The following is a summary of “Hydrophilic catheters for intermittent catheterization and occurrence of urinary tract infections. A retrospective comparative study in patients with spinal cord Injury,” published in the June 2024 issue of Urology by Ali et al.

Neurogenic bladder dysfunction poses significant challenges for patients with spinal cord injury (SCI), not only due to the risk of severe complications but also because of its profound impact on quality of life. This study aimed to compare the incidence of urinary tract infections (UTIs) in patients with SCI with neurogenic bladder sphincter disorders using hydrophilic-coated catheters versus uncoated polyvinyl chloride (PVC) catheters for intermittent catheterization.

This retrospective cohort study spanned from 2005 to 2020 and included adult patients, both male and female, who had sustained an SCI at least one month prior and were experiencing neurogenic bladder dysfunction. These patients utilized intermittent catheterization (single-use hydrophilic-coated catheters or the standard uncoated PVC catheters) at least three times daily to ensure bladder emptying.

A total of 1000 patients were selected through stratified random sampling, with 467 patients (47.60%) using uncoated catheters and 524 patients (52.40%) using hydrophilic-coated catheters. The primary outcome measures—symptomatic UTI, bacteriuria, and pyuria—were significantly higher in the uncoated PVC group than those using hydrophilic-coated catheters. Specifically, symptomatic UTI rates were 79.60% in the uncoated catheter group versus 46.60% in the hydrophilic-coated catheter group. Bacteriuria was observed in 81.10% of patients using uncoated catheters compared to 64.69% in those using coated catheters. In comparison, pyuria was present in 53.57% of the uncoated catheter group versus 41.79% of the hydrophilic-coated catheter group. Notably, increased risk of symptomatic UTI was associated with male gender, older age, longer duration, and greater severity of SCI.

The findings indicate that using hydrophilic-coated catheters significantly reduces the incidence of symptomatic UTIs in patients with SCI and neurogenic bladder dysfunction. Although bacteriuria is common in long-term catheterization, it should not prompt treatment unless clinical symptoms are present. To optimize patient care and outcomes, special attention should be given to high-risk groups for symptomatic UTIs.

Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01510-y