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Evidence summaries

Types of Indwelling Urinary Catheters for Long-Term Bladder Drainage in Adults

There is no evidence to indicate which types of catheters are best to use in patients who need long-term bladder drainage. A permanent indwelling catheter should not be inserted without a medical cause in an incontinent patient in long-term care. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 3 studies with a total of 102 subjects. Two trials had a parallel group design and one was a randomised cross-over trial.Only two of the six targeted comparisons were assessed by these trials: antiseptic impregnated catheters versus standard catheters (one trial) and one type of standard catheter versus another standard catheter (two trials).The single small cross-over trial was inadequate to assess the value of silver alloy (antiseptic) impregnated catheters. In the two trials comparing different types of standard catheters, estimates of differences were all imprecise because the trials also had small sample sizes; confidence intervals (CI) were too wide to rule out clinically important differences. One trial did suggest, however, that the use of a hydrogel coated latex catheter rather than a silicone catheter may be better tolerated (risk ratio (RR) for need for early removal 0.41, 95% CI 0.22 to 0.77).

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals) and by indirectness (differences in studied patients and interventions). Overall, the justification of long-time catheterisation in the patients included in these trials appears questionable.

References

  • Jahn P, Beutner K, Langer G. Types of indwelling urinary catheters for long-term bladder drainage in adults. Cochrane Database Syst Rev 2012;(10):CD004997. [PubMed]

Primary/Secondary Keywords