Editor's Commentary - Washout policies in long-term indwelling urinary catheterization in adults: A short version Cochrane review

BERKELEY, CA (UroToday.com) - This article reviews the current evidence-based research on the use of indwelling urinary catheter (IUC) washouts, referred to in the United States as catheter irrigation.

These are used to prevent catheter blockage and/or to relieve IUC obstruction. The authors reviewed the literature to determine if certain washout regimens (including no washout) are better than others in terms of effectiveness, acceptability, complications, quality of life, and economics for the management of patients with a long term (defined as > 30 days) IUC. This is an abridged version of a previously published Cochrane review (Hagan, 2010) of catheter washout regimens in adults. The authors note there are only 5 trials that compare washout policies. They were unable to conclude whether this is an effective method for preventing or relieving IUC obstruction. The effect of interventions was discussed in terms of bacteruria, and symptomatic UTI and catheter replacement. Irrigation is not a standard practice in the US. This practice is not recommended, as it is felt that the act of disconnecting the catheter from the drainage tub to perform irrigation may actually increase the risk of catheter-associated UTIs. These authors conclude that there is no evidence for or against the use of catheter washout or irrigations.

 

Neurourol Urodyn. 2011 Sep;30(7):1208-12. doi: 10.1002/nau.21063.
doi:

http://dx.doi.org/10.1002/nau.21063

PubMed Abstract
PMID: 21563211

Previously published Cochrane review: Hagen S, Sinclair L, Cross S. Washout policies in long-term indwelling urinary catheterization in adults. Cochrane Database Syst Rev. 2010;17:(3).

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