Age and factors associated with self-clean intermittent catheterization in patients with spina bifida

Abstract

Purpose: The purpose of this study is twofold: 1) to determine the age when a child with spina bifida (SB) will most likely transition from caregiver clean intermittent catheterization (CIC) to self-CIC, and 2) to identify factors associated with self-CIC in children older than that age.

Methods: This is a retrospective, single-institution cohort study of individuals with SB. Data were collected prospectively as part of the National Spina Bifida Patient Registry. For Aim 1, we identified all individuals who perform self-CIC and who had a documented transition from caregiver-CIC. We then determined the age of transition to self-CIC. For Aim 2, we compared individuals over age 10 years (age cutoff determined by Aim 1) who use self-CIC to those who use caregiver-CIC to determine what variables were associated with self-CIC.

Results: From our SB population, 206 individuals used self-CIC. Of these, 64 patients had documented ages of transition from caregiver- to self-CIC. 46 (71.9%) and 56 (87.5%) patients had transitioned to self-CIC by 10 and 14 years, respectively. For Aim 2, we used age 10 as a cutoff, based on the findings from Aim 1, and found that 287/696 patients were ⩾ 10 years and using CIC. Factors independently associated with lower likelihood of self-CIC were thoracic spinal lesions (odds ratio (OR) 0.45) and Medicaid insurance (OR 0.24).

Conclusions: The ages at self-CIC transition vary, although most patients transition by age 10. Thoracic-level spinal lesions and Medicaid insurance are associated with lower odds of self-CIC.

Keywords: Spina bifida; adult; clean intermittent catheterization; pediatric; urologic management.

Conflict of interest statement

1. Statement of Conflicts of Interest

All other authors certify that they have no financial conflict of interest relevant to the publication of the subject matter or materials in this manuscript.

Figures

Figure 1.

Patient selection for Aim 1 (left; age at transition to self-CIC; 64 patients) and Aim 2 (right; factors associated with CIC independence; 287 patients).

Figure 2.

Number of patients transitioning to self-CIC per year (columns) and total percent of 64 patients having transitioned (line).