Effects of Different Urinary Catheterization Practices on Urinary Complications and Quality of Life

Year 2025, Volume: 20 Issue: 1, 32 - 39, 27.02.2025

Yeliz Çulha , Funda Büyükyılmaz , Mehmet Gökhan Çulha

https://doi.org/10.33719/nju1614575

Abstract

Objective: This study investigates the effects of different urinary catheterization methods—transurethral catheterization (TC), suprapubic catheterization (SC), and clean intermittent catheterization (CIC)—on urinary complications and quality of life.
Material and Methods: This research conducted as a descriptive design with 91 patients at a urology clinic in Istanbul between November 2023 and September 2024, the research evaluates catheterization-related complications and their impact on patients’ emotional, social, and physical well-being over a six-month period. Data collection utilized the Patient Information Form and the King’s Quality of Life Questionnaire.
Results: Indicate that while all methods present complications such as urinary tract infections (UTIs), urgency, and hematuria, CIC and SC showed significant reductions in UTI rates over time (p=0.001 and p=0.042, respectively). CIC also resulted in fewer cases of hematuria compared to other methods (p=0.039). In terms of quality of life, SC demonstrated improvements in emotional and social domains over six months, whereas CIC offered enhanced autonomy and better physical health outcomes. Transurethral catheterization, despite its widespread use, was associated with higher complication rates, particularly UTIs.
Conclusion: The findings underscore the importance of individualized catheterization decisions as based on multidisciplinary team approach and emphasize the critical role of nursing in following patient outcomes. Comprehensive patient education and adherence to hygiene protocols were instrumental in reducing complications and enhancing quality of life. Future studies should explore the long-term implications of these catheterization methods and further assess the role of nursing interventions in improving patient care.

Keywords

clean intermittent catheterization, transuretral catheterization, suprapubic cystostomy, complications, quality of life

Ethical Statement

Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital was reviewed by the Clinical Research Ethics Committee at its meeting dated 06.11.2023 and found to be ethically appropriate according to decision number 258.

Supporting Institution

None.

Farklı Üriner Kateterizasyon Uygulamalarının Üriner Komplikasyonlar ve Yaşam Kalitesi Üzerindeki Etkisi

Abstract

Amaç: Bu çalışmada farklı üriner kateterizasyon yöntemlerinin (transüretral kateterizasyon (TC), suprapubik kateterizasyon (SC) ve temiz aralıklı kateterizasyon (TAK) üriner komplikasyonlar ve yaşam kalitesi üzerindeki etkileri araştırılmıştır.
Yöntem: Tanımlayıcı olarak planlanan, Kasım 2023 ile Eylül 2024 arasında İstanbul'daki bir üroloji kliniğinde 91 hasta ile yürütülen araştırma, kateterizasyonla ilişkili komplikasyonları ve bunların altı aylık bir süre boyunca hastaların duygusal, sosyal ve fiziksel refahı üzerindeki etkilerini değerlendirmektedir. Veri toplamada Hasta Bilgi Formu ve King's Yaşam Kalitesi Anketi kullanılmıştır.
Bulgular: Tüm kateterizasyon yöntemleri idrar yolu enfeksiyonları (İYE), aciliyet ve hematüri gibi komplikasyonlara yol açarken, SC ve TAK’ın zamanla İYE oranlarında önemli azalmalar gösterdiği saptanmıştır (sırasıyla p=0,001 ve p=0,042). TAK ayrıca diğer yöntemlere kıyasla daha az hematüri vakasıyla sonuçlanmıştır (p=0,039). Yaşam kalitesi açısından, SC altı ay boyunca duygusal ve sosyal alanlarda iyileşmeler gösterirken, TAK gelişmiş özerklik ve daha iyi fiziksel sağlık sonuçları sunmaktadır. TC, yaygın kullanımına rağmen, özellikle İYE'ler olmak üzere daha yüksek komplikasyon oranlarıyla ilişkilendirilmiştir.
Sonuç: Bulgular, multidisipliner ekip yaklaşımına temelli bireyselleştirilmiş kateterizasyon kararlarının önemini vurgular ve hasta sonuçlarının izleminde hemşireliğin kritik rolünü vurgular. Kapsamlı hasta eğitimi ve hijyen protokollerine uyum, komplikasyonları azaltmada ve yaşam kalitesini artırmada etkilidir. Gelecekteki çalışmalar, bu kateterizasyon yöntemlerinin uzun vadeli etkilerini araştırmalı ve hasta bakımını iyileştirmede hemşirelik girişimlerinin rolünü daha fazla değerlendirmelidir.

Keywords

temiz aralıklı kateterizasyon, transüretral kateterizasyon, suprapubik sistostomi, komplikasyonlar, yaşam kalitesi

References

• 1. Lauridsen, S., et al., European Association of Urology Nurses Evidence-based Guidelines for Best Practice in Urological Health Care Catheterisation Urethral intermittent in adults Dilatation, urethral intermittent in adults Evidence-based Guidelines for Best Practice in Urological Health Care Catheterisation Urethral intermittent in adults Dilatation, urethral intermittent in adults. 2013.
• 2. Niël-Weise BS, van den Broek PJ, da Silva EM, Silva LA. Urinary catheter policies for long-term bladder drainage. Cochrane Database Syst Rev. 2012;(8):CD004201. Published 2012 Aug 15. https://doi.org/10.1002/14651858.CD004201.pub3
• 3. Bhatt NR, Davis NF, Thorman H, Brierly R, Scopes J. Knowledge, skills, and confidence among healthcare staff in urinary catheterization. Can Urol Assoc J. 2021;15(9):E488-E494. https://doi.org/10.5489/ cuaj.6986
• 4. Culha Y, Acaroglu R. The Effect of Video-Assisted Clean Intermittent Catheterization Training on Patients’ Practical Skills and Self-Confidence. Int Neurourol J. 2022;26(4):331-341. https://doi.org/10.5213/ inj.2244166.083
• 5. Newman DK, New PW, Heriseanu R, et al. Intermittent catheterization with single- or multiple-reuse catheters: clinical study on safety and impact on quality of life. Int Urol Nephrol. 2020;52(8):1443-1451. https://doi.org/10.1007/s11255-020-02435-9
• 6. Campeau L, Shamout S, Baverstock RJ, et al. Canadian Urological Association Best Practice Report: Catheter use. Can Urol Assoc J. 2020;14(7):E281-E289. https:// doi.org/10.5489/cuaj.6697
• 7. Silva DRA, Mazzo A, Jorge BM, Souza Júnior VD, Fumincelli L, Almeida RGS. Intermittent Urinary Catheterization: The Impact of Training on a LowFidelity Simulator on the Self-Confidence of Patients and Caregivers. Rehabil Nurs. 2017;42(2):97-103. https://doi.org/10.1002/rnj.226
• 8. Büyükyilmaz F, Culha Y, Zümreler H, Özer M, Culha MG, Ötünçtemur A. The effects of bladder training on bladder functions after transurethral resection of prostate. J Clin Nurs. 2020;29(11-12):1913-1919. https://doi.org/10.1111/jocn.14939
• 9. Kelleher CJ, Cardozo LD, Khullar V, Salvatore S. A new questionnaire to assess the quality of life of urinary incontinent women. Br J Obstet Gynaecol. 1997;104(12):1374-1379. https://doi. org/10.1111/j.1471-0528.1997.tb11006.x
• 10. Akkoc Y, Karapolat H, Eyigor S, Yesil H, Yüceyar N. Quality of life in multiple sclerosis patients with urinary disorders: reliability and validity of the Turkish version of King’s Health Questionnaire. Neurol Sci. 2011;32(3):417- 421. https://doi.org/10.1007/s10072-011-0484-9
• 11. Lavelle RS, Coskun B, Bacsu CD, Gliga LA, Christie AL, Lemack GE. Quality of life after suprapubic catheter placement in patients with neurogenic bladder conditions. Neurourol Urodyn. 2016;35(7):831-835. https://doi.org/10.1002/nau.22812
• 12. Fumincelli L, Mazzo A, Martins JCA, Henriques FMD, Cardoso D, Rodrigues MA. Quality of Life of Intermittent Urinary Catheterization Users and Their Caregivers: A Scoping Review. Worldviews Evid Based Nurs. 2017;14(4):324-333. https://doi.org/10.1111/ wvn.12231
• 13. Nast KJ, Chiang G, Marietti S. Vesicostomy button: how is it placed, in whom, and how is quality of life affected?. Int Braz J Urol. 2019;45(4):807-814. https://doi.org/10.1590/S1677-5538.IBJU.2018.0686
• 14. Fumincelli L, Mazzo A, Martins JCA, Henriques FMD, Orlandin L. Quality of life of patients using intermittent urinary catheterization. Rev Lat Am Enfermagem. 2017;25:e2906. Published 2017 Jul 10. https://doi.org/10.1590/1518-8345.1816.2906
• 15. Schiøtz HA, Malme PA, Tanbo TG. Urinary tract infections and asymptomatic bacteriuria after vaginal plastic surgery. A comparison of suprapubic and transurethral catheters. Acta Obstet Gynecol Scand. 1989;68(5):453- 455. https://doi.org/10.3109/00016348909021020
• 16. Kinnear N, Barnett D, O’Callaghan M, Horsell K, Gani J, Hennessey D. The impact of catheter-based bladder drainage method on urinary tract infection risk in spinal cord injury and neurogenic bladder: A systematic review. Neurourol Urodyn. 2020;39(2):854-862. https:// doi.org/10.1002/nau.24253
• 17. Krebs J, Wöllner J, Pannek J. Risk factors for symptomatic urinary tract infections in individuals with chronic neurogenic lower urinary tract dysfunction. Spinal Cord. 2016;54(9):682-686. https://doi.org/10.1038/sc.2015.214
• 18. Hennessey DB, Kinnear N, MacLellan L, Byrne CE, Gani J, Nunn AK. The effect of appropriate bladder management on urinary tract infection rate in patients with a new spinal cord injury: a prospective observational study. World J Urol. 2019;37(10):2183-2188. https://doi. org/10.1007/s00345-018-02620-7
• 19. Katsumi HK, Kalisvaart JF, Ronningen LD, Hovey RM. Urethral versus suprapubic catheter: choosing the best bladder management for male spinal cord injury patients with indwelling catheters. Spinal Cord. 2010;48(4):325- 329. https://doi.org/10.1038/sc.2009.134
• 20. Alex J, Ferguson C, Ramjan LM, Fishburn ML, Montayre J, Salamonson Y. Development and evaluation of a spaced eLearning intervention for nurses in enhancing urinary catheter management - A co-design study in partnership with research end-users. Nurse Educ Today. 2025;144:106448. https://doi.org/10.1016/j.nedt.2024.106448
• 21. Seyhan Ak E, Özbaş A. The effect of education of nurses on preventing catheter-associated urinary tract infections in patients who undergo hip fracture surgery. J Clin Nurs. 2018;27(5-6):e1078-e1088. https://doi.org/10.1111/ jocn.14160
• 22. Oswald F, Young E, Denison F, Allen RJ, Perry M. Staff and patient perceptions of a community urinary catheter service. Int J Urol Nurs. 2020;14(2):83-91. https://doi. org/10.1111/ijun.12230