A Scoping Review on the Impact of Hydrophilic Versus Non-Hydrophilic Intermittent Catheters on UTI, QoL, Satisfaction, Preference, and Other Outcomes in Neurogenic and Non-Neurogenic Patients Suffering from Urinary Retention- Beyond the Abstract

A new review by Barken and Vaabengaard, investigates the evidence comparing hydrophilic versus non-hydrophilic intermittent catheters for the treatment of bladder dysfunction.

The review concludes that evidence in general supports hydrophilic catheters over non-hydrophilic in terms of higher satisfaction, preference and quality of life. With regard to UTIs, the benefits of hydrophilic catheters are seen in adults in all the studies where raw data was available, but studies in children were inconclusive. Several studies with children reported touching of the catheter surface which may be a much larger risk factor for UTI compared to the difference between hydrophilic and uncoated. Children also complained that hydrophilic coated catheters were slippery, affecting outcomes such as satisfaction and preference. No conclusions were made regarding adverse events on haematuria, bleeding, and strictures.

The review contradicts the findings in the recent Cochrane review1 which was already identified to have numerous limitations and mistakes,2 but conclusions are supported by other recent reviews regarding UTI,3,4 reduction of trauma5 improvement in QoL6 and satisfaction.7

Written by: Andrei Krassioukov, MD, Associate Director and Scientist, ICORD, Vancouver, British Columbia, Canada.

References:

  1. Prieto JA, Murphy CL, Stewart F, Fader M. Intermittent catheter techniques, strategies and designs for managing long-term bladder conditions. Cochrane Database Syst Rev. 2021;10:CD006008.
  2. Walter M, Wyndaele M, Keppenne V, Vrijens D, Averbeck MA, Konstantinidis C, et al. Intermittent catheterisation: The devil is still in the details. Continence. 2022.
  3. Ye D, Chen Y, Jian Z, Liao B, Jin X, Xiang L, et al. Catheters for intermittent catheterization: a systematic review and network meta-analysis. Spinal Cord. 2021;59(6):587-95.
  4. Kennelly M, Thiruchelvam N, Averbeck MA, Konstatinidis C, Chartier-Kastler E, Trojgaard P, et al. Adult Neurogenic Lower Urinary Tract Dysfunction and Intermittent Catheterisation in a Community Setting: Risk Factors Model for Urinary Tract Infections. Adv Urol. 2019;2019:2757862.
  5. Liao X, Liu Y, Liang S, Li K. Effects of hydrophilic coated catheters on urethral trauma, microtrauma and adverse events with intermittent catheterization in patients with bladder dysfunction: a systematic review and meta-analysis. Int Urol Nephrol. 2022;54(7):1461-70.
  6. Theron F, Wilson V, Scriba E, Campbell R, van Zyl M, Terry D, et al. Best practice recommendations for bladder management in spinal cord-afflicted patients in South Africa. S Afr Med J. 2019;109(3):195-202.
  7. Feng D, Cheng L, Bai Y, Yang Y, Han P. Outcomes comparison of hydrophilic and non-hydrophilic catheters for patients with intermittent catheterization: An updated meta-analysis. Asian J Surg. 2020.
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