title: Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study.
abstract: METHODS
  Retrospective review of medical notes.
  
  
  OBJECTIVE
  To evaluate spinal cord injury (SCI) patients' compliance with bladder emptying method at long-term period after discharge and determine the frequency of urinary tract infections (UTIs).
  
  
  METHODS
  Inpatient rehabilitation unit of tertiary research hospital.
  
  
  METHODS
  Bladder management method of 164 new spinal cord injured patients were noted at discharge from rehabilitation center and follow-up. Patients were questioned whether they continued the initial bladder emtying method at follow-up, reasons for discontinuation and the history of treated UTIs.
  
  
  RESULTS
  The most common bladder management method at discharge from inpatient rehabilitation center was clean intermittent catheterization (CIC) (63.4%). At follow-up 42% of the patients who used CIC changed their bladder emptying method. Rate of reverting to urethral indwelling catheter (IC) was 21.4%. Reasons for the patients who switched to IC application were recurrent UTIs, incontinence, nephrolithiasis, dependence on care givers and urethral strictures. For all patients, the frequency of treated UTI in 1 year was 38.8%. The number of UTIs were highest in patients using IC.
  
  
  CONCLUSIONS
  Many factors, including urological complications, patient's preference, living environment, life-style and level of injury should be considered in deciding the method of bladder management in SCI patients. The CIC is a reliable and effective method in selected SCI patients. Despite changes in bladder emptying method, CIC was the most preferred method at long-term follow-up. Education of patients on catheterization technique and periodic follow-up is necessary to maintain patient compliance.
authors.affiliation: Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Baskent University, Ankara, Turkey. ikbaliafsar@hotmail.com
authors.forename: S I
authors.initials: SI
authors.lastname: Afsar
authors.forename: O U
authors.initials: OU
authors.lastname: Yemisci
authors.forename: S N S
authors.initials: SN
authors.lastname: Cosar
authors.forename: N
authors.initials: N
authors.lastname: Cetin
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D057928:Intermittent Urethral Catheterization / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010351:Patient Discharge; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D055815:Young Adult