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Intermittent catheters may be best in older people

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Older people recovering from hip fractures respond better to intermittent catheterisation to prevent urinary retention than those who have an indwelling urethral catheter, according to the results of a recent study.

The research examined how the actions of nurses at a geriatric rehabilitation unit influenced the detection, prevention and treatment of urinary retention - the inability to urinate - in 48 patients aged 65 and over who were recovering from hip fracture.

Before a monitoring programme was implemented the incidence of urinary retention in hip fracture patients was around 82% before surgery and around 56% after surgery.

Researchers looked at the presence of urinary retention, bacteriuria, the patient’s cognitive function, use of ultra-sound bladder scan and type of treatment. After the six-month programme urinary retention was found in 18 (38%) of the patients.

None of the patients were subjected to an ultrasound bladder scan and the mean time of indwelling urethral catheter was three times longer than the programme suggested.

Patients treated with intermittent catheterisation had voiding satisfaction earlier and did not experience urinary retention again, compared with patients who used an indwelling urethral catheter.

The findings show that knowledge can be gained on how to reduce the incidence of urinary retention. How to implement this knowledge however seems to be the greatest challenge.

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