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Purpose Study aimed to compare incidence of urinary tract infection (UTI), type of bacteria grown, development of antibiotic resistance over 2 years in children whose caregivers underwent training based on the Roy Adaptation Model with an android phone application for patients clean intermittent catheterization (RAMACIC) versus those whose caregivers received routine training in hospital. Method This study was conducted as a descriptive, prospective study with 40 patients and caregivers between October 2021 and 2023 as a continuation of a previously conducted randomized controlled experimental study by the researchers. Data were collected the “Participant Form,” and “Urine Test Form” analyzed with the SPSS 22 package. Descriptive data were determined by number (n), percentage (%), mean, and standard deviation. The frequency of UTI between the two groups was determined by the Chi-square test, and the effect size of the data was determined by Cramer’s V value of the Chi-square test. Results A significant reduction in UTI incidence among children of RAMACIC-trained caregivers during the first, second, third, and fourth 6-month periods compared with those under routine CIC training was observed ( p  < 0.05). It was determined that E. coli was the most frequently grown bacteria in both groups, with a higher rate in the group receiving routine training in the hospital, and antibiotic resistance was higher in the group receiving routine training in the hospital compared with RAMACIC. Conclusion RAMACIC, when administered to caregivers, effectively lowers the long-term risk of UTI development in patients undergoing CIC, also effective in reducing the antibiotic resistance that developed in patients.

PurposeThe purpose of this study was to investigate the course of bladder evacuation and the predictors of intermittent self-catheterization (ISC) in individuals with neurogenic lower urinary tract dysfunction (NLUTD) during and after primary rehabilitation.MethodsThe patient database of a single spinal cord injury rehabilitation center was screened for patients with NLUTD admitted for primary rehabilitation. Patient characteristics and bladder evacuation details were collected during and after rehabilitation. Binary logistic regression analysis was used to evaluate predictors of ISC: sex, age > 65 years, injury severity, and bladder capacity ≥ 400 ml.ResultsData of 255 men (74.3%) and 88 women (25.7%) with a mean age of 54 ± 19 years were analyzed. Early in rehabilitation, 21.6% of the evaluated individuals used ISC. In 17.8%, the bladder was evacuated by transurethral catheterization (TUC). The proportion of TUC decreased during rehabilitation and dropped below 2% at the last follow-up. In contrast, the proportion of ISC and suprapubic catheterization (SPC) increased to 28% and 12.8%, respectively, during rehabilitation. These proportions increased further thereafter and reached 37.7% and 18.6% for ISC and SPC, respectively. Age and injury severity were significant (p ≤ 0.041) negative predictors, whereas male sex and above-average bladder capacity were positive predictors of ISC.ConclusionsThere is a shift toward bladder evacuation by ISC and SPC during and after primary rehabilitation. Bladder evacuation by ISC, regarded as the gold standard, is less common in individuals > 65 years or with high-level tetraplegia. The optimal bladder evacuation method needs to be established individually, considering all medical and psychosocial factors rather than simply following a guideline.

IntroductionEvaluating the safety and acceptability of reusing catheters for intermittent catheterisation (IC) is one of the top 10 continence research priorities identified by the UK James Lind Alliance Priority Setting Partnership in 2008. There are an estimated 50 000 IC users in England and this number is rising. Globally, both single-use catheters (thrown away after use) and multi-use/reusable ones (cleaned between uses) are used. Using multi-use catheters as well as single-use ones (mixed-use) could bring benefits (eg, reducing plastic waste and patients never running out of catheters) and offer more choice to users. Evidence is needed that mixed-use is at least as safe and acceptable as using only single-use catheters.MethodsThe MultICath Trial is a non-inferiority randomised controlled trial involving 578 participants. The aim is to compare mixed-use catheter management with single-use catheter management over 12 months. Participants are randomised on a 1:1 basis to either mixed-use catheter management, which includes an evidence-based cleaning method for the multi-use catheters (intervention) or single-use catheter management (control). Following randomisation, participants are followed up for 12 months. The primary outcome is at least one episode of microbiologically confirmed symptomatic urinary tract infection with help-seeking or self-help behaviour over the 12-month follow-up period. Laboratory analysis of patient-initiated urine samples is blind. Secondary outcomes include antibiotic use, microhaematuria, visible blood on catheter/in urine, quality of life and health economics. A qualitative sub-study to examine participant experiences using mixed-use is included.Ethics and disseminationEthical review was undertaken by South Central-Hampshire A Research Ethics Committee and favourable opinion was granted on 12 July 2019 (reference: 19/SC/0334). Written, informed consent to participate was obtained from all participants. Results will be disseminated in peer-reviewed publications, in the National Institute for Health and Care Research journal library and to participants and the public via a lay summary published on the trial website.Trial registration number ISRCTN42028483.

This study aimed to compare the knowledge and skill levels of nursing students who received either mobile learning or face-to-face training on intermittent catheterization. Performing Intermittent Catheterization (IC) with the correct technique can significantly prevent catheterization-related complications. Ensuring that nurses are proficient in IC prevents complications and enables timely and accurate execution of the procedure. A parallel-group, non-inferiority, randomized, controlled trial. A total of 74 fourth-year nursing students in Türkiye were randomly assigned to either the face-to-face training (n = 37) or mobile learning group (n = 37) using block randomization. The study provided intermittent catheterization training via mobile application or traditional face-to-face instruction between April 10 and April 17, 2025. Data were collected using the IC Knowledge test and a skills checklist for both male and female catheterization procedures. No significant difference was determined in the IC knowledge score between mobile learning (14.21 SD 1.58) and face-to-face training (13.56 SD 1.78) groups. There was also no significant difference in the skill performance score between the mobile learning (18.51 SD 1.57/19.13 SD 1.15) and face-to-face training (18.62 SD 1.31/18.56 SD 1.70) groups in respect of female/male catheterization procedures. The results showed that mobile learning on IC was non-inferior (non-inferiority margin: −1.02, 95 % CI: −0.13–1.43). Mobile learning was found to be as effective as face-to-face training in enhancing both knowledge and practical skills in intermittent catheterization. Mobile applications can be considered as a supplement to face-to-face training in nursing education or as an alternative when face-to-face training is not possible. •Intermittent catheterization (IC) is widely used to drain urine in neurogenic bladder, benign prostatic hyperplasia, and other conditions.•There is limited evidence on the use of technology-based educational methods in IC training.•Mobile learning is as effective as face-to-face training in improving IC knowledge and practical skills.•Mobile apps may supplement face-to-face IC education or serve as an alternative when in-person is not possible.

Background Bladder dysfunction, notably urinary retention, emerges as a significant complication for cervical cancer patients following radical hysterectomy, predominantly due to nerve damage, severely impacting their postoperative quality of life. The challenges to recovery include insufficient pelvic floor muscle training and the negative effects of prolonged postoperative indwelling urinary catheters. Intermittent catheterization represents the gold standard for neurogenic bladder management, facilitating bladder training, which is an important behavioral therapy aiming to enhance bladder function through the training of the external urethral sphincter and promoting the recovery of the micturition reflex. Nevertheless, gaps remain in current research regarding optimal timing for intermittent catheterization and the evaluation of subjective symptoms of bladder dysfunction. Methods Cervical cancer patients undergoing laparoscopic radical hysterectomy will be recruited to this randomized controlled trial. Participants will be randomly assigned to either early postoperative catheter removal combined with intermittent catheterization group or a control group receiving standard care with indwelling urinary catheters. All these patients will be followed for 3 months after surgery. The study’s primary endpoint is the comparison of bladder function recovery rates (defined as achieving a Bladder Function Recovery Grade of II or higher) 2 weeks post-surgery. Secondary endpoints include the incidence of urinary tract infections, and changes in urodynamic parameters, and Mesure Du Handicap Urinaire scores within 1 month postoperatively. All analysis will adhere to the intention-to-treat principle. Discussion The findings from this trial are expected to refine clinical management strategies for enhancing postoperative recovery among cervical cancer patients undergoing radical hysterectomy. By providing robust evidence, this study aims to support patients and their families in informed decision-making regarding postoperative bladder management, potentially reducing the incidence of urinary complications and improving overall quality of life post-surgery. Trial registration ChiCTR2200064041, registered on 24th September, 2022.

PurposeIntermittent catheterization (IC) is a proven effective long-term bladder management strategy for individuals who have lower urinary tract dysfunction. This study provides clinical evidence about multiple-reuse versus single-use catheterization techniques and if catheter choice can have an impact on health-related quality of life (HRQoL). MethodA prospective, multi-center, clinical trial studied patients who currently practiced catheter reuse, and who agreed to prospectively evaluate single-use hydrophilic-coated (HC) (i.e. LoFric) catheters for 4 weeks. A validated Intermittent Self-Catheterization Questionnaire (ISC-Q) was used to obtain HRQoL. Reused catheters were collected and studied with regard to microbial and debris contamination. ResultsThe study included 39 patients who had practiced IC for a mean of 10 years, 6 times daily. At inclusion, all patients reused catheters for a mean of 21 days (SD = 48) per catheter. 36 patients completed the prospective test period and the mean ISC-Q score increased from 58.0 (SD = 22.6) to 67.2 (SD = 17.7) when patients switched to the single-use HC catheters (p = 0.0101). At the end of the study, 83% (95% CI [67–94%]) preferred to continue using single-use HC catheters. All collected reused catheters (100%) were contaminated by debris and 74% (95% CI [58–87%]) were contaminated by microorganisms, some with biofilm.ConclusionSingle-use HC catheters improved HRQoL and were preferred over catheter reuse among people practicing IC. Catheter multiple-reuse may pose a potential safety concern due to colonization by microorganisms as well as having reduced acceptance compared to single use.Trial registry numberClinicalTrials.gov NCT02129738.

Objective: To evaluate the performance of a new 30-cm-long, telescoping male intermittent catheter (SpeediCath Compact Male; Coloplast A/S, Humlebæk, Denmark) in urinary bladder emptying, safety and subject acceptance vs a standard-length male intermittent catheter (SpeediCath). Materials and methods: In a prospective, randomized, multicenter, crossover non-inferiority study, 37 male intermittent catheter users self-catheterized three times with the test catheter on one test day and three times with the standard-length male (reference) catheter on another test day. Residual urine (RU) volume in the bladder after catheterization was measured by ultrasound. Safety was assessed in the entire study period in terms of adverse events (AEs) and adverse device events (ADEs). Subjects evaluated their experience, sensation, disposal, bleeding and discomfort with the test and reference catheters and final catheter preference. Results: SpeediCath Compact Male did not differ from the reference catheter in terms of performance (bladder emptying). The upper confidence limit of the mean difference between absolute RU volumes for the test and reference catheter groups did not exceed a pre-established non-inferiority limit of 20 ml, thereby showing the test catheter's non-inferiority to the reference catheter (that is, no worse at bladder emptying). The only AE/ADE reported was one instance of mild urethral burning for 30 min after catheterization, which was judged possibly related to the test catheter but resolved quickly. Conclusions: The SpeediCath Compact Male catheter is as efficient as a conventional intermittent catheter (SpeediCath) at emptying the bladder with the additional benefit of being more discreet and easier to use.

Previous studies have demonstrated that intermittent catheterization (IC) is an effective management strategy for neurogenic bladder (NB), but the knowledge of medical staff in this field remains under-researched. This cross-sectional study aimed to explore the profile of medical staff’s knowledge regarding IC in NB management and its associated factors. In August 2023, we conducted a convenience sampling survey involving 207 eligible medical staff from high-prevalence departments of NB at a tertiary general hospital in Nanchong, Southwest China. Data analysis was performed using latent class analysis (LCA) and logistic regression analysis. The results showed that respondents’ knowledge of IC in NB management scored 10.27 ± 2.89 (maximum possible score of 16). The LCA identified two distinct profiles: a high knowledge group (57.97%) and a low knowledge group (42.03%). Logistic regression revealed that individuals with a college degree or above (OR = 2.15, 95% CI 1.14–4.07), those focusing on NB management (OR = 4.07, 95% CI 2.21–7.49), and those who received relevant training (OR = 2.81, 95% CI 1.57–5.02) were more likely to be in the high level group. Additionally, variations in knowledge profiles were observed across different departments. These findings indicate a need to enhance medical staff’s understanding of IC in NB management in high-prevalence departments of NB, with targeted training programs as a potential solution. Notably, the use of convenience sampling and a single-center design in this study may constrain the generalizability of these findings, necessitating multicenter validation studies in the future.

Study design: Prospective, unblinded, multicenter, randomized, controlled, cross-over study assessing user preference and ease of use characteristics of two gel intermittent catheters in 81 self-catheterizing wheelchair-using men. Objectives: To evaluate the male user’s preference between a 30-cm and a 40-cm intermittent catheter (Apogee Intermittent Catheter, Hollister Incorporated, Libertyville, IL, USA) regarding the ease of insertion and removal, ability to control the catheter during insertion, bladder emptying confidence and ease of draining urine into a receptacle or connecting to a urine bag. Setting: Multiple institutions in the United States. Methods: Subjects were randomized to order of catheter use, using both 10 test catheters (30-cm) and 10 control catheters (40 cm). All catheters were 12 or 14 French and identical in design and composition, except length. Safety was assessed during the entire study period regarding adverse events (AE) and adverse device events (ADE). Subjects evaluated their ease of use characteristics after each catheter use and final catheter preference. Results: Subjects preferred the Apogee 40-cm intermittent catheter (91.4%) over the 30-cm length (8.6%). The preference was due to subject confidence of complete bladder emptying (70%), more satisfactory length (74%) and easier to drain into a receptacle (58%) with a portable urinal being the most utilized (37%), followed by toilet (35%). The only AE/ADE reported was minor urethral bleeding in one subject and minor pain in another subject, both with the 30-cm catheter. None were reported with the 40-cm catheter. Conclusions: The Apogee 40-cm catheter was the preferred intermittent catheter due to subject confidence in bladder emptying, ease of catheter manipulation and the ease of draining urine into a receptacle.

BackgroundHydrophilic coated catheters are recommended to reduce the side effects of intermittent catheterization (IC) in patients with bladder dysfunction. However, there is lack of Level one evidence to support the use of this intervention.Search methodsSeveral electronic databases were systematically searched to evaluate complication incidences for hydrophilic coated (HC) and non-hydrophilic catheters (NHC).ResultsTwelve studies were eligible for inclusion in the review. The meta-analyses exploring microscopic hematuria frequencies (RR = 0.69; 95% CI 0.52–0.90) and urethral stricture frequencies (RR = 0.28; 95% CI 0.13–0.60) showed a lower risk ratio associated with HC in comparison to NHC, whereas gross hematuria was no statistically significant difference in two groups. Subgroup analyses of gross hematuria which was grouped according to \"catheterization frequency\", \"single/multiple catheterization\" and \"self/other catheterization” were performed and the values of combined RR were also no statistically significant difference.ConclusionsCompared with non-hydrophilic catheters, the hydrophilic coated catheters have positive significance in reducing the incidence of urethral microtrauma and the urethral stricture. However, more studies are warranted for evaluating effects of hydrophilic coated catheters on the incidence of gross hematuria.