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Bacteria inserted by product and no urethral rinsing

Intermittent Self Catheterisation is an important contributing risk factor for UTIs in a neurogenic bladder.1 It allows bacteria from the lower urethral region to be deposited directly into the bladder and cannot create the mechanical rinsing of the bladder that occurs during normal voiding.2,3

Additionally, nonhygienic Intermittent Self Catheterisation practices can introduce bacteria into the urinary tract. Use of the no-touch catheter technique, which includes use of a urinary catheters without touch by the user’s hand, like a nontouch sleeve and insertion tip has been shown to reduce the risk.2,3

Clinical Evidence

  • While the data Is based on few patients and bacterial counts, clinical studies suggest that use of a no-touch catheter is associated with a 30% reduction in bacteriuria and general low bacteriuria levels.2-4
  • A hospital study reported on a no-touch catheter and technique with 35% less infection (UTIs not defined) per admission when compared to a retrospective, very different control group.5
  • In a 2 × 2 weeks crossover study of a new no-touch sleeve system compared to a conventional catheter, five UTIs were reported, but without information about in which group they occurred.6
  • In a Canadian survey of Intermittent Self Catheterisation practices following spinal cord injury, there was no difference in UTI incidence rate if catheters were disinfected between use or not.7

Conclusion

The positive influence of catheter design is controversial, but overall, the present evidence suggests beneficial use of hydrophilic catheters for CIC management.4

  1. Vasudeva P and Madersbacher H, Factors implicated in pathogenesis of urinary tract infections in neurogenic bladders: some revered, few forgotten, others ignored. Neurology and Urodynamics. 2014 Jan;33(1):95-100
  2. C. Bennett J, Young M N, and Darrington H, Differences in urinary tract infections in male and female spinal cord injury patients on intermittent catheterization. Spinal Cord. 1995;33(2):69–72
  3. C. Bennett J, Young M N, Razi S S et al., The effect of urethral introducer tip catheters on the incidence of urinary tract infection outcomes in spinal cord injured patients. Journal of Urology. 1997;158(2):519–521
  4. Kennelly M, Thiruchelvam N, Averbeck MA et al., Adult neurogenic lower urinary tract dysfunction and intermittent catheterisation in a community setting: Risk factors model for urinary tract infections. Advances in Urology. 2019;Apr 2:1–13
  5. Charbonneau-Smith R, No-touch catheterization and infection rates in a select spinal cord injured population. Rehabilitation Nursing. 1993;18(5):296–299
  6. Denys P, Prévinaire J G et al.; VaPro Study Group in France, Intermittent self-catheterization habits and opinion on aseptic VaPro catheter in French neurogenic bladder population. Spinal Cord. 2012;50(11):853–858
  7. Woodbury M G, Hayes K C and Askes H K, Intermittent catheterization practices following spinal cord injury: a national survey. Canadian Journal of Urology. 2008;15(3):4065–4071