Intermittent catheterization with single- or multiple-reuse catheters: clinical study on safety and impact on quality of life

• Published in: International urology and nephrology Vol. 52; no. 8; pp. 1443 - 1451
• Main Authors: Newman, Diane K., New, Peter W., Heriseanu, Roxana, Petronis, Sarunas, Håkansson, Joakim, Håkansson, Maria Å., Lee, Bonsan Bonne
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.08.2020; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Biofilms; Catheter-associated urinary tract infection (CAUTI); Catheterization; Catheters; Clean intermittent catheterization; Colonization; Equipment Reuse; Female; Humans; Intermittent Urethral Catheterization - adverse effects; Intermittent Urethral Catheterization - instrumentation; Intubation; Lower urinary tract dysfunction (LUTD); Male; Medicine; Medicine & Public Health; Microbial contamination; Microorganisms; Middle Aged; Nephrology; Neurogenic lower urinary tract dysfunction (NLUTD); Patient Satisfaction; Prospective Studies; Quality of Life; Urinary catheter; Urinary tract; Urinary tract infections; Urology; Urology - Original Paper; Urinary catheter; Lower urinary tract dysfunction (LUTD); Clean intermittent catheterization; Catheter-associated urinary tract infection (CAUTI); Neurogenic lower urinary tract dysfunction (NLUTD)
• ISSN: 0301-1623; 1573-2584; 1573-2584
• DOI: 10.1007/s11255-020-02435-9

Purpose Intermittent catheterization (IC) is a proven effective long-term bladder management strategy for individuals who have lower urinary tract dysfunction. This study provides clinical evidence about multiple-reuse versus single-use catheterization techniques and if catheter choice can have an impact on health-related quality of life (HRQoL). Method A prospective, multi-center, clinical trial studied patients who currently practiced catheter reuse, and who agreed to prospectively evaluate single-use hydrophilic-coated (HC) (i.e. LoFric) catheters for 4 weeks. A validated Intermittent Self-Catheterization Questionnaire (ISC-Q) was used to obtain HRQoL. Reused catheters were collected and studied with regard to microbial and debris contamination. Results The study included 39 patients who had practiced IC for a mean of 10 years, 6 times daily. At inclusion, all patients reused catheters for a mean of 21 days (SD = 48) per catheter. 36 patients completed the prospective test period and the mean ISC-Q score increased from 58.0 (SD = 22.6) to 67.2 (SD = 17.7) when patients switched to the single-use HC catheters ( p  = 0.0101). At the end of the study, 83% (95% CI [67–94%]) preferred to continue using single-use HC catheters. All collected reused catheters (100%) were contaminated by debris and 74% (95% CI [58–87%]) were contaminated by microorganisms, some with biofilm. Conclusion Single-use HC catheters improved HRQoL and were preferred over catheter reuse among people practicing IC. Catheter multiple-reuse may pose a potential safety concern due to colonization by microorganisms as well as having reduced acceptance compared to single use. Trial registry number ClinicalTrials.gov NCT02129738.