Why not choose intermittent self-catheterisation?

Intermittent catheterisation is the oldest form of catheterisation. The ancient Egyptians used reeds to empty a patient's bladder, and in 1752 diplomat and inventor Benjamin Franklin, one of America's founding fathers, created a flexible silver coil catheter to treat one of his brothers (Buckley et al, 2015). Intermittent catheterisation remained the only way to catheterise until Frederic Foley designed an indwelling catheter in the early 20th century (Bloom et al, 1994).

Today, the situation has changed, with the vast majority of patients having an indwelling catheter. A study by Shackley et al (2017) found that 12.9% of NHS patients have an indwelling urinary catheter. But how many of those patients could have been managed with intermittent catheterisation instead?

A combination of medical conditions left Paul Carter (not his real name), who is in his mid-fifties, chair/bed bound. He lives in his own home, supported by a full package of carers. Due to a poor gag reflex, he had a percutaneous endoscopic gastrostomy (PEG) inserted. He is visited three times a day by a district nurse team, of which I am a member, to administer his medicines and feeds, via the PEG, and to provide the other nursing care he requires.