The Clinical Application of Clean Intermittent Self-catheterization

Abstract

Clean intermittent self-catheterization (CISC) can be performed to manage acute or chronic bladder dysfunction. It is a safe and simple technique that may improve the quality of life in patients with urinary incontinence or urinative dysfunction because of a neuropathic or atonic bladder. However, some patients who are indicated for CISC may not have the opportunity to try self-catheterization because their doctors are not familiar with the procedure. The upper urinary tract function often gradually worsens in the hyper-reflexia neurogenic bladder. Whether CISC can alleviate urinary dysfunction was the subject of this study. To elucidate the practical value of CISC, we report here our preliminary experience on using this procedure on patients with urinary dysfunction due to various etiologies. From April 1995 through June 1997, 56 consecutive in-patients from our hospital who suffered from bladder dysfunction were enrolled in this study. All the patients who were admitted to the training program satisfactorily passed, with none of them withdrawn due to intolerance of the procedure. Four patients got mild urinary tract infection (UTI) and needed oral antibiotics during the follow-up period. Five patients with cervical spine injury and quadriplegia got rid of their long-term UTI by replacing the catheterization to CISC. All the patients with detrusor muscle failure showed improvement in their urinative function after a period of CISC. One of the two patients with myelomeningocele recovered from renal insufficiency after CISC. The other patient, however, finally required continuous hemodialysis. There was no renal function deterioration in patients with hyperreflexia. In conclusion, CISC is a safe, simple, and useful technique to releive urinary dysfuntion, it should be considered in both hospital-care and home-care programs.