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Management of Patients with Long-Term Indwelling Urinary Catheters: A Review of Guidelines

Last updated: May 14, 2019
Project Number: RC1112-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What are the evidence-based guidelines regarding the management of patients with long-term indwelling urinary catheters?

Key Message

Four evidence-based guidelines on the management of patients with long-term indwelling urinary catheters were identified; three guidelines are commissioned by the National Institute for Health and Care Excellence and one guideline by the World Health Organization. Each guideline focuses on a different population, condition and/or aspect of a patient’s management plan. The following recommendations are provided: suprapubic catheters should be considered over long-term indwelling urethral catheters for women with urinary incontinence; short duration bladder catheterization (i.e., seven to 10 days) is favoured over a longer duration of catheterization (i.e., more than 10 days) for post-operative patients who had repair of a simple obstetric urinary fistula; health care providers should consider removing or, if not possible, changing the catheter for patients who have a catheter-associated urinary tract infection if the catheter has been in place for more than seven days; do not routinely offer antibiotic prophylaxis for the prevention of catheter-associated urinary tract infections or when changing catheters for patients with long-term indwelling catheters. All guidelines use rigorous methodology to inform their recommendations, but the studies included to inform the recommendations are of varying quality, ranging from very low to moderate quality. It is also unclear how generalizable the recommendations are to the Canadian population. Therefore, caution is advised when interpreting these recommendations.