DETERMINATION OF THE BENEFITS AND COMPLICATIONS OF CLEAN INTERMITTENT CATHETERIZATION TO SPINAL CORD INJURED PATIENTS

Abstract

Background: Intermittent catheterization (IC) is the best method for bladder emptying in patients with spinal cord lesions who are suffering from neurogenic bladder dysfunction. This is safe and effective method, leads to improved kidney and upper urinary tract status, lessening of vesicoureteral reflux and improved of continence and reduce urinary tract infection (UTI). In addition, patient quality of life is enhanced by the increased independence and security offered by use self-Intermittent catheterizations (1, 2).  

Objective: Determine the benefits of using clean intermittent catheters for patients with spinal cord injury at regular intervals daily to empty the bladder and identify the complications from its use

Methodology:  A quantitative descriptive design study was carried out at Ibn Al-Kuff hospital for spinal cord injuries  in Baghdad city, included (60) male spinal cord injured patients from the period 14^th February 2021 to 20^th April 2022. A non-probability (purposive) sample of (60) male spinal cord injured (SCI) patients with paraplegia and tetraplegia were selected from different ages and educational levels who admitted to the hospital for rehabilitation. For the purposes of this study, a questionnaire format was used for data collection which consisted three major parts with total (26) items; the first part is concerned with patients' socio- demographic characteristics which include (4) items; (age, and level of education, marital status, and occupation before injury), the second part  is dealing with the clinical characteristics of SCI patients and the complication that occurs as a result of patients using clean intermittent catheters, which consist of (7) items, and the third part consist observational checklists to evaluate patients' practices concerning clean Intermittent catheterization (CIC) include (15) items.

The validity of questionnaire was estimated through a penal of experts related to the field of study, and its reliability was estimated through conducted a pilot study included (10) SCI patients. Data were analyzed through the application of descriptive and inferential statistical analysis.

Results: the present study included (60) male paraplegic patients, half of them at age group between (18-27) years old, and 33 (55%) of them were single.  Regarding to the level of education, the majority24 (40%) of the study sample were primary school graduated. Furthermore, 24 (40%) of them were employee before injured.

 Concerning to the clinical characteristics of patients, the study indicates that (48 (80%) of sample were paraplegic patients, and 41(68.3%) were complete paralysis, and 55(91.7%) of them the cause of injury was Traumatic SCI.

Furthermore, 51(85%) of them use self-clean intermittent catheterization, concerning to the Number of daily catheterizations, 33(55%) of them used it from 7- and more daily, while 34(56.7%) of them, the Time between catheter and the next was each two hours. Concerning to the urinary complication occurs during last 3 months associated with intermittent catheterization, 22(36.7%) of sample had urinary tract infections (UTIs).

Conclusions: The current study has demonstrated that the practices of spinal cord injury patients with regard to clean intermittent catheters were acceptable and regular, and it was beneficial to them, as it reduced complications, especially urinary tract infections, noting the need to increase the time between each interval of catheterization to (4-6) hours for each period.

Recommendations: The study recommends that there is a need for continuous training program toward clean intermittent catheterization (CIC), for all patients, and a need for implement health educational program to  all  SCI patients (male and female) to improve their knowledge and practices.