Review Article
Volume 3 Issue 2 - 2021
Impact of Catheter Characteristic on Complications Associated with Clean Intermittent Catheterization: Review of the Literature and Our Experience
Miroslav L Djordjevic*, Marta Bizic, Borko Stojanovic, Marko Bencic and Gradimir Korac
Belgrade Center for Urogenital Reconstructive Surgery, Belgrade, Serbia
*Corresponding Author: Miroslav L Djordjevic, Professor of Surgery/Urology, Department of Urology, Belgrade Center for Urogenital Reconstructive Surgery, Belgrade, Serbia..
Received: September 15, 2020; Published: January 27, 2021


Clean intermittent catheterization is considered the gold standard for neurogenic bladder management, and long-term monitoring shows that there are certain complications associated with this procedure. The most important and frequent complication is urinary tract infection followed by urethral bleeding, urethral stricture, and false passages. Because of catheter-related complications, patients face low adherence, so clean intermittent catheterization may be seen as a task they must perform rather than as a technique that brings choice and freedom in resolving urinary problems. Several studies assessed the impact of different catheter features in the incidence of urethral complications, urinary tract infection and patient satisfaction. The aim of this study was to investigate impact of catheter characteristics on urethral complications and patient’s satisfaction to a newly developed hydrophilic‐coated catheter (LentisCath™, Lentismed, Croatia) with comprehensive review of the literature.

Keywords: Clean Intermittent Catheterization; Mitrofanoff Procedure; Urethral Complications; No-Touch Technique; Hydrophilic Layer; Ready to Use; Discretion; Rigidity; Drainage Eyes; Patient Satisfaction


  1. Vapnek JM., et al. “A Prospective Randomized Trial of the LoFric Hydrophilic Coated Catheter Versus Conventional Plastic Catheter for Clean Intermittent Catheterization”. The Journal of Urology 3 (2003): 994-998.
  2. Wyndaele JJ and Maes D. “Clean intermittent self-catheterization: a 12-year followup”. The Journal of Urology 5 (1990): 906-908.
  3. Wyndaele J. “Complications of intermittent catheterization: their prevention and treatment”. Spinal Cord 10 (2002): 536-541.
  4. Schlager TA., et al. “Effect of a single-use sterile catheter for each void on the frequency of bacteriuria in children with neurogenic bladder on intermittent catheterization for bladder emptying”. Pediatrics 4 (2001): E71.
  5. Siroky MB. “Pathogenesis of bacteriuria and infection in the spinal cord injured patient”. The American Journal of Medicine 8 (2002): 67-79.
  6. Obermayr F., et al. “Outcome of augmentation cystoplasty and bladder substitution in a pediatric age group”. European Journal of Pediatric Surgery 2 (2011): 116-119.
  7. Kari J., et al. “Is Mitrofanoff a More Socially Accepted Clean Intermittent Catheterization (CIC) Route for Children and Their Families?” European Journal of Pediatric Surgery05 (2012): 405-410.
  8. Bermingham S., et al. “Intermittent self-catheterisation with hydrophilic, gel reservoir, and non‐coated catheters: a systematic review and cost effectiveness analysis”. BMJ 346 (2013): e8639.
  9. Li L., et al. “Impact of hydrophilic catheters on urinary tract infections in people with spinal cord injury: systematic review and meta‐analysis of randomized controlled trials”. Archives of Physical Medicine and Rehabilitation4 (2013): 782‐787.
  10. Prieto J., et al. “WITHDRAWN: Intermittent catheterisation for long-term bladder management”. Cochrane Database of Systematic Reviews 8 (2017): CD006008.
  11. Newman DK., et al. “Intermittent catheterization with single- or multiple-reuse catheters: clinical study on safety and impact on quality of life”. International Urology and Nephrology (2020).
  12. Cardenas DD., et al. “Intermittent Catheterization With a Hydrophilic-Coated Catheter Delays Urinary Tract Infections in Acute Spinal Cord Injury: A Prospective, Randomized, Multicenter Trial”. PM and R5 (2011): 408-417.
  13. De Ridder DJ., et al. “Intermittent catheterisation with hydrophilic-coated catheters (SpeediCath) reduces the risk of clinical urinary tract infection in spinal cord injured patients: a prospective randomised parallel comparative trial”. European Urology 6 (2005): 991-995.
  14. Medical Advisory Secretariat. “Hydrophilic catheters: an evidence-based analysis”. Journal: Ontario Health Technology Assessment Series 9 (2006): 1-31.
  15. Forchheimer M., et al. “Self-report of behaviors to manage neurogenic bowel and bladder by individuals with chronic spinal cord injury: frequency and associated outcomes”. Spinal Cord Injury Rehabilitation 2 (2016): 85-98.
  16. Koeter I., et al. “User perception of a new hydrophilic‐coated male urinary catheter for intermittent use”. Nursing Open 6 (2019): 116-625.
  17. Hudson E and Murahata RI. “The 'no-touch' method of intermittent urinary catheter insertion: can it reduce the risk of bacteria entering the bladder?” Spinal Cord 10 (2005): 611-614.
  18. Bracken RL., et al. “Polyurethane/polysoprene blend catheter”. U.S. Patent WO2010002914A1 (2009).
  19. Plevnik S., et al. “Directional differences in urethral pressure recordings: Contributions from the stiffness and weight of the recording catheter”. Neurourology Urodynamics 2 (1985): 117-128.
  20. Lane I. “Placing and managing urinary catheters and catheter collection systems (Proceedings)”. DVM (2009).
  21. Webb RJ., et al. “Clean Intermittent Self-catheterisation in 172 Adults”. British Journal of Urology 1 (1990): 20-23.
  22. Lindehall B., et al. “Complications of clean intermittent catheterization in boys and young males with neurogenic bladder dysfunction”. The Journal of Urology4-2 (2004): 1686-1688.
  23. Perrouin-Verbe B., et al. “Clean intermittent catheterization from the acute period in spinal cord injury patients. Long term evaluation of urethral and genital tolerance”. Paraplegia11 (1995): 619-624.
  24. Cornejo-Dávila V., et al. “Incidence of Urethral Stricture in Patients With Spinal Cord Injury Treated With Clean Intermittent Self-Catheterization”. Urology 99 (2017): 260-264.
  25. Di Benedetto P. “Clean intermittent self-catheterization in neuro-urology”. European Journal of Physical and Rehabilitation Medicine 47 (2011): 651-659.
  26. Biardeau X and Corcos J. “Intermittent catheterization in neurologic patients: Update on genitourinary tract infection and urethral trauma”. Annals of Physical and Rehabilitation Medicine 2 (2016): 125-129.
  27. Shamout S., et al. “Outcome comparison of different approaches to self-intermittent catheterization in neurogenic patients: a systematic review”. Spinal Cord 55 (2017): 629-643.
  28. Lundgren J., et al. “The importance of osmolality for intermittent catheterization of the urethra”. Spinal Cord 1 (2000): 45-50.
  29. Waller L., et al. “The importance of osmolality in hydrophilic urethral catheters: a crossover study”. Spinal Cord 4 (1997): 229-233.
  30. Mandal AK and Vaidyanathan S. “Management of urethral stricture in patients practising clean intermittent catheterization”. International Urology and Nephrology 4 (1993): 395-399.
  31. Stickler D., et al. “Why are Foley catheters so vulnerable to encrustation and blockage by crystalline bacterial biofilm?”. Urological Research 5 (2003): 306-311.
  32. Stensballe J., et al. “Hydrophilic-coated catheters for intermittent catheterisation reduce urethral micro trauma: a prospective, randomised, participant-blinded, crossover study of three different types of catheters”. European Urology 48 (2005): 978-983.
  33. Jeong SJ and Oh SJ. “Recent Updates in Urinary Catheter Products for the Neurogenic Bladder Patients with Spinal Cord Injury”. Korean Journal of Neurotrauma 2 (2019): 77-87.
  34. Vermeire E., et al. “Patient adherence to treatment: three decades of research. A comprehensive review”. Journal of Clinical Pharmacy and Therapeutics 5 (2001): 331-342.
  35. Chartier-Kastler E., et al. “A prospective, randomized, crossover, multicenter study comparing quality of life using compact versus standard catheters for intermittent self-catheterization”. The Journal of Urology 3 (2013): 942-947.
  36. Crescenze IM., et al. “Predictors of low urinary quality of life in spinal cord injury patients on clean intermittent catheterization”. Neurourology and Urodynamics 5 (2019): 1332-1338.
  37. Cameron AP., et al. “Bladder management after spinal cord injury in the United States 1972 to 2005”. The Journal of Urology 1 (2010): 213-217.
  38. Seth J., et al. “Ensuring patient adherence to clean intermittent self-catheterization”. Patient Prefer Adherence 8 (2014): 191-198.
  39. Van Achterberg T., et al. “Adherence to clean intermittent self-catheterization procedures: determinants explored”. Journal of Clinical Nursing 3 (2008): 394-402.
  40. Faleiros F., et al. “Intermittent Catheterization and Urinary Tract Infection: A Comparative Study Between Germany and Brazil”. Journal of Wound Ostomy and Continence Nursing6 (2018): 521-526.
  41. Kelly L., et al. “Using intermittent self-catheters: experiences of people with neurological damage to their spinal cord”. Disability and Rehabilitation 03 (2014): 220-226.
  42. Yılmaz B., et al. “Intermittent catheterization in patients with traumatic spinal cord injury: obstacles, worries, level of satisfaction”. Spinal Cord 52 (2014): 826-830.
  43. Pinder B., et al. “Patient preferences and willingness to pay for innovations in intermittent self-catheters”. Patient Prefer Adherence 69 (2015): 381-388.
  44. Goessaert AS., et al. “No-touch Intermittent Catheterization: Caregiver Point of View on Sterility Errors, Duration, Comfort and Costs”. Journal of Advanced Nursing 9 (2013): 2000-2007.
  45. Djordjevic ML., et al. “Objective long-term evaluation after bladder autoaugmentation with rectus muscle backing”. The Journal of Urology 5 (2015): 1824-1829.
Citation: Miroslav L Djordjevic., et al. “Impact of Catheter Characteristic on Complications Associated with Clean Intermittent Catheterization: Review of the Literature and Our Experience”. EC Nursing and Healthcare 3.2 (2021): 175-182.

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