Predictive Factors for Intermittent Self-catheterization in German and Brazilian Individuals With Spina Bifida and Neurogenic Bladder Dysfunction

PURPOSE: Our study aimed to identify predictive factors for the use of intermittent self-catheterization (ISC) in persons with spina bifida (SB) and neurogenic bladder. Cultural effects were evaluated by comparing ISC use in individuals from 2 countries, Germany and Brazil. DESIGN: Cross-sectional, descriptive study. SUBJECTS AND SETTING: The study included 71 Brazilian and 77 German individuals with SB (108 females and 92 males), aged between 6 and 55 years, who have used ISC for bladder management. METHODS: Data were collected using printed (Brazil) and online (Germany) questionnaires, with 53 questions related to intermittent catheterization (IC) technique, the materials used in IC, difficulties with IC, and sociodemographic and health variables. Data were analyzed using analysis of variance and multivariate logistical regression. RESULTS: Self-catheterization and assisted catheterization were used for 92 and 56 patients, respectively. Intermittent self-catheterization was more common in German participants (79.2%), while most Brazilian participants used assisted catheterization (56.3%). The following variables influenced the choice of catheterization method, according to logistic regression: age, education level, presence of hydrocephalus, severity of SB, and nationality. The variables unrelated to ISC use included gender, difficulty obtaining ISC equipment or learning to perform ISC, and wheelchair dependency. CONCLUSIONS: The identification of predictive factors for ISC improved our understanding of ISC in SB patients and should aid in the development of more effective strategies to increase ISC use.