Internal and External Barriers to Bladder Management in Persons with Neurologic Disease Performing Intermittent Catheterization

Int. J. Environ. Res. Public Health, 2023 · DOI: 10.3390/ijerph20126079 · Published: June 8, 2023

Simple Explanation

People with neurogenic lower urinary tract dysfunction (NLUTD) often use clean intermittent catheters (CIC) to manage bladder function. This review discusses the challenges of using catheters due to personal characteristics and external limitations like public toilets. The review covers how age, sex, hand function, caregiver help, time spent on CIC, and incontinence affect CIC use in NLUTD, also considering societal and public health factors. Public toilet problems like lack of access, space, cleanliness, and catheter design are reviewed. These issues significantly affect how people with NLUTD view and handle their bladder care.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Internal barriers such as age, sex, upper extremity motor function, lack of caregiver assistance, time to perform CIC, and urinary incontinence can significantly impact the adoption and adherence to CIC.
2
External barriers, including lack of appropriate space/accessibility, facilities, cleanliness, public understanding, and the cost and type of intermittent catheters, also play a crucial role.
3
Despite CIC being the gold standard, many individuals with NLUTD do not adhere to it long-term due to these intrinsic and extrinsic barriers.

Research Summary

This review outlines significant internal and external barriers that can be encountered by people with NLUTD who perform CIC, including age, sex, upper limb function, caregiver assistance, and public toilet limitations. Internal barriers include factors inherent to the individual, such as age, female sex, hand function, time required to catheterize, urinary incontinence, and limited caregiver support. External barriers encompass challenges encountered outside the home, such as limited wheelchair-accessible stalls, lack of cleanliness in public restrooms, lack of public understanding, and the type and cost of intermittent catheters.

Practical Implications

Improved Patient Counseling

Understanding these barriers is necessary to counsel patients and advocate for beneficial policy changes.

Policy Advocacy

Advocacy for improved public restroom facilities and greater public awareness of the needs of individuals with NLUTD.

Enhanced Quality of Life

Addressing these barriers will lead to improvements in quality of life and social participation for individuals with NLUTD.

Study Limitations

1
The review may be limited by the available literature on the specific barriers encountered by individuals with NLUTD.
2
The review may not fully capture the individual experiences and perspectives of all people living with NLUTD.
3
The solutions proposed may not be feasible or accessible for all individuals due to varying socioeconomic factors.

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