Reuse versus single-use catheters for intermittent catheterization: what is safe and preferred? Review of current status

Study design: This is a narrative review summarizing prevalence and background of reusing catheters for intermittent catheterization. It also compares complications related to reuse versus single use. Objectives and setting: The objective of the review is to highlight the on-going debate regarding whether reuse of catheters is as safe as single-use technique and investigate why reuse is common in some countries (for example, Australia, Canada and the United States). Methods: The review is the result of systematic searches in several databases (for example, MEDLINE, EMBASE and CINAHL) using predefined key words and search strategy. Results: The literature does not explicitly recommend reuse but instead proposes patient-oriented choice. Even so, the prevalence of reuse is similar to 50% in some regions. Both off-label reuse and reuse of catheters intended for multiple use occur. The former is not legally supported. There seems to be no consensus on how many times a catheter can be reused or how to clean it. Poor compliance and efficacy of cleaning techniques have been reported, increasing the risk for introducing bacterial contamination. The literature supports the use of single-use hydrophilic catheters to reduce the risk of urethral trauma and urinary tract infection with a reported incidence of the latter between 40 and 60%, as compared with 70-80% for reuse catheters. Further clinical studies are however needed to verify/reject a difference. Conclusion: Complications associated with reuse need to be further investigated. Although awaiting evidence, it is recommended to use a confirmed safe, patient-preferred, noninfecting and nontraumatic technique for intermittent catheterization.