The 65% ABU noted at baseline increased to 74.2% during the triweekly CIC. In this study, a comparison was made between weekly and triweekly catheter replacement over nine-week intervals. Kanaheswari et al 17 conducted a prospective crossover study among children with neurogenic bladder (n=40) and concluded that a longer duration of catheter reuse resulted in an increased prevalence of ABU, without changing the incidence of UTI.
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HOW TO REUSE SKETCH TRIAL TRIAL
ABU: asymptomatic bacteriuria AMC: anti-microbial coating CIC: clean intermittent catheterization HC: hydrophilic-coated PVC: polyvinyl chloride RCT: randomized controlled trial UTI: urinary tract infection. **After UTI definition was adjusted, the difference between HC catheters and other catheters was no longer significant. Systematic review: 1 study on each topic was found Lower incidence compared to standard catheters Prelubricated catheters (Instantcath) or those with AMC or those with introducer Lower risk of UTI with HC catheters (p=0.003) Lower risk of UTI with single use of HC catheters (p=0.003) Prospective cross-over 24-week: HC catheter 24-week: standard PVC Lower risk of UTI with multiple use of PVC catheters (p<0.001) Lower risk of UTI with single use HC catheter (20–30%) Lower risk of UTI with HC catheters ** (p=0.043) Lower risk of UTI with single use of catheter (p<0.001) Lower risk of ABU with shorter duration of use (Z-score 6.218 p<0.001) In order to draw a conclusion on whether reuse of catheters can still be considered the first option for CIC or not, this literature review was conducted on different IC methods regarding their risk of UTI and their associated costs.ĭuration of use (with multiple use of catheters) 13 Since then, not only has more data become available, but also the abovementioned Cochrane review was withdrawn from publication due to an independent appraisal, which identified crucial discrepancies within this publication.
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The authors concluded that multiple uses of a catheter does not impose a higher risk of UTI compared to single use. In 2014, a Cochrane systematic review was published by Prieto et al and supported the reuse of catheters. 4, 9 – 11 All these uncertainties have led many physicians and patients to reuse catheters. Furthermore, lack of long-term followup makes the decision-making more challenging. The difficulty in making a proper comparison between different methods of catheterization results from inconsistency of the literature regarding study population, UTI definition, type of catheter, cleaning methods, and frequency of catheterization per day. 1, 4Īlthough single-use catheters have been introduced to decrease the risk of urethral trauma and UTI, 5 – 8 comparing their outcomes with those of reusable catheters can be challenging. 3 The main arguments in choosing between these options are risk of urinary tract infections (UTIs), uncertain cleaning methods, social issues, and finally the cost and quality of life (QoL).
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Single-use catheters can be either uncoated (UC), such as those made of polyvinyl chloride (PVC), or they can be coated with hydrophilic or gel coverings. 1 Ever since the landmark paper was published by Lapides et al 2 showing that clean intermittent catheterization (CIC) was possible, it has been widely used and preferred to an indwelling catheter.įor those electing to perform IC, there are two main options: either the traditional reuse of catheters with a form of cleaning between uses or single-use catheterization. Intermittent catheterization (IC) is the recommended technique for bladder drainage in patients with chronic retention resulting from different causes, such as neurogenic bladder (NB).