Catheter care in the community
There are some bizarre contradictions in our attitude to indwelling urinary catheters (IDC).
- We are quick to put them in but are reluctant to take them out. In nearly a half of patients their use is inappropriate.
- Many urological problems would be impossible to manage without an IDC but urologists consider them to be a last resort.
- They are amongst the oldest of medical instruments but there is still no satisfactory design.
- They usually drain into a bag but a flip/flow valve (tap) is more convenient and safer for the patient.
- By one month after insertion 95% of men will have asymptomatic bacteriuria and be given inappropriate antibiotics
- Many will have repeated symptomatic infections but there is no proven prophylaxis.
- When there is a complication in the community patients usually go to accident and emergency departments (A & E) although three quarters of the problems could be dealt with at home.
- Home treatment should be fairly easy but the right (simple) equipment is seldom available.
Some of these are big problems that will only be solved by laboratory and hospital-based research. From the patient’s point of view, day to day management is needed at home.
When there is a complication, a visit to A & E is very inconvenient. Most of the problems are simple and so what are the blocks to home management? Please let us know your thoughts.