Background: The belief that intermittent catheterization results in fewer infections than indwelling catheters is commonly expressed in the spinal cord injury literature. Some practice guidelines strongly recommend intermittent over indwelling catheterization due to concerns about infections and other complications. However, studies on this topic are of low quality. Guidelines from the Consortium for Spinal Cord Medicine suggest the data regarding infection risk are mixed, and they do not recommend one bladder management method over the other.
Objectives: To compare risk of bias in studies reporting higher rates of urinary tract infection (UTI) with indwelling catheters to studies that found equal rates of UTI between indwelling and intermittent catheterization, and to describe implications in clinical decision-making.
Methods: A systematic search of PubMed, CINAHL, Embase, and SCOPUS databases from January 1, 1980, to September 15, 2020, was conducted. Eligible studies compared symptomatic UTI rates between indwelling and intermittent catheterization. We used a risk of bias assessment tool to evaluate each study.
Results: Twenty-four studies were identified. Only three of these reported significantly higher UTI risk with indwelling catheters, and all three demonstrated a critical risk of bias. More than half of the studies reported differences in UTI risk of less than 20% between the two methods. Studies with larger (nonsignificant) differences favoring intermittent catheterization were more susceptible to bias from confounding.
Conclusion: The hypothesis that indwelling catheters cause more UTIs than intermittent catheterization is not supported by the scientific literature. Most studies failed to demonstrate a significant difference in UTI risk, and studies with nonsignificant trends favoring intermittent catheterization were more susceptible to bias from confounding. Perceived risk of infection should not influence a patient's choice of catheter type.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9936901 | PMC |
| http://dx.doi.org/10.46292/sci22-00009 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The utilization of a spare ureter to create a continent catheterizable channel to the bladder in pediatric patients.
J Pediatr Urol
January 2025
Clinic of Urology and Pediatric Urology, University Hospital Erlangen, Germany. Electronic address:
Introduction: Clean intermittent catheterization (CIC) has significant advantages over indwelling catheters. To facilitate CIC, a continent catheterizable channel (CCC) to the bladder is required in some cases. The Mitrofanoff appendicovesicostomy (APV) is considered the gold standard for pediatric CCC creation.
View Article and Find Full Text PDFUrinary retention during and after labor with programmed intermittent epidural bolus (PIEB) analgesia: a prospective observational study.
Int J Obstet Anesth
January 2025
Department of Obstetrics and Gynecology, Ikazia Hospital, the Netherlands. Electronic address:
Background: This study investigates the incidence and risk factors for urinary retention during and after labor in women receiving programmed intermittent epidural bolus (PIEB) analgesia and evaluates the optimal bladder management strategy.
Methods: This prospective observational study assessed urinary retention during voiding attempts every two to three hours during labor and postpartum, among women with labor epidural analgesia using PIEB. Urinary retention was defined as a post-void residual volume >150 mL, determined by catheterization after spontaneous voiding.
Impact of bladder management methods and other factors on sexual activity in women with chronic spinal cord injury/disease.
Sex Med
December 2024
Swiss Paraplegic Research, Neuro-Urology, Nottwil, 6207, Switzerland.
Background: Spinal cord injury/disease (SCI/D) profoundly affects both sexuality and urinary function. Catheterization is often necessary to manage bladder voiding and it can interfere with sexual activity.
Aim: We aim to investigate the effect of the bladder evacuation method on sexual activity in women with chronic SCI/D.
Evaluation of a new model of care for bladder management in a statewide spinal cord service.
Spinal Cord
January 2025
Physiotherapy Department, Austin Health, Melbourne, VIC, Australia.
Study Design: Registry-based cohort study.
Objectives: To evaluate the impact of the introduction of a new bladder management model of care at the Victorian Spinal Cord Service (VSCS) on the incidence of subsequent emergency department presentations and readmissions to hospital for urinary tract infection (UTI) in the first 2 years after injury.
Setting: VSCS, Austin Health, Melbourne, Australia.
Efficacy of the Roy Adaptation Model with smartphone training in reducing urinary tract infection in pediatric clean intermittent catheterization: a prospective study.
Eur J Pediatr
January 2025
Pediatric Nephrology AB, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Purpose: Study aimed to compare incidence of urinary tract infection (UTI), type of bacteria grown, development of antibiotic resistance over 2 years in children whose caregivers underwent training based on the Roy Adaptation Model with an android phone application for patients clean intermittent catheterization (RAMACIC) versus those whose caregivers received routine training in hospital.
Method: This study was conducted as a descriptive, prospective study with 40 patients and caregivers between October 2021 and 2023 as a continuation of a previously conducted randomized controlled experimental study by the researchers. Data were collected the "Participant Form," and "Urine Test Form" analyzed with the SPSS 22 package.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!