Most Patients Have Issues With In-Dwelling Catheters

by U.S. Medicine

October 14, 2018

ANN ARBOR, MI—Patients have more issues than healthcare providers might realize with complications from indwelling urethral catheters, including both infectious and non-infectious problems.

A report in JAMA Internal Medicines revealed the results of a multicenter cohort study of 2,076 adults with an indwelling urethral catheter. More than half, 57%, of the patients complained of at least one complication because of the catheter.1

VA Ann Arbor, MI, Healthcare System-led researchers noted that noninfectious complications (55%) were five times as common as infectious complications (11%). Women were significantly more likely to report infectious complications, whereas men reported a significantly higher frequency of noninfectious complications.

The Center for Innovations in Quality, Effectiveness and Safety at the Michael E. DeBakey VAMC in Houston also participated in the study.

Noting that indwelling urethral catheters (i.e., Foley catheters) are often necessary but can cause complications in some patients, the researchers sought to determine the incidence of infectious and noninfectious patient-reported complications associated with the devices.

They conducted prospective cohort study of consecutive patients with placement of a new indwelling urethral catheter while hospitalized at one of four U.S. hospitals in two states between Aug. 26, 2015, and Aug. 18, 2017. Participants, who were evaluated at baseline, were contacted 14 and 30 days after insertion of the catheter about complications associated with it and how catheterization affected their social activities or activities of daily living. Patients were questioned at 30 days, even if the catheter had been removed by that point.

Of the 2,076 patients evaluated, 71.4% were male with mean age of 60.8. Nearly 80% of the participants received short-term catheters placed for surgical procedures.

Results indicated that, during the 30 days after urethral catheter insertion, 57% of participants reported at least one complication due to the indwelling urethral catheter, but infectious issue were present in only about 10% of cases. Most of the complaints involved noninfectious complications such as pain or discomfort, blood in the urine or sense of urinary urgency.

Restrictions in activities of daily living, reported by 39.5%, or social activity, reported by 43.9%, were common in patients who still had catheters in place. Almost 5% of the patients said they had sexual problems after the device was removed.

“Noninfectious complications of urethral catheters affect a substantial number of patients, underscoring the importance of avoiding urethral catheterization whenever possible,” study authors concluded. “Given the high incidence of these patient-reported complications, urethral catheter-associated noninfectious complications should be a focus of surveillance and prevention efforts.”

1. Saint S, Trautner BW, Fowler KE, Colozzi J, Ratz D, Lescinskas E, Hollingsworth JM, Krein SL. A Multicenter Study of Patient-Reported Infectious and Noninfectious Complications Associated With Indwelling Urethral Catheters. JAMA Intern Med. 2018 Aug 1;178(8):1078-1085. doi: 10.1001/jamainternmed.2018.2417. PubMed PMID: 29971436.

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