Current evidence on intermittent catheterization: sterile single-use catheters or clean reused catheters and the incidence of UTI.
OBJECTIVE
Intermittent catheterization is a commonly prescribed procedure for people with incomplete bladder emptying not managed by other methods. The most frequent complication of intermittent catheterization is urinary tract infection (UTI). It is unclear what strategies, including sterile vs clean catheters or coated vs uncoated PVC catheters, affect the incidence of UTIs. This systematic review summarizes current evidence on the relationship between sterile single-use catheters or clean reused catheters and the incidence of UTIs.


METHODS
The Cochrane Incontinence Group trials register, Medline, EMBASE, CINAHL, and ERIC were searched, plus the reference lists of relevant articles and conference proceedings. Randomized controlled trials comparing at least two different products or methods for intermittent catheterization were included.


METHODS
Three reviewers assessed the methodological quality of trials and abstracted data.


RESULTS
Of the 13 trials that met the inclusion criteria on intermittent catheterization protocols, there was considerable variation in length of follow-up, definitions of UTI, and numbers of subjects. Attrition was a problem for several studies, and all were underpowered. Several studies were more than 10 years old, and outcome measures were imprecise, making it difficult to draw conclusions on the benefit of one catheterization method over another.


CONCLUSIONS
There are no definitive studies illustrating that incidence of UTIs is affected by sterile single-use or coated catheters compared to clean reused catheters. However the current research base is weak and design issues are significant. Based on the current data, it is not possible to state that one catheter method is better than another and further research on the topic is strongly recommended.
Getliffe
Kathryn
K
School of Nursing and Midwifery, University of Southampton, England.
Fader
Mandy
M
Allen
Colleen
C
Pinar
Kim
K
Moore
Katherine N
KN
D015400:Clinical Nursing Research; D020099:Coated Materials, Biocompatible / Q000009:adverse effects / Q000627:therapeutic use; D004209:Disposable Equipment / Q000706:statistics & numerical data; D004866:Equipment Contamination; D017743:Equipment Reuse; D019317:Evidence-Based Medicine; D006301:Health Services Needs and Demand; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods / Q000592:standards; D017063:Outcome Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D014546:Urinary Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control
D020099:Coated Materials, Biocompatible