Can 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

You want to add your comment? Please login
Login