LONG-TERM CATHETERIZATION OF THE BLADDER - PREVALENCE AND MORBIDITY

Objective To estimate the prevalence and morbidity of long-term cathet erization (LTC) of the urinary bladder. Patients and methods A postal survey was conducted over two successive years from February 1989 to d etermine the incidence of LTC in three Bristol Health Districts with a total population of 827 595. During the first gear the number of pati ents requiring emergency treatment for complications of LTC was also m onitored over a 6-month period. In the second year, 54 patients were s elected from the first survey and each was visited by one investigator every 2 weeks for 12 weeks to obtain information on catheter manageme nt, the incidence and type of complications, the attitudes of the pati ents or carers about the catheter and to assess the pH and microbiolog y of the patient's urine. Results The initial surveys identified 457 a nd 467 patients with. long-term catheters during the 2 years, respecti vely; there were similar numbers of men and women in both years. The s urvey of catheter complications recorded 506 emergency referrals durin g the 6 months and the detailed study of 54 patients showed that 48% e xperienced catheter blockage, 37% reported urine by-passing the cathet er and 30% noted haematuria. Patients found the catheter uncomfortable and depended on nursing support, Catheter blockage was associated wit h bladder stones, a high urinary pH and the presence of Proteus spp in the urine. Conclusion The prevalence and high morbidity of LTC cause a considerable demand on the available District and Hospital nursing s ervices: most patients with long-term catheters are elderly, disabled or debilitated and more nurses need to be trained in the technique of catheterization and the management of the catheterized patient. Furthe r research is required to reduce the morbidity of LTC by investigating measures to reduce catheter blockage and encrustation at the urine/bi omaterial interface.