Justification of closed intermittent urinary catheter irrigation/instillation: a review of current research and practice

Abstract

Urinary tract infections secondary to urinary instrumentation continue to affect over 400,000 patients per year in the USA. While the debate continues over the effectiveness of catheter/bladder irrigation or instillation, these procedures continue to be indicated for certain conditions. Inconsistencies in how these procedures are carried out often depend on the type of catheter used, frequency of the procedure, and equipment available. This review article looks at the available literature on pathogenesis of urinary tract infections and specific literature on irrigation techniques and outcomes. This information is summarized and recommendations are made for adoption of a well-supported procedure, which also provides more cost-effective care. Proposals are made for further research involving use of this procedure.

Instillation of 3% Hydrogen Peroxide or Distilled Vinegar in Urethral Catheter Drainage Bag to Decrease Catheter-Associated Bacteriuria

“…Notwithstanding, long-term urethral catheter-associated bacteriuria is the most common nosocomial infection in secondary and tertiary care settings, as well as in home health care environments (Warren and others 1987;Wilde 1997). Research studies indicate that 40% of all nosocomial infections in the United States are associated with the urinary tract, of which 75% are related directly to indwelling catheterization (Burgener 1987). Bacteriuria has been demonstrated as a universal consequence of long-term urethral catheterization (Warren and others 1987), where the majority of urinary tract infections occur through microbial ascension from the distal urethral tubule into the bladder cavity (Quigley and Riggin 1993).…”

“…Factors that contribute to urinary tract infections include structural defects, systemic disorders, sexually transmitted diseases, insertion of a urethral catheter, and long-term indwelling catheterization (Quigley and Riggin 1993). Urethral catheterization obliterates the natural cleansing of the urinary mucosa, encouraging the migration of pathogens into the bladder (Burgener 1987).…”