Evidence shows differences in referral and management patterns for urinary symptoms between sexes, which seem to influence catheterization rates and that females experience more urinary tract infections (UTIs). Using patient-reported data from clean intermittent catheter (CIC) users, we investigated sex differences in UTI symptoms, behaviour when having a UTI, and worries related to UTIs.
In March–April 2022, an online survey of 60 questions was distributed among 55 235 CIC users recruited through a customer panel in 11 European countries, Australia, and the United States. Results are based on descriptive analyses presented in proportions and percentages. The participants' data were treated with confidentiality in compliance with the EU General Data Protection Regulation, and the analyses were performed with aggregated anonymous data.
Among 3464 CIC users who responded to the survey, there were 37% females. The four most prevalent urinary problems among females were urinary retention (34%), urinary incontinence (34%), residual urine (32%), and overactive bladder (32%). In addition, among females, 65% had bowel dysfunction, 63% experienced minimum one antibiotic treated UTI within the last year, 53% worried about not emptying their bladder completely, while 71% worried about acquiring a UTI. The overall UTI mean in the study population was 1.88 UTIs/year (95% CI; 1.71–2.07). Females had a 43% higher risk of UTIs compared with males (relative risk: 1.43; 95% CI: 1.26–1.62).
When having UTIs, there was a significant difference when comparing the reporting of UTI symptoms in females versus males, as females experienced more incontinence (33% vs. 21%), more lower abdominal pain (30% vs. 15%), more discomfort or pain when urinating (41% vs. 31%), discomfort or pain over the kidneys (29% vs. 13%), and less fever (16% vs. 29%). Females also used more supplements (36% vs. 25%), drank more fluid (66% vs. 55%), and took home urine tests (21% vs. 13%).
Findings from this cross-sectional study underline the sex differences in reporting of UTI symptoms, behaviour when having a UTI, and worries related to UTIs. Untreated urinary symptoms may have impactful consequences for health-related quality of life, thus, it is important for nurses to know the sex differences in urinary symptoms to identify any risk of UTIs.
Implications for nursing practice or research: Our study results add new insight to the sparse evidence about female CIC user symptoms and behaviour when having a UTI. This knowledge is useful when assessing the risk of UTIs among CIC users.