Zacharia Saumya Susan, Thomas Raji, George Jacob
Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India.
J Spinal Cord Med. 2025 Sep;48(5):835-841. doi: 10.1080/10790268.2024.2352931. Epub 2024 May 31.
Spinal cord injury often results in neurogenic bladder affecting storage or emptying functions of the bladder. Clean intermittent catheterization (CIC) is considered the gold standard for patients with neurogenic bladder dysfunction. Our study aims to assess the adherence of patients to CIC following discharge from rehabilitation.
: To assess the adherence of patients with spinal cord injury in the community to self-CIC within 12 months of discharge. : To study the reasons and analyze the factors associated with discontinuation of CIC and to assess the perception of patients regarding CIC.
Prospective follow-up of a retrospective cohort in 121 individuals with paraplegia who were trained to do CIC for bladder management. After obtaining telephonic consent, a questionnaire-based interview was conducted.
Out of 121 patients, 97 (80.2%) were males and 24 (19.8%) were females. The mean age was 35.8 ± 11.6 years. About 89 (73.6%) patients were continuing CIC as the primary mode of bladder management after discharge. However, only 18 (15%) patients were fully compliant with the CIC technique, 71 (59%) were partially compliant and 32 (26%) patients discontinued CIC. Reasons for the discontinuation of CIC included medical complications (78%), including leaks, recurrent UTI, hematuria, ulcers, back pain, and spasticity, and other factors like difficulty in following the timing of CIC (12.5%), issues with positioning (3.1%), and difficulty in restricting fluid intake (6.3%).
This study highlights the need for regular follow-up as well as education of patients regarding CIC technique, complications, care, and hygiene while doing CIC which can result in improved adherence to CIC.
脊髓损伤常导致神经源性膀胱,影响膀胱的储存或排空功能。清洁间歇性导尿(CIC)被认为是神经源性膀胱功能障碍患者的金标准。我们的研究旨在评估患者康复出院后对CIC的依从性。
评估脊髓损伤患者在出院后12个月内对自我CIC的依从性。研究CIC中断的原因并分析相关因素,评估患者对CIC的认知。
对121例截瘫患者进行回顾性队列的前瞻性随访,这些患者接受了CIC膀胱管理培训。在获得电话同意后,进行了基于问卷的访谈。
121例患者中,男性97例(80.2%),女性24例(19.8%)。平均年龄为35.8±11.6岁。约89例(73.6%)患者出院后继续将CIC作为膀胱管理的主要方式。然而,只有18例(15%)患者完全依从CIC技术,71例(59%)部分依从,32例(26%)患者停止了CIC。停止CIC的原因包括医学并发症(78%),如漏尿、复发性尿路感染、血尿、溃疡、背痛和痉挛,以及其他因素,如难以遵循CIC的时间安排(12.5%)、体位问题(3.1%)和难以限制液体摄入(6.3%)。
本研究强调了定期随访以及对患者进行CIC技术、并发症、护理和卫生方面教育的必要性,这可以提高对CIC的依从性。