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

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. To investigate the prevalence of encrusted indwelling urinary catheters in outpatients referred to the Department of Urology. An observational study was carried out on outpatients referred to the Department of Urology in need of removal or replacement of indwelling urinary catheters. A table was completed to collect the data of each patient in order to investigate the presence of any possible encrustation. The collected data concerned 85 patients, 81 male (95·3%) and 4 female (4·7%). Patients had different pathologies and different types of catheter, with different sizes and different materials. The number of indwelling urinary catheters that during removal/replacement were visibly encrusted in the eyehole area totaled eight (9·4%). The analysis of the collected data suggests that the permanence of the catheter could potentially be one of the most relevant causes of encrustation; five out of eight patients with encrusted urethral catheter had it in place for 1 month, three of them for 2 weeks. There are many prevention strategies, among which promotion of nucleation pH (pHn) supplementation in the daily diet with liquids containing citrate is the most simple and suitable for all patients being inexpensive and effective.

British Association of Urological Surgeons (BAUS) and Nurses (BAUN) consensus document: management of the complications of long‐term indwelling catheters

“…The length of time a catheter remains in situ has a significant effect on bacteriuria and encrustation. Hence, regular catheter changes are required to reduce the risk of blockages [25]. Clinical guidelines do not recommend a ‘one‐size‐fits‐all’ routine schedule for catheter changes.…”

Prevention and management of urinary catheter blockages in community settings

“…One of the main risk factors for bacteriuria and encrustation is the length of time a urinary catheter remains in situ; therefore, catheter changes are required to reduce the risk of blockages (Marcone Marchitti et al 2015b). Clinical guidelines do not recommend a 'one-size-fits-all' routine schedule for catheter changes, but rather recommend that the schedule should be based on the length of time that a urinary catheter remains functional for each patient (EAUN 2012, Murphy et al 2018.…”