Self-catheterization during adolescence.
OBJECTIVE
It has been suggested that clean intermittent catheterization (CIC) during the teenage years is associated with poor motivation to comply with the treatment, recurrent urinary tract infections and epididymitis. The aim of this study was to identify the main problems and complications associated with self-CIC in a group of adolescents with no overt neurological problems.


METHODS
The medical records of 24 boys and girls aged >/=12 years on self-CIC with severe bladder dysfunction and intact perineal sensibility and motor function in the lower limbs were reviewed. The median age of the patients was 16.5 years (range 12-24 years) and they had been on CIC for a median of 11 years (range 2-16 years).


RESULTS
No urethral damage was reported. Of the 11 patients (46%) who had good CIC routines, two had cystitis and none had epididymitis. Thirteen patients (54%) reported a poor CIC regimen at a median age of 11.5 years (range 9-16 years). In this group, 10 had recurrent cystitis, five had pyelonephritis, four had increasing creatinine levels and three of nine boys had epididymitis.


CONCLUSIONS
One of the main problems associated with CIC during adolescence is poor compliance with the treatment. Epididymitis and recurrent urinary tract infections were seen more frequently in connection with poor CIC routines.
Holmdahl
Gundela
G
Pediatric Urology and Nephrology Centre, Queen Silvia Children's Hospital, Göteborg, Sweden. gundela.holmdahl@vgregion.se
Sillén
Ulla
U
Abrahamsson
Kate
K
Hellström
Annalena
A
Kruse
Sonja
S
Sölsnes
Ewa
E
D000293:Adolescent; D002648:Child; D003404:Creatinine / Q000652:urine; D004823:Epididymitis / Q000209:etiology / Q000517:prevention & control / Q000652:urine; D005260:Female; D005835:Genitalia / Q000002:abnormalities / Q000503:physiopathology; D006801:Humans; D008297:Male; D010349:Patient Compliance; D051437:Renal Insufficiency / Q000209:etiology / Q000517:prevention & control / Q000652:urine; D012189:Retrospective Studies; D012648:Self Care / Q000523:psychology*; D001745:Urinary Bladder Diseases / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D014546:Urinary Catheterization / Q000009:adverse effects / Q000379:methods*; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control / Q000652:urine
D003404:Creatinine