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

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).

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.

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.

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. NCT02129738.

International urology and nephrology. 2020 Mar 14 [Epub ahead of print]

Diane K Newman, Peter W New, Roxana Heriseanu, Sarunas Petronis, Joakim Håkansson, Maria Å Håkansson, Bonsan Bonne Lee

Division of Urology, Department of Surgery, Penn medicine, Perelman School of Medicine, University of Pennsylvania, 3rd Floor West Perelman Bldg, 34th and Civic Center Blvd, Philadelphia, PA, 19104, USA. ., Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, VIC, Australia., Spinal Injury Rehabilitation Unit, Royal Rehab, 235 Morrison Rd, Ryde, NSW, 2112, Australia., Division of Material and Production, Department of Chemistry, Bioscience and Textile, RISE Research Institutes of Sweden, Box 857, 50115, Borås, Sweden., Wellspect, 43121, Molndal, Sweden., Spinal and Rehabilitation Medicine, Prince of Wales Hospital Spinal Unit, Barker St., Randwick, NSW, 2031, Australia.

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