Intermittent catheterisation with hydrophilic and non-hydrophilic urinary catheters: systematic literature review and meta-analyses

Abstract

BackgroundIntermittent catheterisation is the method of choice for the management of bladder dysfunctions. Different urinary catheters are available, but there is conflicting evidence on which type of catheter is best. The present study provides an objective evaluation of the clinical effectiveness of different subsets of urinary catheters.MethodsA systematic literature review was performed for published RCTs regarding hydrophilic coated and PVC (standard) catheters for intermittent catheterisation. Separate meta-analyses were conducted to combine data on frequencies of urinary tract infections (UTIs) and haematuria. Two separate analyses were performed, including or excluding reused standard catheters.ResultsSeven studies were eligible for inclusion in the review. The meta-analyses exploring UTI frequencies showed a lower risk ratio associated with hydrophilic catheters in comparison to standard ones (RR = 0.84; 95% CI, 0.75–0.94; p = 0.003). Results for the “reuse” scenario were consistent with the ones related to “single-use” scenario in terms of frequency of UTIs. The meta-analyses exploring haematuria were not able to demonstrate any statistically significant difference between hydrophilic catheters in comparison to standard ones.ConclusionsThe findings confirm previously reported benefits of hydrophilic catheters but a broader evaluation that takes into account also patient preferences, compliance of therapy, quality of life and costs would be needed to assess the economic sustainability of these advanced devices.Electronic supplementary materialThe online version of this article (doi:10.1186/s12894-016-0191-1) contains supplementary material, which is available to authorized users.

Correlation of pathogenic factors with antimicrobial resistance of clinicalProteus mirabilisstrains

“…Czerwonka et al [11] reported that high hydrophobicity of the P. mirabilis cell surface correlated with low biofilm amount, which is important for hydrophobic surfaces like glass. It was proved that hydrophilic catheters may prevent catheter-associated UTIs [47], so it would be advisable to evaluate hydrophobicity rates that are characteristic for the majority of P. mirabilis clinical strains.…”

The Management of Urine Storage Dysfunction in the Neurological Patient

“…Since its introduction in 1972 by Lapides [130], catheter models and characteristics have significantly improved and today there is a wide selection of high-tech catheters available, covering the needs of nearly every patient. More recent data and expert panels are in favor of single-use catheters with a hydrophilic coating [131,132]. However, further evidence from prospective randomized controlled trials evaluating catheter type (coated vs. uncoated) and catheterization technique (sterile vs. clean vs. aseptic; single-use vs. re-use) in a broader context, including evaluation of therapy compliance, QoL, and costs is needed.…”

The management of urine storage dysfunction in the neurological patient

“…Synthetic tapes are up-to-date rarely investigated in male neurological patients. Currently, only one small study presents promising data from a mixed adult and pediatric male neurological population treated with the AdVance sling [84]. RCT and data on long-term follow-up are lacking.…”

“…expression was also found to be elevated in NDO patients [83,84]. Again, treatment with resiniferatoxin or BoNT/A intradetrusor injections was able to reduce TRPV1 expression in those patients responding also clinically to treatment [79,83,84] Despite their promising effects in human studies, the evidence for intravesical treatment with vanilloids such as capsaicin and resiniferatoxin is still very limited and adverse events including pelvic pain, facial flush, worsening of incontinence, autonomic dysreflexia, urinary tract infection, and haematuria are very frequent [85]. Intravesical vanilloids are not approved for treatment in LUTD / LUTS and have largely fallen into oblivion, particularly after the propagation of BoNT/A intradetrusor injections.…”

“…There are different types of catheters (hydrophilic vs non-coated catheters) and methods (clean vs sterile and single-use vs multi-use) and, due to an insufficient body of evidence, it is still a matter of debate as to which is preferred [80][81][82][83], although some newer data favour single-use hydrophilic catheters in regard to urinary tract infection and urethral trauma [84][85][86].…”