An Intraurethral Mini-Catheter for Prevention of Indwelling Catheter-Induced Morbidity and Mortality in Aging Male

Abstract

Objective: To determine whether replacement of indwelling catheters by intraurethral catheter (IUC) could significantly reduce catheter-induced urinaru tract infection (UTI), and improve men’s life quality. Methods: All patients were sur-gical risks with a catheter for 1–36 month’s due to prostatic obstruction. IUCs were inserted in an ambulatory setting, after local anesthesia of the urethra. Patients stayed in the clinic until they voided 2–3 times. Prophylactic antibiotic was given 48 h before stent insertion and continued for a week. Patients were followed for urinary symptoms and questioned about catheter interference with their life. Urine cultures were obtained after 10 days, a month, and every 3 months. Results: Fifty-seven IUCs replaced indwelling cath-eters in 50 men, from January 2007 to July 2008. Patient’s age ranged from 54 to 99 years. The follow-up period was 1–24 months. IUCs remained in place from 4 to16 months (mean 12.1 months). Six stents (10.5%) had to be removed earlier than intended because of stent displacement; stents were reinserted during 1–2 weeks. Bacteruria was found in 6 patients (12%), additional 2 men (4%) with acute UTI were hospitalized, and successfully treated with antibiotics. Pa-tients suffered dysuria, urgency, and urge incontinence for 4–8 days after stent insertion. Later on, patients were con-tinent, voided satisfactorily, and their life quality improved significantly. Conclusions: Insertion of IUCs instead of an indwelling catheter, did reduce UTI by 84%, and improved significantly patient’s quality of life. An indwelling catheter should be replaced by an IUC in men who are at high risk for surgery or anesthesia.