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WITHDRAWN: Intermittent catheterisation for long-term bladder management.

Jacqui Prieto1, Catherine L Murphy, Katherine N Moore

  • 1Faculty of Health Sciences, University of Southampton, Room AA80, South Academic Block (Mailpoint11), Southampton General Hospital, Southampton, UK, SO16 6YD.

The Cochrane Database of Systematic Reviews
|August 11, 2017
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Summary

Current research on intermittent catheterisation shows no convincing evidence that different catheter designs, techniques, or strategies reduce urinary tract infections (UTIs). More high-quality trials are needed to assess effectiveness and cost-effectiveness for better user outcomes.

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Area of Science:

  • Urology
  • Medical Devices
  • Evidence-Based Medicine

Background:

  • Intermittent catheterisation is common for incomplete bladder emptying.
  • Catheter designs, materials, and coatings vary, with urinary tract infections (UTIs) being a frequent complication.
  • User satisfaction, preference, and ease of use are also critical factors.

Purpose of the Study:

  • To compare different intermittent catheter designs, materials, techniques, and strategies for reducing UTIs and improving user-reported outcomes.
  • To assess the cost-effectiveness of various intermittent catheterisation approaches.

Main Methods:

  • Systematic review of randomised controlled trials (RCTs) and randomised cross-over trials.
  • Searched multiple databases up to September 2013, including reference lists and investigator contact.
  • Assessed methodological quality and abstracted data; combined data where possible, acknowledging heterogeneity.

Main Results:

  • Thirty-one trials (13 RCTs, 18 cross-over) were included, many small with varied follow-up and UTI definitions.
  • No convincing evidence found that aseptic vs. clean technique, coated vs. uncoated, or single vs. multiple-use catheters affect UTI incidence.
  • User-reported outcomes varied; no cost-effectiveness data was available.

Conclusions:

  • Current evidence on intermittent catheterisation strategies for UTI prevention and user outcomes is weak.
  • Significant design issues exist in existing trials.
  • Well-designed trials assessing cost-effectiveness are strongly recommended to guide practice.