Detrusor Underactivity and Acontractile Bladder Patients Performing Clean Intermittent Catheterization in a Single Tertiary Referral Center: What is Happening in Real Life?

Abstract

Objectives: Bladder emptying disorders, caused by detrusor underactivity (DU) and acontractile detrusor (ACD) are frequent conditions, where the focus of treatment is often targeted on minimizing secondary complications by bladder catheterization. If feasible, the preferred method is clean intermittent catheterization (CIC). In this study, we investigate underlying diseases, clinical and urodynamic parameters of a real-life cohort of DU and ACD patients requiring CIC.

Methods: We performed a retrospective chart review of 133 patients performing CIC due to DU or ACD from 2015 to 2020. Demographic, clinical and urodynamic data were extracted for further analyses.

Results: Of 133 patients included, 74% had ACD. Neurogenic diseases were present in 47% of patients, followed by pelvic surgery (23%) and pharmacotherapy (14%). Persistent need for bladder drainage on the long term was observed in 75% of patients. Of patients who discontinued CIC, 44% had a successful treatment. Sacral neuromodulation was the most frequent successful treatment in 56% of patients. Urine tract infections (UTIs) were present in one third of patients.

Conclusions: In this patient cohort needing CIC, ACD was more frequent than DU. Most patients who need CIC for DU or ACD require bladder drainage on the long term. Underlying neurogenic diseases are the most frequent.