Prevention of urine infection in adults and children who use intermittent catheterisation (a treatment involving passing a hollow tube into the bladder regularly) to empty their bladders

Intermittent catheterisation is a common treatment used by people who have bladder emptying problems. A hollow tube (catheter) is passed through the body's channel to the bladder (urethra) or through a surgically made channel to the skin surface, to regularly empty the bladder (usually several times every day). This treatment reduces problems such as loss of bladder control (incontinence) or having to pass urine very frequently or in a hurry (urgency). But people who use this treatment are often troubled by urine infections resulting in days lost from school or work or even hospitalisations. There are many different catheter types and techniques which may affect urine infection. In this review we assessed trials which focused on incidence of urine infection in intermittent catheterisation users who used different catheterisation techniques (sterile or clean); different types of catheters (coated [pre-lubricated] or uncoated [separate lubricant]); sterile (single-use) catheters or clean (multiple use) catheters; self-catheterisation or catheterisation by others (such as parents); and other strategies designed to reduce urine infection, including catheter cleaning (for multiple use). There are no definitive studies showing that the incidence of urine infection is improved with any catheter technique, type or strategy. These studies are difficult because participants need to take part for many months and many of the reviewed studies were too small and had problems with participants dropping out. Also definitions of urine infection varied considerably. The current strength of evidence is weak and well-designed studies are strongly recommended. Based on the current evidence, it is not possible to state that any catheter type, technique or strategy is better than another.