A scoping review on the impact of hydrophilic versus non‑hydrophilic intermittent catheters on UTI, QoL, satisfaction, preference, and other outcomes in neurogenic and non‑neurogenic patients suffering from urinary retention

BMC Urology, 2022 · DOI: https://doi.org/10.1186/s12894-022-01102-8 · Published: September 5, 2022

Simple Explanation

The review compares hydrophilic-coated intermittent catheters (HCICs) with non-hydrophilic (uncoated) catheters in patients with urinary retention. The study analyzes satisfaction, preference, adverse events, urinary tract infection (UTI), quality of life (QoL), cost effectiveness, pain, and discomfort associated with each catheter type. The review includes patients with neurogenic (e.g., spinal cord injury, multiple sclerosis) and non-neurogenic (e.g., cancer, benign prostate hypertrophy) causes of urinary retention.

Study Duration

1 to 24 months

Participants

From 25 to more than 200 participants

Evidence Level

Level 1 to 3. Systematic reviews/meta-analyses, RCTs, cost effectiveness studies, observational cohort studies, retrospective studies and studies based on self-reported questionnaires

Key Findings

1
HCICs generally lead to greater UTI reduction and improved satisfaction, cost-effectiveness, and quality of life.
2
Studies in children with spina bifida did not report a reduction in UTIs, with some children complaining about the catheters being too slippery.
3
Most studies performed on mixed pathologies, including BPH and MS, indicated a strong preference for HCICs compared to non-hydrophilic catheters.

Research Summary

This scoping review examined the impact of hydrophilic versus non-hydrophilic intermittent catheters on various outcomes in patients with urinary retention. The review included 77 articles and found that HCICs generally led to better outcomes, including greater UTI reduction, improved satisfaction, cost-effectiveness, and quality of life. The authors concluded that while the evidence supports HCICs, larger and longer-term studies are needed to confirm these findings, particularly in specific populations like children.

Practical Implications

Clinical Practice

HCICs may be considered as the preferred choice for intermittent catheterization in most patient populations due to improved outcomes.

Pediatric Care

Additional training or redesigned catheters may be necessary for children to fully benefit from the advantages of HCICs.

Future Research

Larger and longer-term studies are needed to support the general finding that HCICs are the preferred choice, especially regarding UTI reduction and adverse events.

Study Limitations

1
Most studies were fairly small, often used a mix of pathologies, and had high drop-out rates.
2
There is heterogeneity in the results for some of the outcomes.
3
Many studies had short time spans, small patient populations, and poorly described control groups.

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