Der intermittierende Einmalkatheterismus

Abstract

In patients with bladder dysfunctions, intermittent catheterisation is a bladder evacuation technique with a low complication rate. Therefore, it is regarded as the method of choice in the treatment of chronic residual urine, mostly due to a hypo- or acontractile detrusor. Regarding the incidence of urinary tract infections and urethral strictures, aseptic catheterisation seems to be superior to the clean technique. There are, however, no independent, prospective, controlled, randomised, double-blinded studies comparing the different catheter types. Thus, the question of which catheter is the ideal one cannot be answered yet. Predominantly in patients who have to perform intermittent catheterisation for good, the prevention of long-term complications, especially of the upper urinary tract, is of the utmost importance. In the long run, using an inadequate technique and catheters not optimally designed will clearly lead to a higher complication rate. Despite the lower prices of certain catheters, treatment of these complications will lead to higher instead of lower costs. The data available today clearly demonstrate that aseptic intermittent catheterisation is the technique of choice today. Important details of this treatment modality, however, have to be elucidated by prospective studies in the future.

Morbidity of urodynamic testing in patients with spinal cord injury: is antibiotic prophylaxis necessary?

“…Both techniques carry an elevated risk of urinary tract infections (UTIs). 3 Thus, this patient group is at risk for post-interventional complications. Although the incidence of post-interventional UTIs in patients with incontinence or benign prostatic hypertrophy has been studied in detail, 4,5 data about the above-mentioned high-risk group are scarce.…”

Long-term follow-up after botulinum toxin A (BTX-A) injection into the detrusor for treatment of neurogenic detrusor hyperactivity in children

“…The other three children were on CIC with recurrent UTI and conversion to aseptic IC helped them become responders to adjuvant antimuscarinics. Regarding the incidence of UTI and urethral strictures, aseptic IC seems to be superior to CIC [40, 41]. …”

Die Bedeutung des Katheterismus in der Neurourologie

“…Hierbei wird ein steril verpackter Einwegkatheter ohne Berührung mit den Fingern nach Desinfektion des Meatus in die Harnröhre vorgeschoben. In retrospektiven Studien [10] konnte nachgewiesen werden, dass sich mit dem aseptischen IK auch ohne Antibiotikaprophylaxe die durchschnittliche HWI-Rate in der Langzeitanwendung auf <1 Infekt/ Jahr reduzieren lässt. Damit ist das aseptische Vorgehen dem "hygienischen" (CIC) überlegen [38].…”

“…Eine asymptomatische Bakteriurie bei IK-Patienten wird überwiegend als tolerabel akzeptiert [10,14,42] [33]. Offenbar besteht ein positiver Zusammenhang zu einer primären oder zwischenzeitlichen Dauerableitung über einen transurethralen Dauerkatheter, Patienten ohne DK in der Vorgeschichte wiesen signifikant seltener Harnröhrenstrikuren auf [12].…”