Long‐term intermittent catheterization: Safety and outcomes from a prospective observational study

Abstract Objectives The aim of this study was to evaluate long‐term safety, urological complication rates and quality of life (QoL) associated with urethral intermittent catheterization (IC) over a 5‐year follow‐up in adult, established, experienced subjects with longstanding IC use. Patients and Methods Prospective, noninterventional, observational cohort study at three European sites. Adults (≥18 years) performing urethral IC with LoFric™ catheters for ≥6 years prior to enrolment were followed for 5 years. Outcomes included symptomatic urinary tract infections (UTIs), urethral strictures, bladder stones, prostatitis, epididymitis, patient‐reported outcomes (PROs) and perception of catheters and IC. QoL, including pain and discomfort, anxiousness and depression, self‐care and performing usual activities, was evaluated through the EQ 5DL questionnaire. Results Ninety‐eight participants were enrolled (April 2015–August 2018); 49 completed 5‐year follow‐up (PP). Median age at inclusion was 61 years; 69% were male. Median follow‐up was 5 years; mean prior LoFric use was 13 years (range 6–30). Neurological conditions comprised 51% of underlying aetiologies. Across 5 years, there were no significant changes in UTI frequency, other urological complications, EQ‐5D tariff, or PRO ratings. At baseline, 59% (PP) reported ≥1 UTI in the prior 12 months versus 55% at Year 5 ( p = 0.8036); mean UTIs decreased from 3.93 to 3.63 ( p = 0.5434). Urethral stricture reports rose from 6% to 12% (NS). EQ‐5D tariff remained stable (mean 0.86 at inclusion and Year 5). Conclusions In adults with more than a decade of prior IC experience, continued use of hydrophilic LoFric catheters over an additional 5 years was associated with unchanged complication rates and stable QoL and PROs, supporting the long‐term safety of IC as a bladder management strategy.