title: Once-daily irrigation of long-term urethral catheters with normal saline. Lack of benefit.
abstract: Urinary incontinence is often managed with a long-term urethral catheter after other methods have failed. Such urethral catheterization is associated with polymicrobial bacteriuria, catheter obstruction, fever, bacteremia, urinary tract stones, and death. Periodic catheter irrigation is a common but untested management procedure intended to prevent catheter obstruction, fevers, and/or bacteremia. To evaluate this technique, we performed a randomized crossover trial comparing ten weeks of once-daily normal saline irrigation with ten weeks of no irrigation in 32 long-term catheterized women. The incidence of catheter obstructions and febrile episodes and the prevalence and species of bacteriuria were similar whether examined as completed crossover patients (N = 23) or as partially completed trials (N = 9). Once-daily irrigation with normal saline of long-term urethral catheters is a time-consuming and costly procedure that is unlikely to have an impact on the morbidity associated with such catheters.
authors.affiliation: Department of Family Medicine, University of Maryland School of Medicine, Baltimore.
authors.forename: H L
authors.initials: HL
authors.lastname: Muncie
authors.forename: J M
authors.initials: JM
authors.lastname: Hoopes
authors.forename: D J
authors.initials: DJ
authors.lastname: Damron
authors.forename: J H
authors.initials: JH
authors.lastname: Tenney
authors.forename: J W
authors.initials: JW
authors.lastname: Warren
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001437:Bacteriuria / Q000382:microbiology; D002408:Catheters, Indwelling; D004868:Equipment Failure; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011897:Random Allocation; D012965:Sodium Chloride; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000379:methods; D013997:Time Factors; D014546:Urinary Catheterization / Q000295:instrumentation / Q000379:methods*; D014549:Urinary Incontinence / Q000628:therapy*
chemical_list: D012965:Sodium Chloride