Indwelling Urinary Catheterization versus Clean Intermittent Catheterization for

Indwelling Urinary Catheterization versus Clean Intermittent Catheterization for the Management of Hospitalized Patients with Transient Acute Urinary Retention: A Prospective Randomized Trial Pocharapong Jenjitranant, Worapat Attawettayanon, Pokket Sirisreetreerux, Premsant Sangkum, Wit Viseshsindh, Division of Urology, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University Acute urinary retention (AUR) is a common problem in hospitalized patients. The causes of AUR in these patients are multifactorial and usually transient. Either indwelling urethral catheterization or clean intermittent catheterization can be the choice of treatment. In chronic urinary retention, most physicians prefer CIC to chronic indwelling urethral catheter claiming that the rate of CAUTI is lower. Catheter -associated urinary tract infection (CAUTI) • Indwelling urethral catheter: daily risk of acquisition of bacteriuria 3 -7% Objective: What is the best treatment for short-term AUR? • CIC: 1 -3% per catheterization, high frequency of catheterization creates a substantial cumulative burden CIC Foley in terms of CAUTI, pain, hematuria, cloudy urine, and QOL Materials and Methods Inclusion Criteria • Hospitalized patients who developed first time AUR from June 2014 to May 2015 Pts with first time AUR U/C, UA positive CAUTI • symptoms or signs compatible with UTI • no other identified source of infection • ≥ 103 CFU/m. L of ≥ 1 bacterial species in a single catheter urine specimen or in a midstream voided urine specimen • urethral catheter removed within the previous 48 hours Exclusion negative Randomized CIC Foley Symptoms Follow up at 2 weeks Try to remove catheter U/C, UA, Pain, QOL Exclusion Criteria • Age under 18 years old • Previous history of urinary retention • Urinary tract infection • Poor compliance U/C positive CAUTI Catheter-associated asymptomatic bacteriuria • patient without symptoms compatible with UTI • ≥ 105 CFU/m. L of ≥ 1 bacterial species Results Patient Characteristics p = 0. 779 Conclusion • CIC was not shown to be superior to indwelling urethral catheterization in terms of rates of CAUTI and catheter associated asymptomatic bacteriuria. • Quality of life, pain, rates of hematuria, and cloudy urine were also similar. • Indwelling urethral catheterization is an appropriate therapeutic intervention for hospitalized patients with transient AUR especially in disabled patients without caretakers to handle the CIC.