Cutting the cost of catheterization for acute retention--a hospital or domiciliary procedure?

To report the views of General Practitioners (GPs) and patients on the most appropriate place and person to catheterize patients in acute urinary retention.

Two separate questionnaires were sent to 50 local GPs and 100 patients who had recently been referred with acute urinary retention. The questionnaires were designed to ascertain the most appropriate place and person to catheterize these patients. They also established the number of hospital admissions due to acute retention, the use of ambulances and the uptake of the district nurse services.

Whilst 54% of GPs advocated domiciliary catheterization, only 20% of emergency catheterizations were carried out in the home. Nearly half the patients catheterized in the Accident and Emergency Department were admitted acutely and 41% of patients had travelled to hospital by ambulance. Patients were equally divided about where they would prefer to be catheterized, but 70% of patients stated that they were happy to be catheterized by a trained nurse; no GP opposed this concept.

The cost/benefit analysis of these results strongly supports the case for establishing best-practice guidelines to promote an emergency domiciliary service led by GPs and trained district nurses and thus hasten the emergency care of acute retention and cut costs.