Venugopal P
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10 Mar 2023 08:34:24 AMCan Catheters for CIC be reused?
Dear All,
World over CIC has become a common procedure, not only for Neurogenic Bladders but also in many other situations as well and at times it appears as overdo. When truly indicated CIC is an useful procedure but one CIC is started on an individual, be it an Adult or Child, we seldom think whether the condition for which CIC is recommended initially can be rectified to enable the patient to void urine.
From
the time Lapides popularized CIC in 1972, it has improved the quality of life
for many patients with Neurogenic Bladder. There is controversy existing
whether in such scenarios, the catheter can be reused. There are proponents for both but many leaders in the field
suggest single use. In many developed countries, this policy may not be
possible due to the cost constraint and non availability.
Andrew J Sun et al
(2018) studying the ‘environmental perspective on single use CIC’ found that by
using single use catheters for just CIC alone cost the country enormously. The
study found that atleast 300?800 persons in the United States perform CIC
for neurogenic bladder management. Assuming five catheterization events per
day, single?use
CIC may generate up to 85 million pounds or 206 million liters of waste annually,
equivalent to more than 26?000 cars or 80 Olympic?sized swimming pools. Laid end?to?end, there is enough catheter length to go around the world more than 5.5
times. The most common materials used in catheter construction have little
to no degradation once in a landfill. They concluded by stating that ‘Given the
unproven clinical benefit of single?use catheterization, the environmental impact and alternatives should be
considered’.
Pedro A Madero-Morales et al (2019) Conducting a
randomized trial found no difference between single-use polyvinylchloride (PVC)
catheters and reused PVC catheters for patients with neurogenic bladder
(Neurogenic Bladder was chosen as it is the most frequent condition for which
CIC is performed). At baseline, 35.1% of the single-use group and 39.5% of the
reusable group had asymptomatic bacteriuria based on a urine culture. At the
follow-up assessment, 32.4% of the single-use group and 23.7% of the reusable
group had bacteriuria. They concluded that ‘there were no differences between both types’. A catheter
cleansed with 0.5% Benzalkonium Chloride is probably as safe for reuse of
catheter as use of non reusable catheter. The catheters were washed with plain soap and
water and stored in container containing Benzalkonium Chloride and can safely
be used for ~a week.
How
many of us in India suggesting CIC, suggest reuse of catheters or do we use it
only once and then disposed of.
With
warm regards,
Venu
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