Results of a prospective randomized control trial comparing hydrophilic to uncoated catheters in children with neurogenic bladder. Issue 4 (August 2017)

• Record Type: Journal Article
• Authors: DeFoor, William; Reddy, Pramod; Reed, Melissa; VanderBrink, Brian; Jackson, Elizabeth; Zhang, Bin; Denlinger, Julie; Noh, Paul; Minevich, Eugene; Sheldon, Curtis
• Is Part Of: Journal of pediatric urology. Volume 13:Issue 4(2017)
• Page Start: 373.e1
• Page End: 373.e5
• Publication Date: 2017-08
• Subjects: Hydrophilic catheter -- Neurogenic bladder -- Urinary tract infection; Pediatric urology -- Periodicals; Urologic Diseases -- Periodicals; Urogenital Diseases -- Periodicals; Urologic Surgical Procedures -- Periodicals; Child; Infant; Urologie pédiatrique -- Périodiques; Appareil urinaire -- Maladies -- Périodiques; Pédiatrie; Urologie; Pediatric urology; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); Electronic journals; Periodicals; Electronic journals; 618.926
• DOI: 10.1016/j.jpurol.2017.06.003
• Languages: English
• ISSNs: 1477-5131

Abstract

Summary: Introduction: Children with neurogenic bladder (NGB) often require a lifetime of clean intermittent catheterization (CIC), typically using uncoated catheters (UCs). Hydrophilic catheters (HCs) have lower friction than UCs with reported less damage to the urethra. The purpose of this study is to compare outcomes between these catheters. Methods: An investigator-initiated, prospective, randomized clinical trial was conducted to compare HCs versus UCs. Children aged 2–17 years with NGB on CIC were enrolled for 1 year. Block randomization was used. Dexterity scores were obtained in those who perform self-catheterization. Outcomes were UTI, difficulty passing the catheter, urethral injury, and patient satisfaction. Results: Demographic data is presented in the Table. Seventy-eight patients were enrolled. Age and gender were similar between the groups. Fifteen patients in each group performed CIC via an abdominal wall stoma. Eight and 15 patients withdrew from the UC and HC groups, respectively. The HC group overall had more problems with the catheter, mainly difficulty with handling. There were no differences for passing the catheter, pain, hematuria, or urethral injuries. There were two urinary tract infections (UTIs) in two HC patients and 17 UTIs in seven UC patients ( p = 0.003). Patients with UTIs in the HC group went from 16% in the previous year to 5% during the study. Three children in the HC group had three or more UTIs in the year before enrollment and none during the study. The patients that completed the study with HC were overall satisfied and many requested to continue with the HC. Conclusions: HCs may decrease the risk of UTI in children with NGB. Urethral complications were low in both groups. Most HC patients were pleased but some found the slippery coating difficult to handle. Table Demographic data. Hydrophilic Uncoated p Patients ( N ) 37 41 NS Male 18 20 Female 19 21 Mean age (years) 12.9 13.6 NS CIC via native urethra ( N ) 22 26 NS Abdominal wall stoma ( N ) 15 15 NS Bladder augmentation ( N ) 8 8 NS Withdrawn (N ) 15 8 0.05 UTIs per person-year ( N ) 2 17 0.003 Difficulty handling ( N ) 4 0 0.02 Difficulty passing catheter ( N ) 3 0 0.06 Urethral pain ( N ) 3 0 0.06 No events for either group in regards to gross hematuria, urethral injury, need for surgical intervention. Bold values represents statistical significance.