Originally published by EurekaAlert!
People with spinal cord injuries rely on catheters to empty their bladder. When a well-respected publication concluded that catheters could be reused without an increased risk of infection, it didn’t sit right with a Vancouver clinician and researcher. He had spoken to wheelchair athletes about this very issue while working at the Summer Paralympics in London.
“Wheelchair athletes from wealthier countries would only use each catheter once while athletes from developing countries would clean and reuse their catheters again and again,” said Dr. Andrei Krassioukov, a professor of medicine at UBC and chair in rehabilitation research with ICORD. “The athletes who used catheters only once experienced three-to-four times fewer urinary tract infections than athletes who reused catheters.”
Urinary tract infections can be disruptive to people’s daily lives, resulting in time off work or from other activities. Antibiotics are prescribed to treat urinary tract infections. People with spinal cord injury are at higher risk for urinary tract infection.
Cochrane is a well-established organization that collects data from many studies and provides evidence for best practices in medicine. In 2014, Cochrane reviewed evidence from 31 clinical trials to compare single vs. multiple-use catheters and urinary tract infections. The review found that there was no convincing evidence that the incidence of infection was affected by catheterization.
From his clinical experience and his study conducted at the Paralympics, Krassioukov had a “gut feeling” that the results were wrong. He assembled a team of experts from around the world to re-examine the evidence. They found a number of errors and wrote to Cochrane’s acting editor-in-chief to alert him. An updated analysis by Cochrane, published in 2017, has since been withdrawn.
“Until evidence can confidently demonstrate that multiple use is as safe as single use, health-care providers should advocate for single-use of catheters since catheter cleaning is a major issue,” said Krassioukov. “This will affect the direction on how we manage patients.”
