Prevalence and Cost of Catheters to Manage Neurogenic Bladder
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Purpose of Review
In this review, we examine the current literature to address the epidemiology of catheters for managing neurogenic bladder. We will address the epidemiology of conditions associated with neurogenic bladder, including multiple sclerosis, spinal cord injury, Parkinson’s disease, stroke, and spina bifida. Rates of utilization of various catheter strategies, including indwelling urethral catheter, suprapubic catheter, and intermittent catheterization rates will be reviewed. Lastly, we examine the cost considerations between and within each type of strategy.
Management strategies for neurogenic bladder have evolved overtime. Costs between catheter strategies are largely driven by complications. The highest cost variation within each strategy is related to the technique and type of intermittent catheter. Recently, there has been an increase in costlier single-use intermittent catheter strategies. However, the short- and long-term benefits of these strategies remained understudied.
Without comparative studies highlighting improvements in complication rates and compliance, the benefits of single-use catheters for intermittent catheterization are largely theoretical. Until such studies are performed, providers should strongly consider managing neurogenic bladder patients with reusable intermittent catheters in order to provide the most cost-conscious care.
KeywordsNeurogenic bladder Cost of catheterization Intermittent catheterization
Compliance with Ethical Standards
Conflict of Interest
The authors declare no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 10.Manack A, Motsko SP, Haag-Molkenteller C, Dmochowski RR, Goehring EL Jr, Nguyen-Khoa BA, et al. Epidemiology and healthcare utilization of neurogenic bladder patients in a US claims database. Neurourol Urodyn. 2011;30(3):395–401.Google Scholar
- 17.Calabrese VP. Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology 2007;69(2):223–224; author reply 4.Google Scholar
- 18.Chapple CR, Wein AJ, Abrams P, Dmochowski RR, Giuliano F, Kaplan SA, et al. Lower urinary tract symptoms revisited: a broader clinical perspective. Eur Urol. 2008;54(3):563–9.Google Scholar
- 21.Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 update: a report from the American Heart Association. Circulation. 2017;135(10):e146–603.Google Scholar
- 22.Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383(9913):245–54.Google Scholar
- 24.Badlani G. Urologic problems in cerebrovascular accidents. Probl Urol. 1993;41Google Scholar
- 26.Centers for Disease C, Prevention. Racial/ethnic differences in the birth prevalence of spina bifida - United States, 1995-2005. MMWR Morb Mortal Wkly Rep. 2009;57(53):1409–13.Google Scholar
- 27.Shin M, Besser LM, Siffel C, Kucik JE, Shaw GM, Lu C, et al. Prevalence of spina bifida among children and adolescents in 10 regions in the United States. Pediatrics. 2010;126(2):274–9.Google Scholar
- 31.Consortium for Spinal Cord M. Bladder management for adults with spinal cord injury: a clinical practice guideline for health-care providers. J Spinal Cord Med. 2006;29(5):527–73.Google Scholar
- 39.• Krebs J, Wollner J, Pannek J. Bladder management in individuals with chronic neurogenic lower urinary tract dysfunction. Spinal Cord. 2016;54(8):609–13. This reference provided an updated epidemiology of bladder management patterns with respect to type of neurologic dysfunction. Rates of catheterization technique were examined in a large heterogenous population of chronic neurogenic bladder patients. Individuals at risk of indwelling catheterization were identified based on female gender, age, injury severity and injury duration.PubMedGoogle Scholar
- 51.Jamison J, Maguire S, McCann J. Catheter policies for management of long term voiding problems in adults with neurogenic bladder disorders. Cochrane Database Syst Rev. 2013;11:CD004375.Google Scholar
- 53.Willson M, Wilde M, Webb ML, Thompson D, Parker D, Harwood J, et al. Nursing interventions to reduce the risk of catheter-associated urinary tract infection: part 2: staff education, monitoring, and care techniques. J Wound Ostomy Continence Nurs. 2009;36(2):137–54.Google Scholar
- 54.Hooton TM, Bradley SF, Cardenas DD, Colgan R, Geerlings SE, Rice JC, et al. Diagnosis, prevention, and treatment of catheter-associated urinary tract infection in adults: 2009 International Clinical Practice Guidelines from the Infectious Diseases Society of America. Clin Infect Dis. 2010;50(5):625–63.Google Scholar
- 57.Jahn P, Preuss M, Kernig A, Seifert-Huhmer A, Langer G. Types of indwelling urinary catheters for long-term bladder drainage in adults. Cochrane Database Syst Rev. 2007;3:CD004997.Google Scholar
- 59.Pickard R, Lam T, MacLennan G, Starr K, Kilonzo M, McPherson G, et al. Antimicrobial catheters for reduction of symptomatic urinary tract infection in adults requiring short-term catheterisation in hospital: a multicentre randomised controlled trial. Lancet. 2012;380(9857):1927–35.Google Scholar
- 65.Lance L. Goetz L Droste, Adam P. Klausner and Diane K. Newman. Catheters used for intermittent catheterization. In: Springer, editor. Clinical application of urologic catheters, devices and products 2018. p. 44–77.Google Scholar
- 69.Goetz LL, Klausner AP. Strategies for prevention of urinary tract infections in neurogenic bladder dysfunction. Phys Med Rehabil Clin N Am 2014;25(3):605–618, viii.Google Scholar
- 70.Lavallee DJ, Lapierre NM, Henwood PK, Pivik JR, Best M, Springthorpe VS, et al. Catheter cleaning for re-use in intermittent catheterization: new light on an old problem. SCI Nurs. 1995;12(1):10–2.Google Scholar
- 71.Kurtz MJ, Van Zandt K, Burns JL. Comparison study of home catheter cleaning methods. Rehabil Nurs 1995;20(4):212–214, 7.Google Scholar
- 73.•• Prieto JA, Murphy C, Moore KN, Fader MJ. Intermittent catheterisation for long-term bladder management (abridged cochrane review). Neurourol Urodyn. 2015;34(7):648–53. These recent references revisited the debate between the merits of single-use catheters that were made in a recent Cochrane review article. By reanalyzing Cochrane review data, (after data correction), no difference was found between single- versus multiple-use of catheters with respect to UTI–53.Google Scholar
- 74.•• Christison K, Walter M, Wyndaele JJM, Kennelly M, Kessler TM, Noonan VK, et al. Intermittent catheterization: the devil is in the details. J Neurotrauma. 2018; These recent references revisited the debate between the merits of single-use catheters that were made in a recent Cochrane review article. By reanalyzing Cochrane review data, (after data correction), no difference was found between single- versus multiple-use of catheters with respect to UTI. Google Scholar
- 75.De Ridder DJ, Everaert K, Fernandez LG, Valero JV, Duran AB, Abrisqueta ML, et al. Intermittent catheterisation with hydrophilic-coated catheters (SpeediCath) reduces the risk of clinical urinary tract infection in spinal cord injured patients: a prospective randomised parallel comparative trial. Eur Urol. 2005;48(6):991–5.PubMedGoogle Scholar
- 82.KC Moore ML, Robinson E, Bagulay N, Pearce I. Cleaning and re-using intermittent self catheters: a questionnaire to gauge patient’s perceptions and prejudices. J Clin Urol. 2014;7(4):277–82.Google Scholar