1. Outcome Comparison of Different Approaches
to Self-Intermittent Catheterization
in Neurogenic Patients: A Systematic Review (#18418)
Samer Shamout, Xavier Biardeau, Jacques Corcos and Lysanne Campeau
Division of Urology, Department of Surgery, Jewish General Hospital, McGill University
BACKGROUND
METHODS
Different types of catheters and techniques have been described in the past three decades to identify the best self-intermittent catheterization method.
Our goal is to systematically review the literature on the most appropriate material and technique to perform self-intermittent catheterization in the adult neurogenic population.
A systematic review search was performed through PubMed/Medline and Embase databases.
Analysing the impact on: urinary tract infections (UTI), urethral trauma, cost-effectiveness, quality of life and patient’s satisfaction.
Keywords: “intermittent catheterization /catheterisation”, “neurogenic”, “urinary catheters for intermittent use”, “urethral catheterization/catheterisation” .
RESULTS
1. UTI and Bacteriuria
Figure 1. Hydrophilic coated catheters ↓ UTI episodes
Figure 2. Sterile technique ↓ the risk of recurrent UTI
2. Urethral Trauma : Microhematuria
3. Satisfaction & Quality of Life * * *
*statistically significant
Figure 3. Hydrophilic coated catheters significantly reduces the risk of urethral trauma
Figure 4. Hydrophilic & pre-lubricated are superior to conventional PVC catheters.
4. Cost-effectiveness
Comparison
Results
Uncoated catheter with multiple-use
~ 1.29 CAD$/£0.5/1US$/0.8 euros per week
Single-use coated
~ 60 CAD$ /£28/46 US$/36.4 euros per week
clean IC technique
Annual saving of approximately 1,883 CAD$/ 1,460 US$ per patient compared to sterile technique
Single-use hydrophilic
4.4 times more expensive than conventional catheters plus gel
CONCLUSION
The present review demonstrated advantages of hydrophilic-coated catheters in decreasing the risk of UTI and urethral trauma as well as improving patient’s satisfaction.
Pre-lubricated catheters has been shown to be superior to conventional polyvinyl chloride catheters.
Randomized controlled trials comparing hydrophilic and pre-lubricated catheters must be conducted to assess possible superiority and cost-effectiveness.