Intermittent catheterisation in older people: a valuable alternative to an indwelling catheter?

Objectives: to investigate whether intermittent catheterisation is a valuable alternative to an indwelling catheter in patients older than 70 years with post-void residuals more than 50% of the bladder capacity. Patients and methods: we retrospectively reviewed the medical records of 21 patients (14 women, 7 men) older than 70 years in whom intermittent catheterisation was initiated because of voiding dysfunction with post-void residuals more than 50% of the bladder capacity resistant to other treatment. Twelve patients mastered the technique of intermittent self-catheterisation, seven were catheterised by their partners and two by nurses. Results: the mean age of patients was 76.5 years (range 71–83 years) and the mean observation period with regard to intermittent catheterisation was 27.9 months (range 5–129 months). For those relying on intermittent catheterisation, the urinary tract infection rate was 0.84 per year and patient (range 0–3), and urinary continence was restored in all of the six previously incontinent patients. Eighteen of the 21 patients reported a significantly improved quality of life owing to the restoration of urinary continence, decreasing of daytime frequency, nocturia and urge, and the lowering of the urinary tract infection rate. Conclusions: intermittent (self-) catheterisation is a safe and valuable technique in older people with significant post-void residuals owing to detrusor underactivity. Urinary continence is restored, urge, daytime frequency and nocturia are decreased, and the urinary tract infection rate is diminished, resulting in improved quality of life. Therefore, intermittent (self-) catheterisation is strongly recommended in older people.