Comparative Study of Intermittent Catheters and Occurrence of Urinary Tract Infections
Comparative Study of Intermittent Catheters and Occurrence of Urinary Tract Infections
The purpose of this study is to investigate the frequency of urinary tract infections with
 symptoms in spinal cord injured patients requiring intermittent catheterization for emptying
 the bladder. Patients will use either a coated catheter or an uncoated catheter with gel.
Introduction:

 Spinal cord injured (SCI) constitutes a large group of patients suffering from neurogenic
 bladder dysfunction, which is often managed by intermittent catheterization (IC).
 Intermittent catheterization is accepted as a safe and effective method for maintaining
 bladder and renal health in individuals with neurogenic bladder dysfunction. However, IC
 several times a day places an individual at risk for urethral trauma, hematuria, and
 particularly symptomatic urinary tract infections (UTI).

 Attempts to control UTI with prophylactic antibiotics or sterile technique have not been
 overly successful but more recent advances in catheter technology, such as the
 hydrophilic-coated catheter, offer potential benefit. The hydrophilic-coated catheter has a
 slippery, pre-lubricated surface (along the entire length of the catheter) when soaked in
 water, allowing smooth insertion without the need for additional water soluble lubricant. Two
 proposed advantages over uncoated catheters are 1) reduced incidence of symptomatic UTI, and
 2) reduction of urethral irritation or urethral trauma, and lowered risk of urethral
 strictures. Currently, while there are trends in favour of hydrophilic-coated catheters with
 respect to UTI overall evidence remains inadequate for clinical decision-making for choice of
 catheter type. Randomised trials to date have been limited by short follow up, heterogeneity,
 attrition, imprecise outcome measures, and varying definitions of UTI5. Conclusions of the
 Cochrane group in 20076 were echoed in a recent comprehensive re-view of all studies on
 hydrophilic-coated catheters - there is modest evidence favouring hydrophilic-coated catheter
 in reduction of UTI, but further robust research is required.
Inclusion Criteria:

 -  Traumatic spinal cord injury within 3 months prior to inclusion

 -  Neurogenic bladder dysfunction requiring intermittent catheterization at least 3 times
 daily

 Exclusion Criteria:

 -  Has symptoms of UTI at inclusion

 -  Treated with prophylactic antibiotics to prevent UTIs

 -  Has a history of unresolved bladder-ureteral reflux and/or stones in the urinary tract

 -  Has used intermittent catheterization for more than 10 days prior to inclusion