Peter Taffo et al., British Journal of Urology International Compass, April 2026
Intermittent catheterization (IC) – is widely recognized as the recommended first-line strategy for bladder emptying in both neurogenic and non-neurogenic lower urinary tract dysfunction (LUTD). Compared with indwelling catheters, IC is associated with lower rates of urinary tract infections (UTIs), a reduced risk of upper urinary tract deterioration and better long-term renal preservation. The introduction of hydrophilic single-use catheters such as the LoFric® has further advanced IC safety by minimizing urethral microtrauma, reducing insertion friction and mitigating infection risks.
While the short-term safety and tolerability of hydrophilic IC are well established, robust prospective evidence on long-term outcomes remains limited. In this non-interventional, prospective, observational cohort study, Taffo et al. evaluated the real-world, long-term impact among adult users of IC with LoFric® hydrophilic catheters on clinical outcomes and quality of life (QoL) over a 5-year period.
The findings, which were demonstrated in a cohort of adults who had already performed IC for more than a decade, suggest that IC using LoFric® hydrophilic catheters is associated with low and stable rates of urological complications, sustained quality of life and high satisfaction.
Bladder Dysfunction and How Intermittent Catheterization Supports Bladder Control
Lower urinary tract dysfunction (LUTD) refers to abnormal storage and/or voiding of urine due to structural, functional or neurogenic issues affecting the bladder, urethra or sphincters. It is frequently seen in people with conditions such as:
- Multiple sclerosis (MS)
- Spinal cord injury (SCI)
- Parkinson’s disease (PD)
- Spina bifida
- Benign prostatic hyperplasia (BPH)
- Surgical conditions
Intermittent catheterization (IC) involves a single-use catheter being introduced into the urinary bladder through the urethra a few times per day to allow for bladder emptying. IC is key for maintaining a healthy urinary bladder and urinary tract for individuals living with LUTD, and the treatment also supports the users through contributing towards independence and a higher quality of life compared with indwelling catheters.
Study Design: Evaluating IC in Adults using LoFric® intermittent urinary catheters
The study by Taffo et al. included 49 adults with lower urinary tract dysfunction who perform IC with LoFric® intermittent urinary catheters, where clinical practice dictated catheter prescription and use.
Patient characteristics included:
- Mean years of performing IC with LoFric® catheters: 13.4 years
- Mean age: 57 years
- Sex: 69% male, 31% female
- Underlying diagnoses:
neurological (51%) [multiple sclerosis, paraplegic spinal cord injury and spina bifida],
urological conditions (20%),
surgical conditions (10%),
other reasons (16%) - Countries: France, Sweden and the United Kingdom
Participants completed structured questionnaires assessing IC use patterns, perceptions, adherence, urological complications (e.g. symptomatic urinary tract infections (UTIs), urethral strictures, bladder stones, prostatitis and epididymitis) as well as quality of life (QoL) using EQ-5D-3L. The questionnaires were filled out at baseline (on average after 13 years of prior LoFric® use) and again after 1, 3 and 5 years of additional IC therapy.
Low and Stable Rates of Urological Complications
After 1, 3 and 5 additional years of intermittent catheterization, the occurrence of the clinical outcomes remained low and stable.
Urinary tract infections (UTIs) were stable
At baseline, 59% of the participants self-reported that they had experienced at least one symptomatic UTI in the past 12 months. After an additional 5 years of using LoFric®, that proportion was 55% of users. At baseline, 97% of users received treatment for UTIs versus 93% at Year 5, and antibiotics were the most common therapy.
Urethral strictures were uncommon
At baseline 6% of participants reported having had a urethral stricture diagnosed during the last 12 months. At Year 1 and 3, around 3-4% of responding participants reported urethral strictures. At follow up at Year 5 the number was at 12%, which was non-significant, but does however align with existing evidence that stricture risk can accumulate gradually with advancing age and cumulative number of catheterizations.
Prostatitis and epididymitis (in male participants) and bladder stones were low and stable
Rates of prostatitis and epididymitis were low and stable over time. Reported bladder stones were infrequent and did not differ significantly from baseline.
Sustained Quality of Life and User Satisfaction
IC is not only a medical intervention but also a critical contributor to overall functional independence and psychosocial well-being. The study demonstrated that the quality of life (QoL) among users assessed with EQ-5D-3L remained stable during the study period. The mean EQ-5D-3L index value – ranging from 0 to 1, where 1 indicates full health – was 0.86 at inclusion and 0.85 at Year 5. This index value is higher than reported values for individuals using indwelling or suprapubic catheters, reinforcing the established preference for IC among patients requiring long-term bladder management.
Satisfaction with LoFric® hydrophilic catheters remained consistently high throughout the study. At baseline 94% of participants were satisfied with their catheter. At the final follow-up, all 100% of participants were expressing agreement or strong agreement with the statement that they were satisfied with their catheter.
Key Takeaways for Long-term Intermittent Catheterization
This non-interventional, prospective, observational cohort study by Taffo et al. brings important clinical real-world data regarding the use of intermittent catheters for more than 13+ years in adults. Short-term safety and tolerability of hydrophilic IC are well established, but this study also provides long-term clinical safety data for hydrophilic IC use in individuals managing lower urinary tract dysfunction on a daily basis.
The findings demonstrate that intermittent catheterization (IC) – using LoFric® hydrophilic catheters – offers both clinical and associated economic benefits:
Clinical benefits of long-term use of LoFric® catheters
- No increased incidence of UTIs over time
- Low and stable rates of urological complications
- High and sustained quality of life based on self-reported health scores
- Sustained 94-100% satisfaction rate among users
Economic benefits of long-term use of LoFric® catheters
- The stable incidence of symptomatic UTIs over long-term follow-up indicates no increase in healthcare resource utilization, such as physician visits, urine cultures, emergency consultations, and hospitalizations related to urinary complications.
- Sustained 94-100% satisfaction rate among users, translates to improved adherence, continued independence, and reduced long-term management burden for patients and healthcare systems.
Although future studies on even larger user cohorts with longer follow-up times would further reinforce the findings in this study, the results support the long-term safety and usability of IC in real-world practice.