Intermittent Catheterization With a Hydrophilic‐Coated Catheter Delays Urinary Tract Infections in Acute Spinal Cord Injury: A Prospective, Randomized, Multicenter Trial

Cardenas, Diana D.; Moore, Katherine; Dannels-McClure, Amy; Scelza, William M.; Graves, Daniel E.; Brooks, Monifa; Busch, Anna K.

doi:10.1016/j.pmrj.2011.01.001

Cited by 114 publications

(102 citation statements)

References 20 publications

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“…Bermingham et al 6 did not include the long-term sequelae of UTI but only 'acute' management issues, and their analysis did not include the latest and largest randomised controlled trial comparing single use of UC and HC catheters. 7 In addition, the included studies had a different study population, and did not exclude to single use of either HC or UC catheters. The results showing preference of gel-reservoir catheters over HC catheters were highly affected by a single-centre crossover study with 18 patients by Giannantoni et al 16 where the definition of UTI was not clear.…”

Section: Discussionmentioning

confidence: 99%

“…Only two 9,10 of these studies included solely adult SCI patients. Subsequently, one further study, investigating HC versus UC in adult SCI patients, has been published; 7 this was not included in the Bermingham analysis.…”

Section: Data Setmentioning

confidence: 99%

“…Furthermore, the analysis by Bermingham et al did not include the most recent and largest study in hospitalised SCI patients comparing UTI incidence rates for single-use HC and UC catheters. 7 The objective of the present study was to perform a cost-effectiveness analysis with a lifetime perspective of the use of two different single-use catheter designs in an adult SCI population, including long-term sequelae of impaired renal function and accessing the latest evidence.…”

Section: Introductionmentioning

confidence: 99%

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A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters

et al. 2015

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Study design: Cost-effectiveness analysis Objective: To establish a model to investigate the cost effectiveness for people with spinal cord injury (SCI), from a lifetime perspective, for the usage of two different single-use catheter designs: hydrophilic-coated (HC) and uncoated (UC). The model includes the long-term sequelae of impaired renal function and urinary tract infection (UTI). Setting: Analysis based on a UK perspective. Methods: A probabilistic Markov decision model was constructed, to compare lifetime costs and quality-adjusted life years, taking renal and UTI health states into consideration, as well as other catheter-related events. UTI event rates for the primary data set were based on data from hospital settings to ensure controlled and accurate reporting. A sensitivity analysis was applied to evaluate best-and worst-case scenarios. Results: The model predicts that a 36-year-old SCI patient with chronic urinary retention will live an additional 1.4 years if using HC catheters compared with UC catheters, at an incremental cost of £2100. Moreover, the lifetime number of UTI events will be reduced by 16%. All best-and worst-case estimates were within the UK threshold of being cost effective. Conclusion: The use of HC catheters for intermittent catheterisation in SCI patients is highly cost effective. The outcome is consistent irrespective of whether UTI data are collected in hospital or community settings.

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Section: Discussionmentioning

confidence: 99%

Section: Data Setmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters

et al. 2015

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“…26,27 Hydrophilic-coated catheters have been associated with lower rates of symptomatic urinary tract infection in patients with acute spinal cord injury; fewer complications related to urinary tract infection; fewer inflammatory episodes at the scrotal level; fewer episodes of post-, intra-and intercatheterization bleeding; lower treatment costs; fewer days of rehabilitation; and a reduction in the emergence of antibiotic-resistant organisms. 26,27 In a randomized parallel comparative trial assessing urinary tract infection in 57 patients with spinal cord injury, 64% of patients with hydrophilic-coated catheters had one or more urinary tract infections compared with 82% of patients with uncoated polyvinyl chloride catheters. 28 There was no significant difference in the incidence of hematuria, pyuria and bacteriuria.…”

Section: Hydrophilic-coated Cathetersmentioning

confidence: 99%

Prevention of urinary tract infections in patients with spinal cord injury

Salameh

Mohajer

Daroucihe

2015

CMAJ

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“…Although newer data and expert panels are in favor of single-use hydrophilic catheters in an aseptic or clean manner [5][6][7][8] [13,16] including male-specific data [17,18].…”

Section: Cathetersmentioning

confidence: 99%

The management of urinary incontinence in the male neurological patient

Mehnert

Kessler

2014

Current Opinion in Urology

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PURPOSE OF REVIEW: Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. RECENT FINDINGS: Intermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SUMMARY: Standard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in male neurological patients, well-designed, multicenter studies are warranted. Purpose of review Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. Recent findingsIntermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SummaryStandard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in mal...

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Intermittent Catheterization With a Hydrophilic‐Coated Catheter Delays Urinary Tract Infections in Acute Spinal Cord Injury: A Prospective, Randomized, Multicenter Trial

Cited by 114 publications

References 20 publications

A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters

A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters

Prevention of urinary tract infections in patients with spinal cord injury

The management of urinary incontinence in the male neurological patient

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