The prevalence of urinary catheterization in women and men with multiple sclerosis

Abstract

Context/objective

To determine the prevalence of urinary catheterization in patients with multiple sclerosis (MS).

Design/intervention

After obtaining Institutional Review Board exemption, results from the Fall 2005 North American Research Committee on Multiple Sclerosis (NARCOMS) survey were reviewed.

Participants

Respondents to the fall 2005 NARCOMS survey.

Outcome measures

Responses to the Urogenital Distress Inventory (UDI-6), the Short Form-12 (SF-12), the Patient Determined Disease Steps measure of physical disability, and urologic history were analyzed using descriptive statistics, the χ² and Student's t-tests, and multivariable logistic and linear regression.

Results

Of 9702 (58%) responses were returned, excluding respondents with prior bladder surgery, 9676 participants were reviewed: primarily white (92.9%), women (75.3%), with average age of diagnosis of 30.2 (SD 10.0) years. Urinary catheterization was reported by 2514 (26%) respondents, with 1091 (11%) reporting current and 1423 (15%) past catheter use. Among all catheter types (possibly ≥1), intermittent self-catheterization was most common (81%), followed by transurethral Foley catheterization (43%) and suprapubic catheterization (8%). Males were more likely to catheterize than females (32 versus 24%, P < 0.001) and use indwelling methods (P < 0.001). Catheterizing patients reported longer disease duration, greater physical disability, increased overactive bladder symptoms, and reduced quality of life (QoL) scores (all P < 0.001).

Conclusions

This is the first study to demonstrate significant rates (1 in 4) of urinary catheterization in patients with MS. Although thought to be common, the true rates of catheter use among MS patient were previously unknown. Urinary catheterization appears to be associated with reduced QoL, increased physical disability and longer disease duration as well.

Keywords:

• Myelopathy
• Urinary catheter
• Multiple sclerosis
• Neurogenic bladder
• Disability
• Voiding dysfunction
• Quality of life
• Incomplete emptying
• Detrusor overactivity
• Urinary catheterization