It is estimated that the generated waste of single-use intermittent catheterization is between 26,500 and 235,400 pounds per day, with the vast majority of urinary catheters made from non-biodegradable materials (Neurourol Urodyn 2018 37:2204-8). Although this regimen is simple enough, having protocols designed for patients who spend part of their day outside the home is needed.Ī topic of interest and debate is the environmental impact of the waste that humans generate. In this study, the catheters were washed with plain soap and water, stored in a container with benzalkonium chloride, and used for 1 week. One of the arguments against reusable catheters is the variability among cleansing methods and patient adherence to a sanitation regimen. In the reusable catheter group, male gender and presence of a bladder diverticulum were risk factors for developing a UTI. Interestingly, being unable to walk and having vesicoureteral reflux grade 2 or higher were identified as risk factors for having a symptomatic UTI in both groups.
Rates of asymptomatic bacteriuria also did not differ between the two groups. In this study of 75 patients with an average age of 12.7 years, they found that the rate of urinary tract infection did not differ between the groups: 35.2% with single-use catheters vs. What was lacking in the literature was a head-to-head comparison of intermittent catheterization with single-use versus reusable catheters (cleansed with 0.5% benzalkonium chloride) with a primary endpoint of urinary tract infections (defined as having a positive urine culture and symptoms). The authors of a study by Madero-Morales et al provide answers to what many urologic providers and patients need (see article here). It was not too long ago in the United States that insurances covered only four catheters per month, but in 2008 Medicare/Medicaid allowed for patients to receive up to 200 catheters per month. In many developing countries, patients have limited access to medical supplies necessitating reusable catheters. Reuse of catheters for intermittent catheterization was the norm and still is common practice it is in fact, the standard of care in some health care systems.
Badlani is vice chair and professor of urology, Wake Forest Baptist Health, Winston-Salem, NC.įrom the time Lapides popularized the use of self-intermittent or clean intermittent catheterization (J Urol 1972 107:458-61), it has improved the quality of life of patients with neurogenic bladder due to a variety of conditions. Smith is a fellow in female pelvic medicine and reconstructive surgery, and Dr.
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