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Comparison of urinary tract infection rates associated with transurethral catheterization, suprapubic tube and clean intermittent catheterization in the postoperative setting: A network meta-analysis

The Journal of Urology Evidence based | Aug 15, 2017

Han CS, et al. – Researchers conducted a network meta–analysis of available randomized controlled trials (RCT) to evaluate the risks of urinary tract infection (UTI) correlated with transurethral catheterization (TUC), suprapubic tube (SPT) and intermittent catheterization (IC) in the postoperative setting. The results confirmed that TUC is not associated with increased UTI risks compared to SPT and IC if DOC is ≤ 5 days. Nevertheless, SPT or IC are correlated with lower rates of UTI if longer term catheterization is expected in postoperative periods.

Methods
  • Between January 1980 to July 2015, researchers conducted PubMed, EMBASE and Google Scholar searches for eligible RCTs for including patients who had TUC, SPT, or IC at the time of surgery and catheterization lasting up to postoperative day 30.
  • The preliminary endpoint of comparison was rates of UTI via a network meta–analysis with random effects model using a package netmeta in R 3.2.

Results
  • They enrolled 14 RCTs in the analysis (n=1,391 patients).
  • It was noted that IC and SPT displayed no evidence of decreased UTI rates compared to TUC.
  • In context of the findings, SPT and IC had comparable UTI rates (OR=0.903, 95% CI 0.479–2.555).
  • In a subgroup analysis on 10 RCTs with available mean duration of catheterization (DOC) data (n=928 patients), IC and SPT were correlated with significantly decreased risks of UTI compared to TUC when DOC > 5 days (OR=0.173, 95% CI 0.073–0.412 and OR=0.142, 95% CI 0.073–0.276, respectively).
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