The International Continence Society (ICS) survey on intermittent catheterization and global practices with regard to the reuse of catheters

To survey members of the International Continence Society (ICS) for exploring global differences in practices with regard to intermittent catheterization (IC) and reuse of catheters in the neuro-urological patient. A project of the Neuro-Urology Promotion Committee (NUPC) of the ICS. Cross-sectional survey of ICS members using the SurveyMonkey platform. Initial survey preparation, revisions, pilot, and finalization were performed within the NUPC. Opt-in survey emailed to all members by the ICS office. Foundation questions ascertained type of clinical practice, health care system, and country of residence which was stratified by World Bank criteria as ‘high-income group, HIG’ or ‘not high-income group, non-HIG’ for analysis. Several questions addressed the reuse of catheters and related practices. Survey results were analyzed using R (version 3.1.3) statistical analysis (p-value <0.05 significant, two-way testing). 244 out of 1107 members (22.0%) responded. Respondents were from 57 countries including 89 (36.5%) from non-HIG countries. 61.1% respondents were urologists and 62.7% were working at public teaching hospitals. Single-use catheters were prescribed by 113 (46.7%), reuse by 51 (21.1%), and both techniques by 78 (32.2%). Reuse was reported by 38.3% and 76.4% of respondents from HIG and non-HIG countries, respectively. There was marked variation with regard to the frequency of IC, method of cleaning of hands and genitalia, and the method of cleaning and storing catheters. Instruction in IC was most commonly provided by nurses in HIG countries (93.6%) but by urologists in non-HIG countries (66.3%). Reuse was recommended between 2–5 times, 6–10 times, 11–30 times, 31–50​ times, 51–90 times, >90 times, and till visible deterioration in 25.0%, 25.8%, 15.8%, 7.5%, 5.0%, 5.0%, and 15.8%, respectively. Reuse of catheters by patients on IC was not restricted to less affluent countries. There were wide variations in every aspect of the IC protocol. These issues are critical to patients, communities, and the environment and urgently require research.