What's known on the subject? and What does the study add?
Clean intermittent catheterization (CIC) is considered the method of choice for bladder emptying when neurological or non-neurological causes make normal voiding impossible or incomplete. The outcome is overall good, also in the long-term. There is neither one best technique nor one best material, as both depend greatly on patients' individual anatomic, social and economic possibilities. The most frequent complication is urinary tract infection (UTI). Studies differ in the definition criteria for UTI, methods for evaluation, CIC techniques, frequency of urine analysis, prophylaxis and patients studied.
The study provides a literature review and shows that most studies do not have a high level of evidence. There are various risk factors for UTI and phenotyping them helps to assess prognosis by considering what can happen if treatment is not initiated. The study concludes, that the role of biofilms in CIC deserves more attention and that diagnosis should be made on urine sample obtained with catheterization, because symptoms are often less reliable. It also concludes that treatment in those who catheterize for a long time is only necessary for symptomatic infections. The study identifies the following areas for further research: prevention of UTI in patients performing CIC; the use of special catheter types; and the role of frequency of catheterization, prophylactic antibiotics and preservation of natural defence mechanisms in the lower urinary tract.