Hydrophilic versus non-hydrophilic catheters for clean intermittent catheterization: a meta-analysis to determine their capacity in reducing urinary tract infections
Introduction Clean intermittent catheterization (CIC) is associated with an increased risk of urinary tract infections (UTI), urethral trauma, urethral stenosis, hematuria, and pain. The first catheters were developed of polyvinyl carbon (PVC). Several types of catheters have been developed to reduc...
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| Veröffentlicht in: | World journal of urology 2023-02, Vol.41 (2), p.491-499 |
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| creator | Plata, Mauricio Santander, Jessica Zuluaga, Laura Torres-Sandoval, Camilo Valencia, Sergio Azuero, Julián Trujillo, Carlos Gustavo |
| description | Introduction
Clean intermittent catheterization (CIC) is associated with an increased risk of urinary tract infections (UTI), urethral trauma, urethral stenosis, hematuria, and pain. The first catheters were developed of polyvinyl carbon (PVC). Several types of catheters have been developed to reduce these complications, such as those with hydrophilic coating.
Objective
To conduct a systematic review and meta-analysis to evaluate the effectiveness of hydrophilic coated catheters compared to uncoated catheters on the rate of UTI in patients using CIC.
Methodology
A systematic literature search was performed in OVID, Embase, Scopus, Web of Science, PubMed, and CENTRAL databases. Randomized controlled trials (RCTs) or randomized crossover trials comparing UTI and hematuria rates in patients using hydrophilic vs. non-hydrophilic catheters for CIC were identified. The selected trials were evaluated for risk of bias using the “Revised Cochrane risk-of-bias tool for randomized trials (RoB 2).” The results were expressed as a risk ratio (RR) with a 95% confidence interval (CI), under a random-effects model. Data were analyzed using Review Manager 5.4 software.
Results
Nine studies with a total of 525 patients in CIC were analyzed. Overall, the use of hydrophilic catheters had a lower risk of UTIs compared to uncoated catheters (RR = 0.78; 95% CI 0.62–0.97;
I
2
= 37%). Five of the studies include patients > 18 years, showing a reduction of UTIs with the use of hydrophilic catheters (RR = 0.83; 95% CI 0.74–0.93;
I
2
= 0%). There was no difference in UTI development when comparing single-use uncoated vs hydrophilic catheters. However, heterogeneity was high (RR = 0.77; 95% CI 0.59–1.00;
I
2
= 57%). Regarding hematuria risk reduction, we were unable to identify differences between the use of hydrophilic catheters compared to uncoated catheters (RR = 1.02; 95% CI 0.66–1.60).
Conclusion
We found a risk reduction of UTIs associated with using hydrophilic catheters in adults, with low heterogeneity. Regarding hematuria, significant differences were not proved. We do not find a significant difference in UTI risk reduction in the pediatric population. Urethral trauma presence could not be meta‐analyzed due to a lack of information reported. |
| doi_str_mv | 10.1007/s00345-022-04235-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2757055898</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2757055898</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-f39fba3adfbee6934266139b484b53e6004d83556cf12313fa206a5ef970c1e13</originalsourceid><addsrcrecordid>eNp9kU9rFTEUxYMotrZ-ARcScOMmNn8myYw7KWqFQjd2HTKZm76UmeSZZITX7-P3NK-v1uLCVcI9v3Mul4PQG0Y_MEr1WaFUdJJQzgntuJBEPkPHrBOC9Jqr50_-R-hVKbeUMq2ofImOhJKdVno4Rr8udlNO202Yg8M_IZe14Jgi2TwZO1s3UJuGfcrYzWAjDrENllArxPoIhDtbQ4ofscULVEtstPOuhIJrwhPcGyLgxoYWY7fWhbprSTjDtLoQb_CaQ7R5h2u2rjbFg9sHllP0wtu5wOuH9wRdf_n8_fyCXF59_Xb-6ZI4oWUlXgx-tMJOfgRQg-i4UkwMY9d3oxSgKO2mXkipnGdcMOEtp8pK8IOmjgETJ-j9IXeb048VSjVLKA7m2UZIazFcS02l7Ie-oe_-QW_TmtvBe0r3WvGBykbxA-VyKiWDN9sclnaiYdTsSzSHEk0r0dyXaPamtw_R67jA9Gj501oDxAEoTYo3kP_u_k_sb4BQq8g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2778762905</pqid></control><display><type>article</type><title>Hydrophilic versus non-hydrophilic catheters for clean intermittent catheterization: a meta-analysis to determine their capacity in reducing urinary tract infections</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Plata, Mauricio ; Santander, Jessica ; Zuluaga, Laura ; Torres-Sandoval, Camilo ; Valencia, Sergio ; Azuero, Julián ; Trujillo, Carlos Gustavo</creator><creatorcontrib>Plata, Mauricio ; Santander, Jessica ; Zuluaga, Laura ; Torres-Sandoval, Camilo ; Valencia, Sergio ; Azuero, Julián ; Trujillo, Carlos Gustavo</creatorcontrib><description>Introduction
Clean intermittent catheterization (CIC) is associated with an increased risk of urinary tract infections (UTI), urethral trauma, urethral stenosis, hematuria, and pain. The first catheters were developed of polyvinyl carbon (PVC). Several types of catheters have been developed to reduce these complications, such as those with hydrophilic coating.
Objective
To conduct a systematic review and meta-analysis to evaluate the effectiveness of hydrophilic coated catheters compared to uncoated catheters on the rate of UTI in patients using CIC.
Methodology
A systematic literature search was performed in OVID, Embase, Scopus, Web of Science, PubMed, and CENTRAL databases. Randomized controlled trials (RCTs) or randomized crossover trials comparing UTI and hematuria rates in patients using hydrophilic vs. non-hydrophilic catheters for CIC were identified. The selected trials were evaluated for risk of bias using the “Revised Cochrane risk-of-bias tool for randomized trials (RoB 2).” The results were expressed as a risk ratio (RR) with a 95% confidence interval (CI), under a random-effects model. Data were analyzed using Review Manager 5.4 software.
Results
Nine studies with a total of 525 patients in CIC were analyzed. Overall, the use of hydrophilic catheters had a lower risk of UTIs compared to uncoated catheters (RR = 0.78; 95% CI 0.62–0.97;
I
2
= 37%). Five of the studies include patients > 18 years, showing a reduction of UTIs with the use of hydrophilic catheters (RR = 0.83; 95% CI 0.74–0.93;
I
2
= 0%). There was no difference in UTI development when comparing single-use uncoated vs hydrophilic catheters. However, heterogeneity was high (RR = 0.77; 95% CI 0.59–1.00;
I
2
= 57%). Regarding hematuria risk reduction, we were unable to identify differences between the use of hydrophilic catheters compared to uncoated catheters (RR = 1.02; 95% CI 0.66–1.60).
Conclusion
We found a risk reduction of UTIs associated with using hydrophilic catheters in adults, with low heterogeneity. Regarding hematuria, significant differences were not proved. We do not find a significant difference in UTI risk reduction in the pediatric population. Urethral trauma presence could not be meta‐analyzed due to a lack of information reported.</description><identifier>ISSN: 1433-8726</identifier><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-022-04235-5</identifier><identifier>PMID: 36547679</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Catheterization ; Catheters ; Catheters - adverse effects ; Child ; Clinical trials ; Hematuria ; Hematuria - etiology ; Humans ; Intermittent Urethral Catheterization - adverse effects ; Intubation ; Medicine ; Medicine & Public Health ; Meta-analysis ; Nephrology ; Oncology ; Original Article ; Pediatrics ; Stenosis ; Trauma ; Urinary Catheterization - methods ; Urinary Catheters - adverse effects ; Urinary tract ; Urinary tract diseases ; Urinary tract infections ; Urinary Tract Infections - epidemiology ; Urogenital system ; Urology</subject><ispartof>World journal of urology, 2023-02, Vol.41 (2), p.491-499</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-f39fba3adfbee6934266139b484b53e6004d83556cf12313fa206a5ef970c1e13</citedby><cites>FETCH-LOGICAL-c375t-f39fba3adfbee6934266139b484b53e6004d83556cf12313fa206a5ef970c1e13</cites><orcidid>0000-0002-6179-3660</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00345-022-04235-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00345-022-04235-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36547679$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Plata, Mauricio</creatorcontrib><creatorcontrib>Santander, Jessica</creatorcontrib><creatorcontrib>Zuluaga, Laura</creatorcontrib><creatorcontrib>Torres-Sandoval, Camilo</creatorcontrib><creatorcontrib>Valencia, Sergio</creatorcontrib><creatorcontrib>Azuero, Julián</creatorcontrib><creatorcontrib>Trujillo, Carlos Gustavo</creatorcontrib><title>Hydrophilic versus non-hydrophilic catheters for clean intermittent catheterization: a meta-analysis to determine their capacity in reducing urinary tract infections</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><addtitle>World J Urol</addtitle><description>Introduction
Clean intermittent catheterization (CIC) is associated with an increased risk of urinary tract infections (UTI), urethral trauma, urethral stenosis, hematuria, and pain. The first catheters were developed of polyvinyl carbon (PVC). Several types of catheters have been developed to reduce these complications, such as those with hydrophilic coating.
Objective
To conduct a systematic review and meta-analysis to evaluate the effectiveness of hydrophilic coated catheters compared to uncoated catheters on the rate of UTI in patients using CIC.
Methodology
A systematic literature search was performed in OVID, Embase, Scopus, Web of Science, PubMed, and CENTRAL databases. Randomized controlled trials (RCTs) or randomized crossover trials comparing UTI and hematuria rates in patients using hydrophilic vs. non-hydrophilic catheters for CIC were identified. The selected trials were evaluated for risk of bias using the “Revised Cochrane risk-of-bias tool for randomized trials (RoB 2).” The results were expressed as a risk ratio (RR) with a 95% confidence interval (CI), under a random-effects model. Data were analyzed using Review Manager 5.4 software.
Results
Nine studies with a total of 525 patients in CIC were analyzed. Overall, the use of hydrophilic catheters had a lower risk of UTIs compared to uncoated catheters (RR = 0.78; 95% CI 0.62–0.97;
I
2
= 37%). Five of the studies include patients > 18 years, showing a reduction of UTIs with the use of hydrophilic catheters (RR = 0.83; 95% CI 0.74–0.93;
I
2
= 0%). There was no difference in UTI development when comparing single-use uncoated vs hydrophilic catheters. However, heterogeneity was high (RR = 0.77; 95% CI 0.59–1.00;
I
2
= 57%). Regarding hematuria risk reduction, we were unable to identify differences between the use of hydrophilic catheters compared to uncoated catheters (RR = 1.02; 95% CI 0.66–1.60).
Conclusion
We found a risk reduction of UTIs associated with using hydrophilic catheters in adults, with low heterogeneity. Regarding hematuria, significant differences were not proved. We do not find a significant difference in UTI risk reduction in the pediatric population. Urethral trauma presence could not be meta‐analyzed due to a lack of information reported.</description><subject>Adult</subject><subject>Catheterization</subject><subject>Catheters</subject><subject>Catheters - adverse effects</subject><subject>Child</subject><subject>Clinical trials</subject><subject>Hematuria</subject><subject>Hematuria - etiology</subject><subject>Humans</subject><subject>Intermittent Urethral Catheterization - adverse effects</subject><subject>Intubation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Nephrology</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Pediatrics</subject><subject>Stenosis</subject><subject>Trauma</subject><subject>Urinary Catheterization - methods</subject><subject>Urinary Catheters - adverse effects</subject><subject>Urinary tract</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urinary Tract Infections - epidemiology</subject><subject>Urogenital system</subject><subject>Urology</subject><issn>1433-8726</issn><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU9rFTEUxYMotrZ-ARcScOMmNn8myYw7KWqFQjd2HTKZm76UmeSZZITX7-P3NK-v1uLCVcI9v3Mul4PQG0Y_MEr1WaFUdJJQzgntuJBEPkPHrBOC9Jqr50_-R-hVKbeUMq2ofImOhJKdVno4Rr8udlNO202Yg8M_IZe14Jgi2TwZO1s3UJuGfcrYzWAjDrENllArxPoIhDtbQ4ofscULVEtstPOuhIJrwhPcGyLgxoYWY7fWhbprSTjDtLoQb_CaQ7R5h2u2rjbFg9sHllP0wtu5wOuH9wRdf_n8_fyCXF59_Xb-6ZI4oWUlXgx-tMJOfgRQg-i4UkwMY9d3oxSgKO2mXkipnGdcMOEtp8pK8IOmjgETJ-j9IXeb048VSjVLKA7m2UZIazFcS02l7Ie-oe_-QW_TmtvBe0r3WvGBykbxA-VyKiWDN9sclnaiYdTsSzSHEk0r0dyXaPamtw_R67jA9Gj501oDxAEoTYo3kP_u_k_sb4BQq8g</recordid><startdate>20230201</startdate><enddate>20230201</enddate><creator>Plata, Mauricio</creator><creator>Santander, Jessica</creator><creator>Zuluaga, Laura</creator><creator>Torres-Sandoval, Camilo</creator><creator>Valencia, Sergio</creator><creator>Azuero, Julián</creator><creator>Trujillo, Carlos Gustavo</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-6179-3660</orcidid></search><sort><creationdate>20230201</creationdate><title>Hydrophilic versus non-hydrophilic catheters for clean intermittent catheterization: a meta-analysis to determine their capacity in reducing urinary tract infections</title><author>Plata, Mauricio ; Santander, Jessica ; Zuluaga, Laura ; Torres-Sandoval, Camilo ; Valencia, Sergio ; Azuero, Julián ; Trujillo, Carlos Gustavo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-f39fba3adfbee6934266139b484b53e6004d83556cf12313fa206a5ef970c1e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Catheterization</topic><topic>Catheters</topic><topic>Catheters - adverse effects</topic><topic>Child</topic><topic>Clinical trials</topic><topic>Hematuria</topic><topic>Hematuria - etiology</topic><topic>Humans</topic><topic>Intermittent Urethral Catheterization - adverse effects</topic><topic>Intubation</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Nephrology</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Pediatrics</topic><topic>Stenosis</topic><topic>Trauma</topic><topic>Urinary Catheterization - methods</topic><topic>Urinary Catheters - adverse effects</topic><topic>Urinary tract</topic><topic>Urinary tract diseases</topic><topic>Urinary tract infections</topic><topic>Urinary Tract Infections - epidemiology</topic><topic>Urogenital system</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Plata, Mauricio</creatorcontrib><creatorcontrib>Santander, Jessica</creatorcontrib><creatorcontrib>Zuluaga, Laura</creatorcontrib><creatorcontrib>Torres-Sandoval, Camilo</creatorcontrib><creatorcontrib>Valencia, Sergio</creatorcontrib><creatorcontrib>Azuero, Julián</creatorcontrib><creatorcontrib>Trujillo, Carlos Gustavo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Plata, Mauricio</au><au>Santander, Jessica</au><au>Zuluaga, Laura</au><au>Torres-Sandoval, Camilo</au><au>Valencia, Sergio</au><au>Azuero, Julián</au><au>Trujillo, Carlos Gustavo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hydrophilic versus non-hydrophilic catheters for clean intermittent catheterization: a meta-analysis to determine their capacity in reducing urinary tract infections</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><addtitle>World J Urol</addtitle><date>2023-02-01</date><risdate>2023</risdate><volume>41</volume><issue>2</issue><spage>491</spage><epage>499</epage><pages>491-499</pages><issn>1433-8726</issn><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Introduction
Clean intermittent catheterization (CIC) is associated with an increased risk of urinary tract infections (UTI), urethral trauma, urethral stenosis, hematuria, and pain. The first catheters were developed of polyvinyl carbon (PVC). Several types of catheters have been developed to reduce these complications, such as those with hydrophilic coating.
Objective
To conduct a systematic review and meta-analysis to evaluate the effectiveness of hydrophilic coated catheters compared to uncoated catheters on the rate of UTI in patients using CIC.
Methodology
A systematic literature search was performed in OVID, Embase, Scopus, Web of Science, PubMed, and CENTRAL databases. Randomized controlled trials (RCTs) or randomized crossover trials comparing UTI and hematuria rates in patients using hydrophilic vs. non-hydrophilic catheters for CIC were identified. The selected trials were evaluated for risk of bias using the “Revised Cochrane risk-of-bias tool for randomized trials (RoB 2).” The results were expressed as a risk ratio (RR) with a 95% confidence interval (CI), under a random-effects model. Data were analyzed using Review Manager 5.4 software.
Results
Nine studies with a total of 525 patients in CIC were analyzed. Overall, the use of hydrophilic catheters had a lower risk of UTIs compared to uncoated catheters (RR = 0.78; 95% CI 0.62–0.97;
I
2
= 37%). Five of the studies include patients > 18 years, showing a reduction of UTIs with the use of hydrophilic catheters (RR = 0.83; 95% CI 0.74–0.93;
I
2
= 0%). There was no difference in UTI development when comparing single-use uncoated vs hydrophilic catheters. However, heterogeneity was high (RR = 0.77; 95% CI 0.59–1.00;
I
2
= 57%). Regarding hematuria risk reduction, we were unable to identify differences between the use of hydrophilic catheters compared to uncoated catheters (RR = 1.02; 95% CI 0.66–1.60).
Conclusion
We found a risk reduction of UTIs associated with using hydrophilic catheters in adults, with low heterogeneity. Regarding hematuria, significant differences were not proved. We do not find a significant difference in UTI risk reduction in the pediatric population. Urethral trauma presence could not be meta‐analyzed due to a lack of information reported.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36547679</pmid><doi>10.1007/s00345-022-04235-5</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6179-3660</orcidid></addata></record> |
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| ispartof | World journal of urology, 2023-02, Vol.41 (2), p.491-499 |
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| subjects | Adult Catheterization Catheters Catheters - adverse effects Child Clinical trials Hematuria Hematuria - etiology Humans Intermittent Urethral Catheterization - adverse effects Intubation Medicine Medicine & Public Health Meta-analysis Nephrology Oncology Original Article Pediatrics Stenosis Trauma Urinary Catheterization - methods Urinary Catheters - adverse effects Urinary tract Urinary tract diseases Urinary tract infections Urinary Tract Infections - epidemiology Urogenital system Urology |
| title | Hydrophilic versus non-hydrophilic catheters for clean intermittent catheterization: a meta-analysis to determine their capacity in reducing urinary tract infections |
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