Hygiene management of intermittent self‐catheterization using reusable silicone catheters in people with spinal cord lesions: A cross‐sectional Internet survey in Japan

Abstract

ObjectivesTo investigate hygiene management and catheter maintenance of reusable silicone catheters for intermittent self‐catheterization (ISC) in Japan and examine their relationship with symptomatic urinary tract infection (sUTI).MethodsWe conducted a cross‐sectional Internet survey of people performing ISC using reusable silicone catheters owing to spinal cord lesions in Japan. Hygiene management and catheter maintenance of reusable silicone catheters and the incidence and frequency of sUTI were evaluated. We also examined the significant risk factors for sUTI.ResultsOf 136 respondents, 62 (46%), 41 (30%), and 58 (43%) washed hands with water, washed hands with soap, and cleaned or disinfected the urethral meatus every time or most of the time before ISC, respectively. No significant difference was observed in the incidence and frequency of sUTI between respondents who adhered to these procedures and those who did not. There were no significant differences in the incidence and frequency of sUTI in respondents who changed their catheters every month and in those who changed their preservation solution within 2 days compared with those who did not. In multivariate analysis, pain during ISC, inconvenience of indoor mobility, bowel management problems, and participants' feeling of never having received instruction on catheter replacement were significant risk factors for sUTI.ConclusionsThere are individual differences in hygiene management and catheter maintenance of reusable silicone catheters, but the influence of these differences on the incidence and frequency of sUTI is not clear. Pain during ISC, bowel management problems, and inadequate instruction on catheter maintenance procedures are factors associated with sUTI.

Factors associated with symptomatic urinary tract infection in persons with spinal cord lesions who perform clean intermittent catheterization with single‐use catheters

“…We have already reported findings on topic 1 3 and, subsequently, on the reusable silicone catheter part of topic 2. 7 Therefore, the present study reports findings on the SC part of topic 2. This study was conducted in accordance with the ethical standards of the Declaration of Helsinki and was approved by the ethical committee (the nonprofit organization MINS Research Ethics Committee; http://www.npomins.com/library/5fcf039bd6164603646daf12/602f7e0c12830e793 b214646.pdf).…”

“…21 They highlighted that single-use HCCs improve QoL and were preferred over multiple catheter re-use among men and women practicing intermittent catheterization. 21 The limitations mentioned in our previous reports 3,7 still are relevant to this study: the inherent limitations of an internet survey, no national registration system for SCL in Japan, an exploratory study using data from the burden of illness study, use of self-reported sUTI, misremembering in responses, small sample size, and the dearth of information on the exact neurological level of SCL as well as urodynamic findings. Moreover, except manual dexterity, indoor movement, and bowel management, factors relevant to self-management were not investigated.…”

“…The methods of the survey have been previously reported. 3,7 Briefly, this was a cross-sectional internet survey of adult men and women who perform ISC due to SCL in Japan. We included persons who were 20 years old or older, had a traumatic or nontraumatic spinal cord injury (SCI) or spina bifida, performed ISC for urinary management, were able to access the internet by themselves, and submitted the informed consent.…”

“…For this reason, the PVC and HCC were analyzed together in this study. As previously reported, 3,7 sUTI was defined as self-diagnosis of UTI or healthcare providers' diagnosis of it (Supplementary Table S1). We investigated whether or not the participants had experienced sUTI in the past year and, if they had, the frequency of sUTI was evaluated.…”

“…5,6 We previously investigated these associations in those with SCL performing intermittent self-catheterization (ISC) using a Japanese reusable silicone catheter and demonstrated, for the first time, that the inconvenience of indoor mobility, bowel management problems, inadequate education on how to maintain catheters, and pain during ISC could be associated with sUTI. 7 In the present study, we investigated these associations in Japanese persons with SCL performing ISC with a single-use catheter (SC).…”