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Condom Catheters versus Indwelling Urethral Catheters in Men: A Prospective, Observational Study.

ABSTRACT: To assess complications of condom catheters compared with indwelling urethral catheters, we conducted a prospective cohort study in two Veterans Affairs hospitals. Male patients who used a condom catheter or indwelling urethral catheter during their hospital stay were followed for one month by interview and medical record review. Participants included 36 men who used condom catheters and 44 who used indwelling urethral catheters. At least one catheter-related complication was reported by 80.6% of condom catheter users and 88.6% of indwelling catheter users (P = .32), and noninfectious complications (eg, leaking urine, pain, or discomfort) were more common than infectious complications in both groups. Condom catheter patients were significantly less likely than indwelling catheter patients to report complications during catheter placement (13.9% vs 43.2%; P < .001). Patients reported approximately three times more noninfectious complications than the number recorded in the medical record.

SUBMITTER: Saint S

PROVIDER: S-EPMC7839072 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Condom Catheters versus Indwelling Urethral Catheters in Men: A Prospective, Observational Study.

Saint Sanjay S Krein Sarah L SL Fowler Karen E KE Colozzi John J Ratz David D Lescinskas Erica E Chrouser Kristin K Trautner Barbara W BW

Journal of hospital medicine 20190320

To assess complications of condom catheters compared with indwelling urethral catheters, we conducted a prospective cohort study in two Veterans Affairs hospitals. Male patients who used a condom catheter or indwelling urethral catheter during their hospital stay were followed for one month by interview and medical record review. Participants included 36 men who used condom catheters and 44 who used indwelling urethral catheters. At least one catheter-related complication was reported by 80.6% o ...[more]

PMID: 30897057

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Project description:Importance:Indwelling urethral catheters (ie, Foley catheters) are important in caring for certain hospitalized patients but can also cause complications in patients. Objective:To determine the incidence of infectious and noninfectious patient-reported complications associated with the indwelling urethral catheter. Design, Setting, and Participants:A prospective cohort study of consecutive patients with placement of a new indwelling urethral catheter while hospitalized at 1 of 4 US hospitals in 2 states. The study was conducted from August 26, 2015, to August 18, 2017. Participants were evaluated at baseline and contacted at 14 days and 30 days after insertion of the catheter about complications associated with the indwelling urethral catheter and how catheterization affected their social activities or activities of daily living. Exposures:Indwelling urethral catheter placement during hospitalization. Patients were enrolled within 3 days of catheter insertion and followed up for 30 days after catheter placement, whether the catheter remained in or was removed from the patient. Main Outcomes and Measures:Infectious and noninfectious complications associated with an indwelling urethral catheter as well as how the catheter affected patient social activities or activities of daily living. Results:Of 2967 eligible patients, 2227 (75.1%) agreed to participate at 1 of 4 study sites; 2076 total patients were evaluated. Of these, 71.4% were male; mean (SD) age was 60.8 (13.4) years. Most patients (1653 of 2076 [79.6%]) had short-term catheters placed for surgical procedures. During the 30 days after urethral catheter insertion, 1184 of 2076 patients (57.0%; 95% CI, 54.9%-59.2%) reported at least 1 complication due to the indwelling urethral catheter. Infectious complications were reported by 219 of 2076 patients (10.5%; 95% CI, 9.3%-12.0%), whereas noninfectious complications (eg, pain or discomfort, blood in the urine, or sense of urinary urgency) occurred in 1150 patients (55.4%; 95% CI, 53.2%-57.6%) (P?<?.001). Women were more likely to report an infectious complication (92 of 594 [15.5%] women vs 127 of 1482 [8.6%] men; P?<?.001), while men were more likely to report a noninfectious complication (869 of 1482 [58.6%] men vs 281 of 594 [47.3%] women; P?<?.001). Restrictions in activities of daily living (49 of 124 patients [39.5%]) or social activity (54 of 124 [43.9%]) were commonly reported by the patients who had catheters still in place; sexual problems were reported by 99 of 2034 patients (4.9%) after their catheter was removed. Conclusions and Relevance:Noninfectious complications of urethral catheters affect a substantial number of patients, underscoring the importance of avoiding urethral catheterization whenever possible. Given the high incidence of these patient-reported complications, urethral catheter-associated noninfectious complications should be a focus of surveillance and prevention efforts.

Project description:BackgroundIndwelling urethral catheters are widely used in clinical settings. Catheter-associated urinary tract infection has been recognized as a common adverse event in older patients. However, noninfectious complications are almost 5 times as common as infectious complications, and insufficient attention has been given to noninfectious complications. Given this importance, a novel intervention related to removing unnecessary catheters in a timely manner to promote, after removal, the recovery of self-voiding function is herein developed to reduce infectious and noninfectious complications associated with indwelling urethral catheters in hospitalized older patients.MethodsA quasi-experimental study design was adopted. Patients aged 65 and older who had a urinary catheter placed within 24 h of hospital admission were included. All patients were allocated into either an intervention group, in which the novel intervention developed in the study was implemented, or a control group, who received care as usual. The outcomes of this study were to evaluate whether the novel intervention reduced the incidence of the following: catheter-associated urinary tract infections, catheter-associated noninfectious complications, decline in activities of daily living, and new nursing home admissions.ResultsOf 106 hospitalized older patients who consented to participate, 92 completed follow-up until discharge, including 49 in the control group and 43 in the intervention group. The patients in the intervention group were significantly older than those in the control group [83.72 ± 9.18 vs. 80.26 ± 7.66, p = 0.038], and no differences were found between the groups in other demographics or present health conditions. Multivariable logistic regression analysis showed that the control group was more likely to develop noninfectious complications [adjusted odds ratio: 3.01, 95% confidence interval: 1.32-6.81] and a decline in ADLs [adjusted odds ratio: 11.20, 95% confidence interval: 3.68-34.00].ConclusionsA novel intervention can be effective as a means of reducing noninfectious complications associated with indwelling urethral catheters in hospitalized older patients. This approach will help to standardize urethral catheter care, and it highlights the fact that health care professionals can play a crucial role in preventing harm from urethral catheters.

Dataset Information

Condom Catheters versus Indwelling Urethral Catheters in Men: A Prospective, Observational Study.

Publications

Condom Catheters versus Indwelling Urethral Catheters in Men: A Prospective, Observational Study.

Similar Datasets

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