Intermittent catheterization (IC) is widely regarded as the gold standard for bladder emptying in patients with neurogenic and non-neurogenic lower urinary tract dysfunction. Compared with indwelling catheters, IC is associated with lower rates of urinary tract infections (UTIs), reduced risk of upper urinary tract deterioration, and improved long-term renal preservation [1, 2]. Hydrophilic single-use catheters have further enhanced IC safety by reducing urethral friction and microtrauma, lowering infection risk, and improving patients’ quality of life (QoL). Despite these advances, UTIs remains a common complication among IC users [3]. While short-term safety and tolerability are well established, data on long-term outcomes are limited. Previous studies with follow-up periods of 5–10 years have reported adverse events such as urethral trauma, strictures, and epididymitis, underscoring the need for extended evaluation. To address this gap, this study assessed the long-term safety, urological complication rates, and patient-reported outcomes associated with IC.

This prospective, non-interventional, observational cohort study was conducted at three European sites. Adults (≥18 years) performing urethral IC with LoFric™ catheters for at least 6 years prior to enrolment were followed for an additional 5 years. Outcomes included symptomatic UTIs, urethral strictures, bladder stones, prostatitis, epididymitis, patient-reported outcomes (PROs), and perceptions of catheter use and IC. QoL—including pain/discomfort, anxiety/depression, self-care, and usual activities—was assessed using the EQ-5D questionnaire.

Ninety-eight adults were enrolled between April 2015 and August 2018, of whom 49 completed the 5-year follow-up. Mean age at inclusion was 61 years, and 69% of participants were male. Mean duration of IC use was 14 years, including a mean of 13 years with LoFric catheters (range 6–30 years). Neurological conditions accounted for 51% of underlying etiologies. Over the 5-year follow-up, no significant changes were observed in UTI frequency, other urological complications, EQ-5D tariff scores, or PRO ratings. A non-significant trend toward fewer UTIs and a slight increase in urethral strictures was noted.

Taken together, these results add to the growing body of longitudinal evidence demonstrating that IC is a safe and effective long-term method for bladder management. It supports continence, preserves upper urinary tract function, and maintains patient quality of life over time. While UTIs remain the predominant long-term complication, their occurrence appears largely stable and influenced by individual patient factors and catheterization techniques. Overall, the findings support continued use of hydrophilic-coated catheters as a preferred option to minimize infection risk, reduce urethral trauma, and promote sustained user satisfaction in chronic IC populations

This long-term follow-up study evaluated outcomes after more than 11 years of intermittent catheterization and demonstrated that continuous use of LoFric catheters was associated with low complication rates and stable QoL and patient-reported outcomes. These findings support the long-term safety of IC as a bladder management strategy.

Lapides J, Diokno AC, Silber SJ, Lowe BS. Clean intermittent self-catheterization in the treatment of urinary tract disease. J Urol. 1972;107(3):458-61
Wyndaele JJ. Complications of intermittent catheterization: their prevention and treatment. Spinal Cord. 2002;40:536-41.
Bakke A, Digranes A, Høisaeter PA. Physical predictors of infection in patients treated with clean intermittent catheterization: a 7-year follow-up study. Br J Urol. 1997;79(1):85-90