Encrustations of the urinary catheter and prevention strategies: a literature review

Abstract

Patients with an indwelling urinary catheter are at risk of developing urinary tract infection: for each day of the catheter remaining in situ, there is an increasing risk from 3% to 7% for infection to appear. One of the main complications of catheterization is the onset of encrustations, frequently resulting in obstruction of the catheter. Aim of this study is to describe the problem of indwelling urinary catheter encrustation and prevention strategies. A narrative review of the literature was conducted. Indwelling urinary catheter encrustations originate more easily when urine contains high concentrations of poorly soluble constituents and when the state of the urinary tract enables their precipitation as an alkaline urinary pH, often associated with the presence of bacteria urease‐producers, for instance Proteus mirabilis. Urease can generate crystals and this process keeps going until the accumulation of crystalline deposits block the urine flow within the catheter lumen. The literature suggests that there are manifold pharmacological and non‐pharmacological strategies to prevent encrustations. The literature analysis suggests that the permanence of the catheter could potentially be one of the most relevant causes of encrustation. The catheterization duration is the most important risk factor for bacteriuria, essential for the process of encrustation to start off. There are many prevention strategies, among which promotion of nucleation pH (pHn) supplementation in the daily diet with liquids containing citrate; this is the most simple and suitable for all patients being inexpensive and effective.

Prevention and management of urinary catheter blockages in community settings

“…Of the various types of Foley catheters available, silicone catheters have been shown to display optimal performance in preventing encrustation because of Revalidation Prepare for revalidation: read this CPD article, answer the quiz and write a reflective account. For more information, go to rcni.com/ revalidation nursingstandard.com volume 34 number 9 / September 2019 / 63 | PEER-REVIEWED | their relatively large lumen size and since they can remain in situ for longer than other types of catheter (Marcone Marchitti et al 2015a). The EAUN (2012) guidelines recommend a 100% silicone catheter for patients who have a latex allergy and for those who experience frequent catheter blockages.…”

Encrustations of the urinary catheter and prevention strategies: an observational study

“…The literature suggests that there are manifold strategies concerning the prevention of IUC encrustations; some of them need a pharmacological intervention (e.g. antibiotics, silver nitrate, urease inhibitors, Ibicella lutea , biocide triclosan, bacteriophage therapy, washouts) (Kennedy et al , ; Getliffe, ; Morris and Stickler, ; Choong et al , ; Schierholz et al , ; Williams and Stickler, ; Carson et al , ; Sosa and Zunino, ; Marcone Marchitti et al , ). In contrast other studies, have showed how the formation of encrustations can be reduced without using pharmacological treatments (e.g.…”