CIC. Additionally, we examined the late outcome of bladder function and the need for any surgical intervention at follow-up. Between 1999 and 2006, 52 patients with PUV (38 patients) or NNBSD (14 patients) were started on CIC. Of these 52 patients, 48% were under the age of 4. A total of 44 patients (85%) accepted the recommendation for CIC, and 34 patients (65%) were compliant with the protocol after at least 2 years of follow-up. The age of the patients was the only significant factor related to the success of the protocol (4 years old or younger, p = 0.03). After at least 2 years of follow-up, 28 patients (54%) remained on CIC and have not required urinary diversion or bladder reconstruction. The current study showed that CIC is a feasible option for patients with sensate urethra, which necessitates the introduction of treatment as early as possible. Further, those patients who are compliant with the CIC demonstrated a better chance of avoiding subsequent surgical intervention for the management of a non-compliant bladder.