title: Urinary catheter management.
abstract: The use of urinary catheters should be avoided whenever possible. Clean intermittent catheterization, when practical, is preferable to long-term catheterization. Suprapubic catheters offer some advantages, and condom catheters may be appropriate for some men. While clean handling of catheters is important, routine perineal cleaning and catheter irrigation or changing are ineffective in eliminating bacteriuria. Bacteriuria is inevitable in patients requiring long-term catheterization, but only symptomatic infections should be treated. Infections are usually polymicrobial, and seriously ill patients require therapy with two antibiotics. Patients with spinal cord injuries and those using catheters for more than 10 years are at greater risk of bladder cancer and renal complications; periodic renal scans, urine cytology and cystoscopy may be indicated in these patients.
authors.affiliation: Department of Family and Community Medicine, University of Missouri-Columbia School of Medicine, 65212, USA. cravensd@health.missouri.edu
authors.forename: D D
authors.initials: DD
authors.lastname: Cravens
authors.forename: S
authors.initials: S
authors.lastname: Zweig
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001437:Bacteriuria / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control; D002408:Catheters, Indwelling / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D013035:Spasm / Q000188:drug therapy / Q000209:etiology; D001745:Urinary Bladder Diseases / Q000188:drug therapy / Q000209:etiology; D014546:Urinary Catheterization / Q000009:adverse effects* / Q000379:methods*; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000209:etiology* / Q000517:prevention & control
chemical_list: D000900:Anti-Bacterial Agents