JOURNAL ARTICLE
REVIEW

Urinary catheter policies for short-term bladder drainage in adults

B S Niël-Weise, P J van den Broek
Cochrane Database of Systematic Reviews 2005, (3): CD004203
16034924

BACKGROUND: Indwelling urinary catheters are often used for bladder drainage during hospital care. Urinary tract infection is a common complication. Other issues that should be considered when choosing an approach to catheterisation are patients' comfort, other complications/adverse effects, and costs.

OBJECTIVES: To determine the advantages and disadvantages of alternative approaches to catheterisation for short-term bladder drainage in adults.

SEARCH STRATEGY: We searched the Cochrane Incontinence Group Specialised Register (searched 20 December 2004). Additionally, we examined all reference lists of identified trials.

SELECTION CRITERIA: All randomised and quasi-randomised trials comparing catheter route of insertion for adults catheterised for up to 14 days.

DATA COLLECTION AND ANALYSIS: Data were extracted by both reviewers independently and compared. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook. If the data in trials had not been fully reported, clarification was sought directly from the authors.

MAIN RESULTS: Seventeen parallel-group randomised controlled trials met the inclusion criteria. Fourteen trials compared indwelling urethral catheterisation with suprapubic catheterisation. Groups managed with an indwelling catheter had more cases of bacteriuria (RR 2.60; 95%CI 2.12 to 3.18), more frequent recatheterisation (RR 4.12; 95%CI 2.94 to 7.56), and more people with discomfort (RR 2.98; 95%CI 2.31 to 3.85). There were no reports of complications during insertion, although not all trials stated this explicitly. Three trials compared indwelling urethral catheterisation with intermittent catheterisation. In the two trials with data, there were fewer cases of bacteriuria in the intermittent catheterisation group (RR 2.90; 95%CI 1.44 to 5.84). Costs analyses reported in two trials favoured the indwelling group.

AUTHORS' CONCLUSIONS: There was evidence that suprapubic catheters have advantages over indwelling catheters in respect of bacteriuria, recatheterisation and discomfort. The clinical significance of bacteriuria was uncertain, however, and there was no information about possible complications or adverse effects during catheter insertion. There was more limited evidence that the use of intermittent catheterisation was also associated with a lower risk of bacteriuria than indwelling urethral catheterisation, but might be more costly. Using intermittent catheterisation postoperatively limits catheterisation to those people who definitely need it.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
16034924
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"