Hydrophilic catheters for intermittent catheterization and occurrence of urinary tract infections. A retrospective comparative study in patients with spinal cord Injury

BMC Urology, 2024 · DOI: https://doi.org/10.1186/s12894-024-01510-y · Published: June 5, 2024

Simple Explanation

Spinal cord injuries can lead to neurogenic bladder, requiring catheterization. This study compares urinary tract infection (UTI) rates between hydrophilic-coated and uncoated catheters in spinal cord injury patients. The study found that hydrophilic-coated catheters were associated with significantly lower rates of symptomatic UTI, bacteriuria, and pyuria compared to uncoated catheters. The findings suggest that using hydrophilic-coated catheters can reduce the risk of UTIs in spinal cord injury patients undergoing intermittent catheterization.

Study Duration

15 years (2005 to 2020)

Participants

1000 patients with spinal cord injury

Evidence Level

Retrospective cohort study

Key Findings

1
Symptomatic UTI, bacteriuria, and pyuria were significantly higher in patients using uncoated polyvinyl chloride (PVC) catheters compared to hydrophilic-coated catheters.
2
The odds of developing symptomatic UTI were more than 12 times higher among patients using uncoated PVC catheters.
3
Male gender and ASIA scale level C or higher were associated with an increased risk of symptomatic UTI.

Research Summary

This retrospective study compared the rate of urinary tract infection (UTI) associated with hydrophilic-coated catheters versus uncoated polyvinyl chloride (PVC) catheters among SCI patients. The study revealed a significantly lower proportion of symptomatic UTI, bacteriuria, and pyuria among patients using hydrophilic-coated catheters compared to those using PVC uncoated catheters. The study concludes that hydrophilic-coated catheters have superior beneficial clinical effects compared to PVC uncoated catheters in reducing symptomatic UTIs in SCI patients.

Practical Implications

Reduced UTI Risk

Using hydrophilic-coated catheters can significantly reduce the risk of symptomatic UTIs in spinal cord injury patients undergoing intermittent catheterization.

Targeted Monitoring

Male patients and those with more severe spinal cord injuries (ASIA scale C or higher) should be monitored more closely for UTI symptoms.

Informed Treatment Decisions

Treatment for bacteriuria should not be initiated unless clinical symptoms of UTI are present, even in patients with long-term catheterization.

Study Limitations

1
Retrospective study design limits the assessment of causality.
2
The study did not report other adverse events such as hematuria and urethral trauma.
3
Some confounding factors, such as the overall bladder management, were not addressed.

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