Hydrophilic versus non-coated catheters for intermittent catheterization

Since Lapides reintroduced clean intermittent catheterization (CIC) in 1972 , this procedure has been used routinely in individualized programmes for b ladder evacuation in various bladder disorders. It has been suggested that in clinical practice hydrophilic catheters are preferable to non-coated cat heters, In reviewing the literature on CIC, many of the reports were found to rely on data from non-randomized retrospective studies. In some recent p rospective studies, involving a limited number of patients, hydrophilic and non-coated catheters have been evaluated and compared, especially with reg ard to bacteriuria and urethral irritation. The available data indicate tha t using hydrophilic catheters for CIC may induce lower rates of bacteriuria and long-term urethral complications such as urethral strictures. However, to reach a reliable conclusion about the supposed advantage of the hydroph ilic catheters, there is a need for a prospective, randomized long-tron mul ticentre study. It is important in such a study to define patient character istics including age, gender, diagnosis of bladder dysfunction, reason for CIC, physical and mental handicap, manual dexterity and previous treatments . Effect parameters should include number of catheterizations, urinary trac t infection, early and long-term urethral complications, patient satisfacti on, preferences and dropout rates. It is obligatory to include factors such as cost-benefit and cost-effectiveness.