References

American Urologic Association. Non-neurogenic chronic urinary retention: consensus definition, management strategies, and future opportunities. 2016. https://tinyurl.com/4vj5srvn (accessed 5 May 2021)

EAU guidelines on neurourology. 2019. https://tinyurl.com/4tfm6yup (accessed 5 May 2021)

Bruyère F, Cariou G, Boiteux JP Diagnosis, treatment and follow-up of community-acquired bacterial infections of the urinary system of men and women (acute cystitis and acute pyelonephritis) and of the genital system of men (acute prostatitis):general remarks [in French]. Prog Urol. 2008; 18:4-8 https://doi.org/10.1016/S1166-7087(08)70505-0

Campeau L, Shamout S, Baverstock RJ Canadian Urological Association best practice report: catheter use. Can Urol Assoc J. 2020; 14:(7)E281-E289 https://doi.org/10.5489/cuaj.6697

Chan MF, Tan HY, Lian X, Ng LY, Ang LL, Lim LH. A randomized controlled study to compare the 2% lignocaine and aqueous lubricating gels for female urethral catheterization. Pain Pract. 2014; 14:(2)140-145 https://doi.org/10.1111/papr.12056

Chaudhry R, Balsara ZR, Madden-Fuentes RJ Risk factors associated with recurrent urinary tract infection in neurogenic bladders managed by clean intermittent catheterization. Urology. 2017; 102:213-218 https://doi.org/10.1016/j.urology.2016.12.049

Couloures KG, Anderson M, Machiorlatti M, Marsenic O, Opas L. Discontinuation of antimicrobial prophylaxis (AP) in children with spina bifida: a case series analysis. Nephro Urol Mon. 2016; 8:(5) https://doi.org/10.5812/numonthly.38484

Cornejo-Dávila V, Palmeros-Rodríguez MA, Uberetagoyena-Tello de Meneses I Management of complicated urinary tract infections in a referral center in Mexico. Int Urol Nephrol. 2015; 47:(2)229-233 https://doi.org/10.1007/s11255-014-0883-y

Engberg S, Clapper J, McNichol L, Thompson D, Welch VW, Gray M. Current evidence related to intermittent catheterization: a scoping review. J Wound Ostomy Continence Nurs. 2020; 47:(2)140-165 https://doi.org/10.1097/WON.0000000000000625

Faleiros F, de Oliveira Käppler C, Rosa T, Gimenes FRE. Intermittent catheterization and urinary tract infection: a comparative study between Germany and Brazil. J Wound Ostomy Continence Nurs. 2018; 45:(6)521-526 https://doi.org/10.1097/WON.0000000000000476

Gamé X, Phé V, Castel-Lacanal E Intermittent catheterization: clinical practice guidelines from Association Française d'Urologie (AFU), Groupe de Neurourologie de Langue Française (GENULF), Société Française de Médecine Physique et de Réadaptation (SOFMER) and Société Interdisciplinaire Francophone d'UroDynamique et de Pelvi-Périnéologie (SIFUD-PP). Prog Urol. 2020; 30:(5)232-251 https://doi.org/10.1016/j.purol.2020.02.009

Gazewski JB, Schurch B, Hamid R An International Continence Society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD). Neurourol Urodyn. 2018; 37:(3)1152-1161 https://doi.org/10.1002/nau.23397

Girard R, Mazoyer MA, Plauchu MM, Rode G. High prevalence of nosocomial infections in rehabilitation units accounted for by urinary tract infections in patients with spinal cord injury. J Hosp Infect. 2006; 62:(4)473-479 https://doi.org/10.1016/j.jhin.2005.07.013

Groen J, Pannek J, Castro Diaz D Summary of European Association of Urology (EAU) guidelines on neuro-urology. Eur Urol. 2016; 69:(2)324-333 https://doi.org/10.1016/j.eururo.2015.07.071

Håkansson MÅ, Neovius K, Norrbäck M, Svensson J, Lundqvist T. Health care utilization and complications rates among users of hydrophilic coated catheters. Urol Nurs. 2015; 35:(5)239-247

Hooton TM, Bradley SF, Cardenas DD Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010; 50:(5)625-63 https://doi.org/10.1086/650482

Jones LF, Meyrick J, Bath J, Dunham O, McNulty CAM. Effectiveness of behavioural interventions to reduce urinary tract infections and Escherichia coli bacteraemia for older adults across all care settings: a systematic review. J Hosp Infect. 2019; 102:(2)200-208 https://doi.org/10.1016/j.jhin.2018.10.013

Kennelly M, Thiruchelvam N, Averbeck MA Adult neurogenic lower urinary tract dysfunction and intermittent catheterisation in a community setting: risk factors model for urinary tract infections. Adv Urol. 2019; 2019 https://doi.org/10.1155/2019/275786

Lamin E, Newman DK. Clean intermittent catheterization revisited. Int Urol Nephrol. 2016; 48:(6)931-939 https://doi.org/10.1007/s11255-016-1236-9

Lee KC, Chao YF, Wang YM, Lin PC. A nurse-family partnership intervention to increase the self-efficacy of family caregivers and reduce catheter-associated urinary tract infection in catheterized patients. Int J Nurs Pract. 2015; 21:(6)771-779 https://doi.org/10.1111/ijn.12319

Li L, Ye W, Ruan H, Yang B, Zhang S, Li L. Impact of hydrophilic catheters on urinary tract infections in people with spinal cord injury: systematic review and meta-analysis of randomized controlled trials. Arch Phys Med Rehabil. 2013; 94:(4)782-787 https://doi.org/10.1016/j.apmr.2012.11.010

Mangera A, Chapple CR. Urethral stricture disease. Surgery (Oxford). 2011; 29:(6)272-277 https://doi.org/10.1016/j.mpsur.2011.03.004

Newman DK, Willson MM. Review of intermittent catheterization and current best practices. Urol Nurs. 2011; 31:(1)12-28 https://doi.org/10.1097/01.WON.0000299816.82983.4a

National Institute for Heath and Care Excellence. Urinary tract infections in adults. QS90. 2015. https://tinyurl.com/5mx9jvvz (accessed 5 May 2021)

National Institute for Health and Clinical Excellence. Urinary tract infection (catheter-associated): antimicrobial prescribing. NG113. 2018. https://tinyurl.com/4aktj6nd (accessed 5 May 2021)

Prieto J, Murphy CL, Moore KN, Fader M. Intermittent catheterisation for long-term bladder management. Cochrane Database Syst Rev. 2014; 9 https://doi.org/10.1002/14651858.CD006008.pub3

Royal College of Nursing. Catheter care: RCN guidance for health care professionals. 2019. https://tinyurl.com/me6ah2j8 (accessed 5 May 2021)

EAU pocket guidelines on neurogenic lower urinary tract dysfunction. 2009. https://tinyurl.com/3dyfuay4 (accessed 5 May 2021)

Tenke P, Kovacs B, Bjerklund Johansen TE, Matsumoto T, Tambyah PA, Naber KG. European and Asian guidelines on management and prevention of catheter-associated urinary tract infections. Int J Antimicrob Agents. 2008; 31:S68-78 https://doi.org/10.1016/j.ijantimicag.2007.07.033

Catheterisation: urethral intermittent in adults. 2013. https://tinyurl.com/acazyw (accessed 7 May 2021)

Wyndaele JJ, Brauner A, Geerlings SE, Bela K, Peter T, Bjerklund-Johanson TE. Clean intermittent catheterization and urinary tract infection: review and guide for future research. BJU Int. 2012; 110:(11 Pt C)E910-E917 https://doi.org/10.1111/j.1464-410X.2012.11549.x

Woodbury MG, Hayes KC, Askes HK. Intermittent catheterization practices following spinal cord injury: a national survey. Can J Urol. 2008; 15:(3)4065-4071

Woodward S. Community nursing and intermittent self-catheterisation. Br J Community Nurs. 2014; 19:(8)388-393 https://doi.org/10.12968/bjcn.2014.19.8.388

Zegers SH, Dieleman J, van der Bruggen T, Kimpen J, de Jong-de Vos van Steenwijk C, Zegers B. The influence of antibiotic prophylaxis on bacterial resistance in urinary tract infections in children with spina bifida. BMC Infect Dis. 2017; 17:(1) https://doi.org/10.1186/s12879-016-2166-y

Intermittent catheterisation: the common complications

02 June 2021
Volume 26 · Issue 6

Abstract

Intermittent catheterisation (IC) has been in practice for more than 40 years and is considered the gold standard in the management of urinary retention in the neurological bladder. IC has many advantages over indwelling urethral or suprapubic catheterisation, including reducing the risk of infection, protecting the bladder and improving quality of life. However, complications can be caused by the practice of this technique, the most common of which is infection. This review discusses some of the common complications that can occur with the use of intermittent catheterisation, including urinary tract infection (UTIs) and urethral complications. It also highlights the role of the nurse in the management of its complications.

Intermittent catheterisation (IC) has been in practice for more than 40 years and is considered the gold standard for bladder drainage for chronic urine retention (National Institute for Health and Care Excellence (NICE), 2015). It is a simple, safe and effective method, in which the catheter is introduced through the meatus and then gradually pushed into the bladder. Urine emptying is ensured and then supplemented by manual pressure above the pubis to finish emptying the bladder. Once the bladder is emptied, the catheter is removed. This procedure can be repeated up to four to six times per day.

IC has many advantages over indwelling urethral or suprapubic catheterisation, including a reduced risk of infection, better bladder protection and improved quality of life (Woodward, 2014).

According to the literature, there are relatively few risks or complications associated with IC. Many risks have been reduced with the introduction of various different types of catheters on the market (Vahr et al, 2013). The risks are recognised as rare compared with the benefits derived from IC (Newman and Willson, 2011).

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