The Troubling Link Between Urinary Catheters and Infections

By: Richard Roach, MD | Posted on: 22 Jun 2016

The Troubling Link Between Urinary Catheters and Infections

Hundreds of thousands of men across the U.S. use urinary catheters (a tube placed in the bladder to drain urine). They might be used for prostate problems, urinary retention (not being able to fully empty the bladder) and incontinence (urine leakage). Unfortunately, too many people think a catheter is the only choice they have, but there are other options.

The Centers for Disease Control (CDC) says Urinary Tract Infections (UTIs) are the most common type of healthcare-associated infection in the U.S. More than 500,000 people a year develop UTIs in the hospital and catheters are the leading cause. These numbers don't include people who get an infection while using catheters at home. As a urologist who supports a large senior community in Florida, I can tell you that number excludes lot of people.

For instance, I recently treated a man with long-term urinary retention whose doctor gave him a urinary catheter. The catheter allowed him to pass urine, but it caused him to have many UTIs, which often led to hospital visits. In fact, I met him after a lengthy hospital stay.

In addition to infections, the gentlemen had trouble using his hands, which made the catheter tubes and drainage bag difficult to handle. To make matters worse, his wife is blind, so it was hard for her to help.

After evaluation he was not a candidate for surgery or other types of treatments given his overall health, so I spoke with him about inserting a temporary prostate stent. This is a way of keeping the urethra open without surgery.

Like many, he didn't know about it before, but it worked extremely well in his case and has had a major impact on his life! Now he can urinate on his own without a catheter, sleep through the night again and he's been infection-free for months.

"I'm very, very grateful," this patient told me. "I lived with a catheter for months. It was torture. Having the stent is a huge lifestyle improvement. There's no comparison."

There are options for patients beyond catheters and your urologist will present these to you. The ultimate goal is to help as many men as possible avoid infections and the troubles of living with catheters.

Dr. Tomas L. Griebling is the John P. Wolf 33 Masonic Distinguished Professor of Urology at the University of Kansas. He is also Professor and Vice-Chair of the Department of Urology, and Program Director of the Urology residency training. Dr. Griebling says another option to consider is clean intermittent catheterization (CIC). CIC has a lower risk of complications or infection compared to indwelling catheters.

CIC is when the catheter is inserted intermittently into the urethral opening to get it into the bladder to allow it to empty. The Society of Urologic Nurses and Associates (SUNA) recommend that CIC be performed at regular intervals throughout the day depending on the patient's fluid intake as directed by the healthcare provider.

Unfortunately, indwelling catheter removal isn't always an option for people with bladder troubles. But for many-- a surprising number I've found-- there are options that can cut the risk of UTIs and improve quality of life. It's hard for patients to know what's right for them, but by being informed you're better able to ask the right questions.

And your first question should be: "Is the catheter really my only choice?"

Dr. Richard Roach is a urologist in the Oxford, FL, office of Advanced Urology Specialists.

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