Intermittent catheterization in wheelchair athletes with SCI


Lay Summary by Alanna Shwed

Edited by Rona Herzog, Tiffany Fong, and Alyssa Chong

This is a summary of research conducted by ICORD researchers Matthias Walter, Ian Ruiz, Jordan Squair, ICORD PI Dr. Andrei Krassioukov, and their colleagues Luis Rios and Marcio Averbeck. Click here to access the original research paper.

After suffering a spinal cord injury (SCI) many people are unable to control their lower urinary tract (LUT), so they are unable to urinate voluntarily and/or they urinate when they do not want to. A catheter is commonly used to help a person with a SCI empty their bladder. Catheters can either be left in place (i.e., indwelling) or be inserted and removed several times a day (i.e., intermittent catheterization). Catheters that are left in place can increase an individual’s risk of developing a urinary tract infection (UTI). Intermittent catheterization is considered the better option because this preserves LUT function and reduces the risk of complications. However, despite developments and improvements in catheters, UTIs and urethral injuries are still highly prevalent, impacting the wellbeing of people living with a SCI.

What is the purpose of this research?

Complications from intermittent catheterization can be detrimental to an individual’s health but they also bring another level of complication for athletes with a SCI. Although high levels of physical activity can lead to improved physical health, complications from intermittent catheterization can negatively impact sport performance. Therefore, this study aimed to identify how common complications associated with intermittent catheterization are among athletes with a SCI.

How was this research conducted?

A cross-sectional study (i.e., one-time analysis) was conducted with 130 competitive wheelchair athletes with SCI from the 2015 ParaPan American Games, the 2016 Summer Paralympics, the 2017 Prairie League Tournament, and the 2017 Invitational Wheelchair Rugby Tournament. A survey was given to participants asking questions about the severity of their SCI, their remaining autonomic function, the history of their catheterization techniques, and history of complications, inflammations, or infections that have resulted from intermittent catheterization.

What did researchers find?

Researchers found that 84 out of 109 athletes who used intermittent catheterization experienced at least one complication associated with intermittent catheterization since sustaining their SCI. Despite intermittent catheterization being the preferred method for bladder emptying among individuals with a SCI, there is still a high overall prevalence of complications.

What do these findings mean for people and athletes with SCI?

Individuals with SCI may need to rely on catheterization for decades to come. However, with each UTI that a person experiences, there is a risk for developing a worse condition that can have very serious implications on quality of life or even lead to death. These implications are important for athletes with a SCI, who have not always received as much attention in research as compared to the SCI community as a whole. Intermittent catheterization and the potential effects on LUT function in athletes with SCI can negatively impact their training, sport performance, and overall health and well-being. The findings from this study indicate that prevention strategies involving continued education through SCI dedicated platforms (e.g., SCI blogs) and organizations (e.g., SCI BC) are key to reducing complications associated with intermittent catheterization. Continued education should involve updating the SCI population on the latest advances in both catheterization types as well as catheterization techniques. Further, behaviour medication may be another target as previous evidence suggests increased rates of UTIs in individuals who are reusing their single-use catheters.


Presently Dr. Krassioukov and his team are conducting research on the reuse of catheters and the impact it may have on the health of individuals with SCI. If interested, please contact Rachel Lai, the research coordinator of this project, by email.