Indwelling Urinary Catheterization versus Clean Intermittent Catheterization for the Short-Term Management of Hospitalized Patients with Transient Acute Urinary Retention: A Prospective Randomized Trial
Pocharapong Jenjitranant MD*, Worapat Attawettayanon MD*, Pokket Sirisreetreerux MD*, Premsant Sangkum MD*, Wit Viseshsindh MD*
Affiliation : * Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Background : Acute urinary retention (AUR) is a common problem in hospitalized patients. Either indwelling urethral
catheterization or clean intermittent catheterization (CIC) can be the choice of treatment. Catheter-associated urinary tract
infection (CAUTI) is the common complication.
Objective : The primary objective of this study was to compare rates of CAUTI between CIC and indwelling urethral catheter
technique for the short-term management of patients with transient AUR.
Material and Method: One hundred patients hospitalized patients who developed first-time AUR between June 2014 and May
2015 were randomized into CIC and indwelling urethral catheter groups using a sealed-envelope technique. The primary
outcomes of the study were catheter-associated asymptomatic bacteriuria and CAUTI. The secondary outcomes were pain,
gross hematuria, cloudy urine, and quality of life.
Results : There was no statistically significant difference between the CIC and indwelling urethral catheter groups in terms of
the rates of CAUTI (10% vs. 8%) and catheter-associated asymptomatic bacteriuria (52% vs. 36%) (p = 0.214). In addition,
there was no statistically significant difference in terms of gross hematuria (8% vs. 20%, p = 0.084), cloudy urine (26% vs.
22%, p = 0.640), pain score [0 (range, 0 to 7) vs. 0 (range, 0 to 6), p = 0.246], and quality of life [5 (range, 2 to 5) vs. 5 (range,
2 to 5), p = 0.596].
Conclusion : In hospitalized patients with transient AUR, CIC was not shown to be superior to indwelling urethral catheterization
in terms of rates of infections. Quality of life, pain, rates of gross hematuria, and cloudy urine were also similar in both
groups. Furthermore, indwelling catheterization is preferable in patients without caretakers.
Keywords : Urethral catheter, Clean intermittent catheterization, UTI, Pain, Quality of life, Hematuria, Cloudy urine
