Time needed to perform intermittent catheterization in adults with spinal cord injury: A pilot randomized controlled cross-over trial

Abstract

Intermittent catheterization (IC), considered the gold standard for bladder management for individuals with spinal cord injury (SCI) with sufficient dexterity, is usually performed using hydrophilic (HPC) or non-hydrophilic catheters (non-HPC). Currently, there is little evidence on the temporal burden associated with IC in general. Our objective was to compare both catheters regarding their time requirement for IC and participant satisfaction. Twenty individuals with chronic (>1-year) SCI were randomized to undergo two cross-over assessments within 10 days (i.e., either starting with HPC or non-HPC). We measured the time taken to perform IC using a 13 step pre-determined protocol. Furthermore, we assessed user satisfaction of both catheters using a Likert scale. Time to perform IC and participant satisfaction were compared using non-parametric statistics. Results are presented as median with lower and upper quartiles. Participants using an HPC spent significantly less time overall to perform IC [283 s (242;352) vs. 373 s (249;441), p=0.01] and to prepare a catheter [15 s (10;20) vs. 41 (20;69), p=0.002, i.e. adjusted for multiple comparisons] compared to non-HPC. No significant differences between both catheters were found with respect to participant satisfaction. This crossover RCT revealed that the overall time to perform IC appears to be a significant temporal burden for individuals with SCI independent of the catheter type. Further, we found that the preparation and usage of HPC for IC is faster compared to non-HPC. These findings warrant a larger trial to further assess the temporal burden of IC in this cohort.