Long-Term Clean Intermittent Catheterization, Chronic Inflammation and Cancer: A Case Report and Review

In areas not endemic for schistosomiasis, the development of squamous cell carcinoma of the bladder (bSCC) is commonly associated with long-term indwelling catheterization (LTIC) and its associated bladder inflammation. Today, many patients unable to void use clean intermittent catheterization (CIC), a practice which gained popularity over the last 2-3 decades. Historically, CIC has not been perceived as a potential risk factor for bSCC; yet we believe that for many of the same reasons LTIC creates a hostile inflammatory environment potentially resulting in bSCC, CIC may also lead to bSCC, albeit at a slower pace. Using our interesting case as a starting point, we reviewed LTIC-related inflammatory mechanisms and drew connections between these mechanisms and CIC in an effort to raise awareness of the possible link to bSCC as the number of patients practicing CIC over multiple decades continues to grow.