Decision-making algorithm for difficult intermittent self-catheterization: construction and validation using the Delphi method
Intermittent Self Catheterization (ISC) is the gold standard for chronic neurogenic and non neurogenic urinary retention. However, difficulties encountered may lead to poor adherence and discontinuation. This study aimed to develop and validate a decision-making algorithm to guide first and second line management of the more common difficulties reported by patients performing ISC. A survey conducted amongst patients, nurses and physicians identified the most frequent difficulties encountered with ISC. Based on a literature review and expert experience, a steering committee, composed of 14 urologists and physical medicine and rehabilitation practitioners, developed a preliminary algorithm outlining management strategies for each identified issues. The algorithm was then validated by a panel of experts through a Delphi process. Six difficulties were identified: pain, infections, bleeding, blockage, technical issues and neuro-psychological barriers. Twenty experts participated in the voting group. Of the 68 initial items, 61 were validated and included in the final algorithm (30 with a strong agreement, 31 with a relative agreement). This multidisciplinary collaborative work resulted in a validated decision-making algorithm designed to complement to existing guidelines. It supports healthcare professionals from different backgrounds in managing patients who report difficulties with ISC.
Authors
- Marie‐Aimée Perrouin‐Verbe (ORCID: https://orcid.org/0000-0002-0212-2840)
- J. Kerdraon (ORCID: https://orcid.org/0000-0002-4549-4820)
- G. Amarenco (ORCID: https://orcid.org/0000-0001-8067-7983)
- Claire Hentzen (ORCID: https://orcid.org/0000-0002-9223-4925)
- A. Ruffion (ORCID: https://orcid.org/0000-0003-0512-3459)
- C. Saussine (ORCID: https://orcid.org/0000-0002-2559-1666)
- Xavier Biardeau (ORCID: https://orcid.org/0000-0003-1270-7401)
- K. Charvier (ORCID: https://orcid.org/0000-0002-5309-7729)
- X. Gamé (ORCID: https://orcid.org/0000-0001-5353-9008)
- P. Denys
- Camille Chesnel (ORCID: https://orcid.org/0000-0002-8260-3678)
- B. Peyronnet (ORCID: https://orcid.org/0000-0001-8157-2825)
- Jean-Marc Soler
- J.-F. Hermieu
Institutions
- Université Claude Bernard Lyon 1 (FR)
- Université Toulouse III - Paul Sabatier (FR)
- Université de Perpignan (FR)
- Inserm (FR)
- Lyon College (US)
- Université de Versailles Saint-Quentin-en-Yvelines (FR)
- Université de Lille (FR)
- Université Paris-Saclay (FR)
- Centre Hospitalier Universitaire de Lille (FR)
- Centre Hospitalier Universitaire de Nantes (FR)
- Sorbonne Université (FR)
- Assistance Publique – Hôpitaux de Paris (FR)
- Hospices Civils de Lyon (FR)
- Pitié-Salpêtrière Hospital (FR)
- Hôpital Rangueil (FR)
- Hôpital Pontchaillou (FR)
- Hôpital Raymond-Poincaré (FR)
- Hôpital Bichat-Claude-Bernard (FR)
- Hôpitaux Universitaires de Strasbourg (FR)
- Clinique Mutualiste de l'Estuaire (FR)
- Groupe de Recherche Clinique en Neuro-urologie (FR)
Publication Details
- Journal
- World Journal of Urology
- Published
- 2025-07-24
- DOI
- https://doi.org/10.1007/s00345-025-05838-4
- Primary Topic
- Hemodynamic Monitoring and Therapy
- Type
- article
- Field-Weighted Citation Impact
- 0.00