Clean intermittent catheterization (CIC) is the standard of care for patients with chronic retention of urine, particularly those with spinal cord injury, multiple sclerosis, and other causes of neurogenic lower urinary tract dysfunction, as well as in cases of idiopathic and non-neurogenic bladder dysfunction. The aim of this literature scoping review was to analyze the functional, practical, and psychological barriers to successful adoption and continuation of CIC among eligible patients. It also considers key principles of education on CIC for patients and healthcare professionals and the potential value of specific educational interventions.
We conducted a literature scoping search on PubMed and Embase. The findings have been classified into the following four main categories: (A) functional ability as a driver of success or failure; (B) practical and psychological barriers; (C) guiding principles for designing patient education and training the trainers; (D) value of specific educational interventions.
(A) Physical challenges can fundamentally affect ability to implement CIC. A number of studies focus specifically on degree of functional ability as a driver of success or failure. (B) As for practical and psychological barriers, specific numbers of common themes emerged from the studies, including education and support, access to choice of products, urinary tract infections and other medical complications, planning timings and opportunities for catheterization, and emotional adjustment. (C) Several studies highlight the need for evidence-based care and a structured, consistent approach, along with the need of verbal explanation, practical instruction, and written information. It has been noted that clinical staff who teach CIC should themselves be trained in a standardized way. (D) Relatively few studies have investigated specific educational interventions like web-based support, a centralized education system, or a simulator.
Despite CIC is a widely recognized and accepted tool, its acceptance and long-term integration into patients' daily lives is often challenging. Functional, practical and psychological barriers may affect patients' adherence. Further studies are needed to gain a more in-depth knowledge of this specific issue.
Not applicable.
Neurourology and urodynamics. 2025 Oct 14 [Epub ahead of print]
Daniele Bianchi, Eleonora Rosato, Stefano Terzoni, Andrea Turbanti, Simone Pletto, Enrico Finazzi Agrò
Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy., Department of Biomedical Sciences for Health, University of Milan, Milan, Italy., Department of Surgical Sciences, Urology Unit, Policlinico Tor Vergata University Hospital, Rome, Italy.