Urinary Retention (UR) is one of the main complications of benign prostatic hyperplasia (BPH). The UR in the Italian Urology departements is traditionally managed with the indwelling bladder catheter (CVP), intermittent catheterization (IC) can be an alternative to the CVP and to medical therapy alone both as conservative-rehabilitative treatment or waiting for a surgical intervention.
In a regional referral center almost all patients suffering from UR/BPH are referred to the IC.
The aim of the study is to extend the “Best Practice” (BP) by a regional reference center to other regional centers and to evaluate the safety profile of CI compared to CVP in patients suffering from UR/BPH, the incidence of urinary tract infections (UTIs), the adherence to treatment, the sexual activity.

From November 2022 to November 2024, six centers in addition to the regional reference center enrolled patients (pts) suffering from UR/BPH.
The pts were divided in two groups, Group A pts treated with IC and Group B pts treated with CVP. The incidence of UTIs and complications was evaluated at 6 and 12 months (T1-T2), were also assessed rates and reasons for abandonment of IC.
Group A patients participated in three visits:
1) Training (baseline-T0): Theoretical/practical education, delivery bladder diary.
2) Re-evaluation (7 days): Check learning of IC, evaluation bladder diary.
3) Follow-up (30 days): Monitoring patient's condition and compliance; notation of changes to the therapeutic plan and any complications or abandonments.
Furthermore, pts completed the IIEF-5 questionnaire at baseline and follow-up.

183 pts were enrolled
1st phase: adoption of BP and analysis of complications.
• Patients: Compared to the situation prior to the adoption of the BP, which almost entirely included treatment with CVP, one year after the start of the study 90% of pts are treated with IC
• UTIs: 12% Group A, 37% Group B.
• Suspensions: 20% Group A abandoned the IC (24%Complications, 24%Limited compliance, 40% Surgery, 12%Resumption of spontaneous urination).
2nd phase: analysis of improvement relating to sexuality.
The change in the IIEF5 average value shows a clear increase in scores after the adoption of the BP. Starting from a baseline condition of severe erectile dysfunction (with an average IIEF score of 2), a significant change is observed 30 days after treatment (the average score rises to 10).

The results highlight a significant improvement in UR management with the adoption of IC-BP. In the 1st phase, the IC mainly replaced the use of the CVP, significantly reducing complications such as UTIs. Treatment suspensions were mainly due to positive events confirming the effectiveness of theIC.Inthe2nd phase,IChadapositiveimpactonsexualitydocumentedbythesignificantincrease in the mean IIEF5 score.

The project highlighted the effectiveness of IC in the management of UR. IC significantly reduces symptomatic UTIs compared to CVP and determines a notable improvement in sexual activity.