Urinary catheters are soft tubes inserted into the bladder to drain urine to a collection bag or valve. In the UK, an average of 1 in 1000 people use long-term indwelling catheters (LTCs). LTCs can be associated with complications such as blockages (where urine accumulates in the urinary bladder and does not drain into the catheter bag), urinary tract infections and urinary incontinence. These complications can impact quality of life and NHS resources. People with catheters consider catheter blockage as one of the most significant complications of long-term catheter use and blockages can lead to urine retention, incontinence, severe pain, anxiety and the need for an emergency catheter change increasing reliance on health resources.
LTC washouts are widely used in clinical practice to prevent LTC blockage but we really don’t know enough about the benefits or harms of LTC washouts to either recommend their widespread use or stoppage. Nor do we know what the costs or savings for the NHS that might arise if preventative washouts were used routinely.
In CATHETER II, funded by the NIHR HTA Programme, 600 participants with LTC have a chance of receiving either standard catheter care with or without weekly catheter washouts (citric acid or saline), so we can compare the effects on important outcomes. We will keep in touch with patients for 2 years and evaluate a range of outcome measures including the number of catheter blockages; satisfaction, catheter-associated urinary tract infections and other complications as well as costs to the NHS.
The CATHETER II study is led by Professor Mohamed Abdel-fattah based at the University of Aberdeen.