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Foley catheters tied to multiple problems

NEW YORK (Reuters Health) – Foley catheters may increase the risk for urinary infections, but that’s not their only disadvantage, a new study shows.

“Urinary tract infections receive significant attention as a complication of Foley catheter use. We found that genitourinary trauma related to Foley catheters, ranging from minor bleeding to perforation of the bladder, is an additional risk,” said Dr. Anne-Marie Leuck in an email to Reuters Health.

“Also,” she said, “despite education about correct treatment of catheter-related urinary tract infections, most of the antibiotics prescribed are unnecessary.”

As reported online March 15th in the Journal of Urology, Dr. Leuck of the University of Minnesota, Minneapolis and colleagues reviewed the medical records of inpatients with a Foley catheter at the Minneapolis Veterans Affairs Medical Center over a period of 16 months. Catheters were checked daily.

During 6,513 surveyed Foley catheter days, urinalysis/urine culture conducted on 407 days showed 116 possible urinary tract infections, of which only 21 (18%) involved clinical manifestations. Of these, 17 (81%) were treated with antimicrobials.

Thirty-nine (41%) of the 95 asymptomatic bacteriuria episodes were also treated with antimicrobials. Although the proportion was not greater, the number of asymptomatic patients who were treated was significantly higher.

In addition, there were 100 cases of catheter associated genitourinary trauma (1.5% of Foley catheter days), including 32 that led to interventions such as prolonged catheterization or cystoscopy.

In fact, such trauma was essentially as common as symptomatic infection.

“The current focus on infection as the main Foley catheter associated harm may be counterproductive by causing providers to overlook other important risks,” the authors wrote.

Dr. Leuck added in her email to Reuters Health, “The best way to avoid infection, unnecessary antibiotic use, and trauma is to focus efforts on eliminating unnecessary Foley catheter use.”


J Urol 2011.