Dr. Sanjay Saint (and friends), of the Center for Practice Management and Outcomes Research, Ann Arbor Department of Veterans Affairs, Department of Internal Medicine, University of Michigan and Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program (which we suspect are actually 3 different cubicles in the same office), attracted some attention in the International Herald Tribune with a study suggesting external condom-like urinary catheters have a lower incidence of complications than their (evil) internal counterparts…
Working with patients at the Veterans Affairs Puget Sound Health Care System, the researchers sought volunteers who would agree to be randomly given either standard or condom like catheters. The researchers monitored infection rates for more than three years and surveyed the patients about their comfort with the catheters.
Unfortunately, we’re not all in the clear:
But, the researchers said, the standard catheter is preferred in certain situations: when the urinary tract is obstructed or when doctors need to monitor urine output, for example.
Follow through for the complete abstract…
…from the Journal of the American Geriatrics Society:
OBJECTIVES: To compare condom and indwelling urinary catheters in terms of infection risk and patient satisfaction.
DESIGN: A prospective, randomized, unblinded, controlled trial.
SETTING: An academically affiliated Veterans Affairs Medical Center.
PARTICIPANTS: Hospitalized men aged 40 and older who required a urinary collection device.
MEASUREMENTS: The incidence of adverse outcomes (bacteriuria, symptomatic urinary tract infection (UTI), or death) and patient device-related satisfaction as determined according to a questionnaire. Dementia status was recorded to assess effect modification by the presence of dementia.
RESULTS: Seventy-five subjects were randomized: 41 receiving an indwelling catheter and 34 a condom catheter. The incidence of an adverse outcome was 131/1,000 patient-days with an indwelling catheter and 70/1,000 patient-days with a condom catheter (P=.07). The median time to an adverse event was 7 days in the indwelling group and 11 days in the condom group. After adjusting for other risk factors, it was found that condom catheter use reduced adverse outcomes (P=.04). Patients without dementia who had an indwelling catheter were approximately five times as likely to develop bacteriuria or symptomatic UTI or to die (hazard ratio=4.84, 95% confidence interval=1.46â€“16.02) as those with a condom catheter (P=.01). Patients reported that condom catheters were more comfortable (P=.02) and less painful (P=.02) than indwelling catheters.
CONCLUSION: The use of condom catheters is less likely to lead to bacteriuria, symptomatic UTI, or death than the use of indwelling catheters. This protection is especially apparent in men without dementia.
Less likely to die is always nice….
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