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Title: The impact of catheter-based bladder drainage method on urinary tract infection risk in spinal cord injury and neurogenic bladder: A systematic review.
Austin Authors: Kinnear, Ned J;Barnett, Dylan;O'Callaghan, Michael;Horsell, Kym;Gani, Johan ;Hennessey, Derek B
Affiliation: Department of Urology, Royal Adelaide Hospital, Adelaide, Australia
South Australian Prostate Cancer Clinical Outcomes Collaborative, Flinders Medical Centre, Adelaide, Australia
School of Medicine, University of Adelaide, Adelaide, Australia
Flinders Centre for Innovation in Cancer, Adelaide, Australia
Department of Urology, Flinders Medical Centre, Australia
Department of Surgery, University of Melbourne, Australia
Department of Urology, Austin Health, Melbourne, Australia
Department of Urology, Mercy University Hospital, Cork, Ireland..
Issue Date: 17-Dec-2019 2019-12-17
Publication information: Neurourology and urodynamics 2019; online first: 17 December
Abstract: To systematically compare the impact of catheter-based bladder drainage methods on the rate of urinary tract infections (UTIs) amongst patients with neurogenic bladder. A search of Cochrane Library, Embase, Medline, and Grey literature to February 2019 was performed using methods prepublished on PROSPERO. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Eligible studies were published in English and compared UTI incidence between neurogenic bladder patients utilizing bladder drainage methods of the indwelling urethral catheter (IUC), suprapubic catheter (SPC) or intermittent self-catheterization (ISC). The odds ratio of UTI was the sole outcome of interest. Eight nonrandomized observational cohort studies were identified, totaling 2321 patients who utilized either IUC, SPC, or ISC. Studies enrolled patients with neurogenic bladder due to spinal cord injury (seven studies) or from any cause (one study). UTI rates were compared between patients utilizing IUC vs SPC (four studies), IUC vs ISC (six studies), and SPC vs ISC (four studies). Compared with IUC, five of six studies suggested ISC use was associated with lower rates of UTI. Studies comparing IUC vs SPC and SPC vs ISC gave mixed results. Meta-analysis was not appropriate due to study methodology heterogeneity. Low-level evidence suggests amongst patients with neurogenic bladder requiring catheter-based drainage, the use of ISC is associated with lower rates of UTI than IUC. Comparisons of IUC vs SPC and SPC vs ISC gave mixed results. Future randomized trials are required to confirm these findings.
DOI: 10.1002/nau.24253
ORCID: 0000-0002-7833-2537
Journal: Neurourology and urodynamics
PubMed URL: 31845396
Type: Journal Article
Subjects: bladder drainage
bladder management
neurogenic bladder
spinal cord injury
urinary tract infection
Appears in Collections:Journal articles

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