Catheter washout solutions for long-term urinary catheterisation in adults: a Cochrane Review Summary

Ashley J. Shepherd, William Gordon Mackay, Suzanne Hagen

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Abstract

Objectives: To determine if certain urinary catheter washout regimens are better than
others in terms of effectiveness, acceptability, complications, quality of life and critically
appraise and summarise economic evidence for the management of long-term indwelling
urinary catheterisation in adults.
Methods: We searched the Cochrane Incontinence Group Specialised Trials Register, which contains trials identified from the Cochrane Central Register of Controlled Trials
(CENTRAL), MEDLINE, MEDLINE In-Process, MEDLINE Epub Ahead of Print, CINAHL,
ClinicalTrials.gov, WHO ICTRP and hand-searching of journals and conference proceedings to 23 May 2016.
Results: We included seven trials involving a total of 349 participants, 217 of whom
completed the studies. Three were cross-over and four were parallel-group randomised
controlled trials (RCTs). Analyses of three cross-over trials yielded suboptimal results
because they were based on between-group differences rather than individual participants'
differences for sequential interventions. Two parallel-group trials had limited clinical value.
Only one trial was free of significant methodological limitations, but there were difficulties with recruitment and maintaining participants in this study. None of the trials addressed:
number of catheters used, washout acceptability measures (including patient satisfaction,
patient discomfort, pain and ease of use), or health status/measures of psychological
health; very limited data were collected for health economic outcomes. Trials assessed; a
washout with no washout, different types of washout versus no washout, and stronger
washout solutions versus a weaker solution.
Conclusions: Data from seven trials that compared different washout policies were limited, and generally, of poor methodological quality or were poorly reported. The evidence was not adequate to conclude if washouts were beneficial or harmful. Further rigorous, high
quality trials that are adequately powered to detect benefits from washout being performed
as opposed to no washout are needed. Trials comparing different washout solutions,
washout volumes, and frequencies or timings are also needed.
Original languageEnglish
Pages (from-to)167-170
Number of pages4
JournalInternational Journal of Nursing Studies
Volume82
Early online date26 Oct 2017
DOIs
Publication statusPublished - Jun 2018

Keywords

  • catheter blockages, catheter care, community care, quality of life, urinary incontinence

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