Urinary management in patients with lower urinary tract dysfunction such as neurogenic bladder is crucial for preventing urinary tract infections and protecting renal function. While pharmacotherapy can usually address voiding disorders, patients in whom pharmacotherapy is ineffective may undergo clean intermittent self-catheterization (CISC). Although the above issues can be resolved by using CISC to manage urination, the quality of life (QOL) becomes a concern in patients undergoing CISC several times per day.
In clinical settings, CISC is primarily performed using three types of catheters—reusable, uncoated single use, and hydrophilic-coated single use. However, there has been little research on how these three catheter types can affect patients’ QOL. This study aimed to investigate the differences in QOL among patients using the three catheter types for CISC.

We examined patients undergoing CISC at our institution for lower urinary tract disorders such as neurogenic bladder and prostatic hypertrophy. After fully explaining how each catheter is used, the patients were asked to choose one of the three types. The differences in the QOL between the three groups after one month of catheter use were evaluated using the Japanese version of the Intermittent Self-catheterization Questionnaire (J-ISC-Q) and compared by statistical methods. P<0.05 was considered a statistically significant difference.

There were 93 patients (38 men, 40.9%) in the analysis set, including 35 patients in the reusable group (18 men, 51.4%), 38 in the uncoated group (13 men, 34.2%), and 20 in the coated group (7 men, 35.0%) (P=0.284). The mean age was not significantly different between the three groups, while the coated group had the fewest urethral catheterizations at 3.2±1.9 times per day (P=0.001). While the total J-ISC-Q score did not differ significantly between the groups, the coated group had the highest score (reusable group 54.9±10.1, uncoated group 56.5±16.3, coated group 63.6±13.4, P=0.133).
There were no significant differences between the groups in the subscales for convenience and psychological well-being (convenience score: P=0.110, psychological well-being score: P=0.310). 
However, the coated group had the highest score for ease of use, indicating that catheter use was the easiest in this group (reusable group 67.3±14.9, uncoated group 70.7±18.4, coated group 80.2±7.5, P=0.013), and the best discreetness score (reusable group 49.8±26.0, uncoated group 56.8±24.1, coated group 69.2±15.7, P=0.023).

The overall QOL of patients undergoing CISC using hydrophilic-coated catheters did not differ from that of the other two groups, although the catheters were easier to use and more discreet in the coated group. Although coated urinary catheters have been reported to reduce the risk of urinary tract infections compared to other catheter types, our results suggest they may also be useful in ensuring a better QOL while undergoing urethral catheterization and maintaining CISC adherence.

Among the patients undergoing CISC, those using a catheter with a hydrophilic coating are considered to be able to maintain the best QOL.