Factors associated with successful clean intermittent catheterization in children with neurogenic lower urinary tract dysfunction

Abstract

Objective: Clean intermittent catheterization (CIC) is the standard treatment for children with neurogenic lower urinary tract dysfunction (NLUTD). Despite its effectiveness, many patients encounter obstacles such as the affordability of necessary instruments and finding a suitable location for CIC, which can impact treatment outcomes. This research aims to investigate factors associated with successful CIC in children with NLUTD.

Materials and Methods: This is an observational analytical study, focusing on patients under 18 diagnosed with NLUTD through urodynamic studies at our center from 2009 to 2020. Multivariate analyses were conducted to identify factors associated with successful CIC and prevalence of UTI in children with NLUTD.

Results: Between 2009 and 2020, 233 patients were recruited onto the study. Of these, CIC was successfully achieved in 148 (63.5%) cases. The effectiveness of performing CIC was high at 93.2%, with a cooperation rate of 94.6%. n the unsuccessful group, numbering 85, 71 patients (83.5%) experienced UTI, with the mean occurring approximately 8 months after the diagnosis of neurologic bladder dysfunction. Multivariate analysis revealed that the ability to perform CIC effectively (OR 5.679; 95%CI 2.423-13.311) is an independent factor associated with successful outcomes. However, no significant differences were found between the successful and unsuccessful CIC groups regarding cooperation, socioeconomic status, caregiver, etiology of disease, medication use, number of CIC, school environment, healthcare provider access, and gender.

Conclusion: The ability to perform CIC effectively is the primary factor associated with successful CIC in children diagnosed with NLUTD. Improving the effectiveness of CIC is crucial for the achievement of success treatment of these patients.