In this randomized prospective trial urethral and suprapubic routes were compared in terms of tolerance and infectious potential. Daily bacteriuria determined infectious danger and patients were interrogated on the pain and discomfort induced by their catheter every day. Identical single dose pre-operative antibiotic prophylaxis was routinely applied. Patients (n = 50) were divided into two similar groups (25 suprapubic catheters and 25 urethral catheters). Four patients in the suprapubic group were excluded. All specimen cultured by suprapubic catheter remained sterile. Nine patients with urethral catheterization eventually developed bacteriuria. The difference became significant on the third day of catheterization (p < 0.05) and increased on days 4 and 5 (p < 0.01). Between the two groups, pain and discomfort did not achieve statistical significance. Suprapubic catheterization is preferable to the alternative using the urethral route in terms of improving urine sterility.
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