Indwelling Urinary Catheters and Infection Risk: An Assessment of Risk Factors, Necessity, and Impact in Male...

Indwelling urinary catheter (IUC) placement is a significant risk factor for catheter-associated urinary tract infections (CAUTI). Most prior studies of CAUTI include both male and female patients, resulting in heterogenous generalizable cohorts. However, male patients have distinct anatomical differences and sex-specific justifications for IUC placement. This study aimed to exclusively characterize the common indications for in-hospital IUC placement in male patients and identify risk factors associated with CAUTI in this cohort.

This is a retrospective single-center study at a tertiary academic medical center. A total of 1000 male patients aged ≥18 y with an intraurethral IUC placed during their hospital course were included, and those who developed CAUTI during hospitalization were identified. A multivariable logistic regression model was used to identify independent risk factors for CAUTI.

Among 1000 male patients, the most common indications for IUC placement were acute urinary retention (32%), strict ins/outs monitoring (24.3%), and postoperative monitoring (18.5%). Of all included patients, 7.7% developed a CAUTI. On multivariable analysis, benign prostatic hyperplasia (odds ratio [OR] = 1.99, P = 0.027), history of frequent UTIs (OR = 9.04, P < 0.001), and a urinary catheter present on admission (OR = 3.86, P < 0.001) were associated with increased risk of CAUTI development.

In our study, the most common indication for IUC placement in male hospitalized patients was acute urinary retention. CAUTI occurred in nearly 8% of male patients with IUC. Benign prostatic hyperplasia, history of frequent urinary tract infections, and presence of an existing indwelling catheter on admission were independent risk factors for CAUTI development. These findings may inform strategies for inpatient IUC management, especially in patients with prior urologic diagnoses.