Infection is just one of the problems associated with urinary catheters. A new study found that other problems, including pain and impaired sexual function, may also occur.

A new study provides a lot of evidence for what many hospital patients already know: a catheter may help empty the bladder - but it can also be painful, cause urinary tract infections and cause other problems inside and outside the hospital.

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Based on in-depth interviews and chart reviews with more than 2,000 patients, more than half of catheterization hospital patients experienced complications. The results were published in JAMA Internal Medicine.

The study found that although many patient safety experts are concerned about UTI that may be caused by indwelling catheters (also known as Foley catheters), this risk is 5 times less than non-infectious problems.

These problems include pain while the catheter is still being inserted, hematuria, and restricted mobility; problems with urination and sexual function may occur after removing the device.

"Our findings emphasize the importance of avoiding indwelling catheters unless absolutely necessary, and removing them as soon as possible," said Sanjay Saint, MD and Master of Public Health, the lead author of the new study.

He is also the Medical Director of the VA Ann Arbor Healthcare System, the George Dock Professor of Internal Medicine at the University of Michigan, and the head of the UM/VA Patient Safety Enhancement Program.

In this new study, San and his colleagues from UM, Ann Arbor, Virginia, and two Texas hospitals analyzed data from 2,076 patients who had recently placed short-term catheters. Most of them received catheters because they are undergoing surgery.

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The team visited each patient twice—two weeks and one month after their catheterization—and asked them about their catheter-related experiences.

Since the two hospitals in the study are Department of Veterans Affairs hospitals, nearly three-quarters of the patients are men. 76% of patients had the catheter removed within three days of insertion.

Overall, 57% of patients said they had experienced at least one complication.

More than 10% of patients have reported infections. These include a formal diagnosis and symptoms consistent with symptoms that require a doctor's attention.

55% of patients reported at least one non-infectious complication.

Not many patients say that the catheter is painful, although most patients are undergoing surgery and are not awake when the catheter is placed. However, 31% of people who had already removed the catheter in the first interview said it would cause injury or cause bleeding. More than half of the respondents said in an interview with the catheter still that it made them feel pain or discomfort.

A quarter of patients said that the catheter caused them to have bladder spasm or urgency; 10% said it caused their urine to be bloody.

Among those interviewed while the catheter was still there, nearly 40% said it restricted their daily activities, and 44% said it restricted their social activities.

Among those who have had their urinary catheters removed, approximately 20% said they have experienced leakage of urine or difficulty starting or stopping urination. Nearly 5% said that this caused sexual problems.

Saint is a long-time advocate of measurement and prevention of catheter-related infections, and he plans to conduct further research on the subject.

"Although the infectious hazards of indwelling catheters have received due attention in the past few decades, recently we have better understood the extent of the non-infectious hazards caused by these devices," he said.

Better monitoring of catheter patients and more education are also important.

"Given the results of our study, we believe it is important to develop strategies to better track non-infectious complications of urinary catheters and prepare patients for these types of problems, especially after they are discharged from the hospital," the senior author Said Dr. Sarah Krein. ., RN, Ann Arbor VA and UM.

Saint, Kerin and co-authors John Colozzi, Karen Fowler, and David Ratz are members of the VA Clinical Management Research Center. Saint, Kerin, and co-author John Hollingsworth, MD, of the Department of Urology at the University of Michigan, are all members of the UM Institute for Healthcare Policy and Innovation. The other co-authors of the paper are Barbara Trautner, MD, and Erica Lescinskas, MD, of Baylor College of Medicine.

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