Cross-sectional study by members of patient advocacy groups.
To evaluate the incidence and frequency of symptomatic urinary tract infection (sUTI) in persons with spinal cord lesion (SCL) using different types of catheters based on an internet survey in Japan.
An internet survey.
We conducted an Internet survey of persons with SCL who were considered to be able to perform intermittent self-catheterization (ISC). We evaluated the incidence and frequency of sUTI over the last year in persons performing ISC and those managed by indwelling catheterization (IDC). We also compared the same parameters between persons in the ISC group using reusable silicone catheters and single-use catheters and those with and without a concomitant use of intermittent balloon catheters (i-IDC).
Two-hundred and eighty-two persons were analyzed. In the ISC and IDC groups, sUTI occurred in 52.2% and 31.4% of persons (p = 0.021), respectively, in the last year, and the frequencies were 2.8 and 3.5 times a year (p = 0.127), respectively. There were no significant differences in the incidence or frequency of sUTI between persons using reusable catheters and single-use catheters or those with and without the concomitant use of i-IDC.
sUTI occurred in about 1 in 2 persons with SCL performing ISC, which was significantly higher than in the IDC group, and the frequency of sUTI in persons performing ISC was about 3 times a year. The different types of catheters used for ISC were not associated with the incidence or frequency of sUTI.
Sponsorship Coloplast Japan Inc.
This is a preview of subscription content, access via your institution
Subscribe to this journal
Receive 1 print issues and online access
We are sorry, but there is no personal subscription option available for your country.
Rent or buy this article
Prices vary by article type
Prices may be subject to local taxes which are calculated during checkout
The data generated and analyzed during this study can be found within the published article.
Sekido N, Igawa Y, Kakizaki H, Kitta T, Sengoku A, Takahashi S, et al. Clinical guidelines for the diagnosis and treatment of lower urinary tract dysfunction in patients with spinal cord injury. Int J Urol. 2020;27:276–88.
Romo PGB, Smith CP, Cox A, Averbeck MA, Dowling C, Beckford C, et al. Non-surgical urologic management of neurogenic bladder after spinal cord injury. World J Urol. 2018;36:1555–68.
Biardeau X, Corcos J. Intermittent catheterization in neurologic patients: update on genitourinary tract infection and urethral trauma. Ann Phys Rehabil Med. 2016;59:125–9.
Kinnear N, Barnett D, O’Callaghan M, Horsell K, Gani J, Hennessey D. The impact of catheter-based bladder drainage method on urinary tract infection risk in spinal cord injury and neurogenic bladder: a systematic review. Neurourol Urodyn. 2020;39:854–62.
Coyne KS, Sexton CC, Kopp ZS, Luks S, Gross A, Irwin D, et al. Rationale for the study methods and design of the epidemiology of lower urinary tract symptoms (EpiLUTS) study. BJU Int. 2009;104:348–51.
Intermittent Balloon Catheter. https://www.dib-cs.co.jp/intermittent-balloon-catheter/. DIB International Co., Ltd. Accessed 16 Jun 2022.
DIB CAP. https://www.dib-cs.co.jp/dib-cap/. DIB International Co., Ltd. Accessed 15 Oct 2022.
OT-balloon catheter. https://www.otsukakj.jp/med_nutrition/archives/urination/catheter/ or https://www.otsukakj.jp/en/news_release/20220729.html. Accessed 15 Oct 2022.
Krebs J, Wöllner J, Pannek J. Risk factors for symptomatic urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction. Spinal Cord. 2016;54:682–6.
Singh R, Rohilla RK, Sangwan K, Siwach R, Magu NK, Sangwan SS. Bladder management methods and urological complications in spinal cord injury patients. Indian J Orthop. 2011;45:141–7.
Weld KJ, Dmochowski RR. Effect of bladder management on urological complications in spinal cord injured patients. J Urol. 2000;163:768–72.
Afsar SI, Yemisci OU, Cosar SN, Cetin N. Compliance with clean intermittent catheterization in spinal cord injury patients: a long-term follow-up study. Spinal Cord. 2013;51:645–9.
Roth JD, Pariser JJ, Stoffel JT, Lenherr SM, Myers JB, Welk B, et al. Patient subjective assessment of urinary tract infection frequency and severity is associated with bladder management method in spinal cord injury. Spinal Cord. 2019;57:700–7.
Pinder B, Lloyd AJ, Nafees B, Elkin EP, Marley J. Patient preferences and willingness to pay for innovations in intermittent self-catheters. Patient Prefer Adherence. 2015;9:381–8.
Linsenmeyer TA. Catheter-associated urinary tract infections in persons with neurogenic bladders. J Spinal Cord Med. 2018;41:132–41.
Håkansson MÅ. Reuse versus single-use catheters for intermittent catheterization: what is safe and preferred? Review of current status. Spinal Cord. 2014;52:511–6.
Christison K, Walter M, Wyndaele JJM, Kennelly M, Kessler TM, Noonan VK, et al. Intermittent catheterization: the devil is in the details. J Neurotrauma. 2018;35:985–9.
Prieto JA, Murphy CL, Stewart F, Fader M. Intermittent catheter techniques, strategies and designs for managing long-term bladder conditions. Cochrane Database Syst Rev. 2021;10:CD006008. https://doi.org/10.1002/14651858.CD006008.
New PW. The evidence supporting single-use intermittent catheters in people with spinal cord injury. Spinal Cord Ser Cases. 2020;6:89. https://doi.org/10.1038/s41394-020-00339-5.
Sun AJ, Comiter CV, Elliott CS. The cost of a catheter: an environmental perspective on single use clean intermittent catheterization. Neurourol Urodyn. 2018;37:2204–8. https://doi.org/10.1002/nau.23562.
Department of Economics and Social Affairs. Sustainable Development Goals. United Nations. https://sdgs.un.org/goals. Accessed 16 Jun 2022.
Del Popolo G, Antonucci L. Disability and sustainability: reusable versus single-use catheters for persons with neurogenic bladder due to spinal cord injury. Spinal Cord Ser Cases. 2020;6:90. https://doi.org/10.1038/s41394-020-00340-y
Kovindha A, Mai WN, Madersbacher H. Reused silicone catheter for clean intermittent catheterization (CIC): is it safe for spinal cord-injured (SCI) men? Spinal Cord. 2004;42:638–42.
van Doorn T, Berendsen SA, Scheepe JR, Blok BFM. Single use versus reusable catheters in intermittent catheterisation for treatment of urinary retention: a protocol for a multicentre, prospective, randomised controlled, non-inferiority trial (COMPaRE. BMJ Open. 2022;12:e056649. https://doi.org/10.1136/bmjopen-2021-056649.
Ozawa H, Uematsu K, Ohmori H, Kondo A, Iwatsubo E, Takasaka S. Long-term usefulness and safety of the contemporary balloon catheter. Nihon Hinyokika Gakkai Zasshi. 2005;96:541–7.
Koff SA, Gigax MR, Jayanthi VR. Nocturnal bladder emptying: a simple technique for reversing urinary tract deterioration in children with neurogenic bladder. J Urol. 2005;174:1629–32.
Joshi AD, Shukla A, Chawathe V, Gaur AK. Clean intermittent catheterization in long-term management of neurogenic bladder in spinal cord injury: patient perspective and experiences. Int J Urol. 2022. https://doi.org/10.1111/iju.14776.
Ministry of Internal Affairs and Communications. Communication Usage Trend Survey in 2019 Complied. https://www.soumu.go.jp/johotsusintokei/tsusin_riyou/data/eng_tsusin_riyou02_2019.pdf. Accessed 16 Jun 2022.
Goetz LL, Cardenas DD, Kennelly M, Bonne Lee BS, Linsenmeyer T, Moser C, et al. International spinal cord injury urinary tract infection basic data set. Spinal Cord. 2013;51:700–4.
We sincerely appreciate the cooperation of the members of the Non-Profit Organization Japan Spinal Cord Foundation, the Public Interest Incorporated Foundation Spinal Injuries Japan, and the Spina Bifida Association of Japan in the Internet-based survey, as well as the very devoted efforts of Mr. Makoto Ohama, the President of the former two patient advocacy groups and Ms. Tamae Usami, the President of the last group for sending the survey request letter. We also express sincere thanks to Ms. Yuka Tone of INTAGE Healthcare Inc. for creating the survey site and collecting the data. This study was funded by Coloplast Japan Inc. but the company was not involved in collecting, managing, analyzing, and interpreting the data, and preparing the manuscript.
No investigators have individual conflicts of interest to be disclosed with any company including those manufacturing or selling urinary catheters as well as Coloplast Japan Inc.
The protocol for this research project has been approved by a suitably constituted Ethics Committee (the Non-Profit Organization MINS Research Ethics Committee (http://www.npo-mins.com/library/5fcf039bd6164603646daf12/602f7e0c12830e793b214646.pdf) and it conforms to the provisions of the Declaration of Helsinki.
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Sekido, N., Matsuoka, M., Takahashi, R. et al. Cross-sectional internet survey exploring symptomatic urinary tract infection by type of urinary catheter in persons with spinal cord lesion in Japan. Spinal Cord Ser Cases 9, 3 (2023). https://doi.org/10.1038/s41394-023-00559-5