An intraurethral mini-catheter for prevention of indwelling catheter-induced morbidity and mortality in aging male

Objective: To determine whether replacement of indwelling catheters by intraurethral catheter (IUC) could significantly reduce catheter-induced urinaru tract infection (UTI), and improve men's life quality. Methods: All patients were sur-gical risks with a catheter for 1-36 month's due to prostatic obstruction. IUCs were inserted in an ambulatory setting, after local anesthesia of the urethra. Patients stayed in the clinic until they voided 2-3 times. Prophylactic antibiotic was given 48 h before stent insertion and continued for a week. Patients were followed for urinary symptoms and questioned about catheter interference with their life. Urine cultures were obtained after 10 days, a month, and every 3 months. Results: Fifty-seven IUCs replaced indwelling cath-eters in 50 men, from January 2007 to July 2008. Patient's age ranged from 54 to 99 years. The follow-up period was 1-24 months. IUCs remained in place from 4 to16 months (mean 12.1 months). Six stents (10.5%) had to be removed earlier than intended because of stent displacement; stents were reinserted during 1-2 weeks. Bacteruria was found in 6 patients (12%), additional 2 men (4%) with acute UTI were hospitalized, and successfully treated with antibiotics. Pa-tients suffered dysuria, urgency, and urge incontinence for 4-8 days after stent insertion. Later on, patients were con-tinent, voided satisfactorily, and their life quality improved significantly. Conclusions: Insertion of IUCs instead of an indwelling catheter, did reduce UTI by 84%, and improved significantly patient's quality of life. An indwelling catheter should be replaced by an IUC in men who are at high risk for surgery or anesthesia.