[Catheter drainage of the urinary tract. Status of the technique and prospects]

In the last few years, progress in the field of catheter drainage of the urinary tract was limited to the introduction of some new devices, materials, and catheter coatings as well as specific points of technique [37]. At the same time a substantial number of evidence-based guidelines for the use of urinary catheters have been developed by various institutions [9, 13, 15, 17, 23, 28, 39], aiming at a reduction of catheter-associated nosocomial urinary tract infections. Based on these guidelines, this article provides a detailed overview of the current state of the art of catheter drainage of the urinary tract, focussing on practical aspects and hygiene. Urinary tract infections (UTI) still account for 30-40% of all nosocomial infections nowadays, while 90% of these nosocomial UTIs are associated with urinary catheters! The prevention of catheter-associated nosocomial UTIs, therefore, is an individual as well as infectiological and socioeconomic issue of utmost importance requiring cost-effective surveillance strategies and modern individualized concepts for the catheter drainage of the urinary tract in a multidisciplinary approach. Continuous training and education must ensure the above-mentioned medical standards since nurses, outpatient health care networks, and patients themselves increasingly assume the management of catheter drainage of the urinary tract. Because of their unique and specific expertise, urologists have to take responsibility and must play a key role in these projects.