A Real-world Data Analysis of Intermittent Catheterization, Showing the Impact of Prelubricated Versus Hydrophilic Catheter Use on the Occurrence of Symptoms Suggestive of Urinary Tract Infections.

Systematic reviews have highlighted the lack of evidence on choosing the type of intermittent urinary catheter (IUC) with regard to the occurrence of urinary tract infections (UTIs).

To describe the incidence and frequency of symptoms suggestive of UTIs (ssUTIs) for prelubricated versus hydrophilic IUCs.

An observational study of a patient database compiled by UK general practitioners was conducted.

The primary outcome measures were the proportion of patients with at least one ssUTI (prescription of a nonspecific antibiotic with a UTI-related diagnosis, or prescription of a UTI-specific antibiotic) and the mean number of ssUTIs per affected patient in the 12 mo following the index IUC prescription. Comparable prelubricated ("PRELUBE") and hydrophilic ("HYDRO") catheter groups were obtained with 1:1 propensity score matching (PSM).

A total of 5296 patients were included (prelubricated: n = 458; hydrophilic: n = 4838). After PSM, the two groups had similar proportions of patients with ssUTIs at baseline. The proportion of patients with ssUTIs during exposure was similar in the PRELUBE (36.9%) and HYDRO groups (41.5%; p = 0.155). However, among patients having used the same type of catheter throughout the exposure period, the proportion with ssUTIs was significantly lower in the PRELUBE group (44.6%, vs 55.0% for HYDRO; p = 0.015), as was the number of ssUTIs per patient (1.3 vs 1.8; p = 0.036).

When choosing a coated IUC, physicians and patients should not rule out PRELUBE IUCs for safety reasons alone.

Using real-world data compiled by UK general practitioners, we described the incidence and frequency of symptoms suggestive of urinary tract infection in people who were using various types of intermittent urinary catheters. When the same type of prelubricated catheter was used throughout the study period, the incidence of these symptoms was lower than for hydrophilic catheters.

European urology open science. 2022 Mar 04*** epublish ***

Emmanuel Chartier-Kastler, Christopher Chapple, Brigitte Schurch, Mehdi Saad

Department of Urology, Médecine Sorbonne Université, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France., Department of Urology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK., Neuro-urology Unit, Department of Clinical Neurosciences, Vaudois University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland., B. Braun Medical SAS, Saint-Cloud, France.