Related Experiment Video
Updated: Aug 19, 2026
Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
Published on: August 9, 2012
Urinary catheter policies for long-term bladder drainage
B S Niël-Weise1, P J van den Broek
1Medical Centre, Leiden University, C9-43 Box 9600, 2300 RC Leiden, Netherlands, 0031. B.S.Niel-Weise@lumc.nl
Insights
This review found limited evidence on catheter policies for long-term bladder drainage. Antibiotic prophylaxis shows inconsistent benefits for preventing symptomatic urinary tract infections in catheterized patients.
Area of Science:
- Urology
- Infectious Diseases
- Evidence-Based Medicine
Background:
- Long-term bladder catheterization frequently leads to catheter-associated urinary tract infections (CAUTI) and other complications.
- Effective management strategies for long-term catheter use are crucial for patient well-being.
Purpose of the Study:
- To evaluate the effectiveness, complications, quality of life, and cost-effectiveness of different catheter policies in adults and children requiring long-term bladder drainage.
- To compare various antibiotic strategies and catheter insertion routes.
Main Methods:
- Systematic review of randomized and quasi-randomized trials identified through the Cochrane Incontinence Group specialized trials register.
- Inclusion of trials comparing catheter policies (route, antibiotic use) for long-term catheterization (over 14 days).
- Independent data extraction and analysis, including calculation of incidence-density rates when necessary.
Main Results:
- Seven trials involving 328 patients were included, but only two of six planned comparisons were addressed.
- Antibiotic prophylaxis showed inconsistent effects on symptomatic urinary tract infections for intermittent catheterization and limited evidence of benefit for indwelling catheterization.
- Evidence for antibiotic use based on microbiological indication suggested a reduction in bacteriuria, but data were sparse.
Conclusions:
- No trials compared alternative catheter insertion routes.
- Sparse data exist on antibiotic policies, especially differentiating between intermittent and indwelling catheterization.
- Potential benefits of antibiotic prophylaxis must be weighed against risks like antibiotic resistance, which cannot be reliably estimated from current trials.
Background:
People requiring long-term bladder draining commonly experience catheter-associated urinary tract infection and other problems.
Objectives:
To determine if certain catheter policies are better than others in terms of effectiveness, complications, quality of life and cost-effectiveness in long-term catheterised adults and children.
Search Strategy:
We searched the Cochrane Incontinence Group specialised trials register (searched 9 June 2003). Additionally, we examined all reference lists of identified trials.
Selection Criteria:
All randomised and quasi-randomised trials comparing catheter policies (route of insertion and use of antibiotics) for long-term (more than 14 days) catheterisation in adults and children.
Data Collection And Analysis:
Data were extracted by both reviewers independently and compared. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook. If the data in trials have not been fully reported, clarification were sought from the authors. When necessary, the incidence-density rates (IDR) and/or the incidence-density differences (IDD) within a certain time period were calculated.
Main Results:
Seven trials met the inclusion criteria involving 328 patients in four crossover and three parallel-group randomised controlled trials. Only two of the pre-stated six comparisons were addressed in these trials. Three trials compared antibiotic prophylaxis with antibiotics when clinically indicated. For patients using intermittent catheterisation, there were inconsistent findings about the effect of antibiotic prophylaxis on symptomatic urinary tract infection. For patients using indwelling urethral catheterisation, one small trial reported fewer episodes of symptomatic UTI in the prophylaxis group.Four trials compared antibiotic prophylaxis with giving antibiotics when microbiologically indicated. For patients using intermittent catheterisation, there was limited evidence that receiving antibiotics reduced the rate of bacteriuria (asymptomatic and symptomatic). There was weak evidence that prophylactic antibiotics were better in terms of fewer symptomatic bacteriuria.
Authors' Conclusions:
No eligible trials were identified that compared alternative routes of catheter insertion. The data from seven trials comparing differing antibiotic policies were sparse, particularly when intermittent catheterisation was considered separately from in-dwelling catheterisation. Possible benefits of antibiotic prophylaxis must be balanced against possible adverse effects, such as development of antibiotic resistant bacteria; these cannot be reliably estimated from currently available trials.
Related Concept Videos
01:17Urinary Tract Infection IV: Nursing Management
01:26Cardiac Catheterization IV: Nursing Management
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
01:28Urologic Endoscopic Procedure: Cystoscopic Examination
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:28Urinary Tract Calculi V: Nursing Management