Prolonged indwelling lower urinary tract catheters among males attending outpatient urologic clinic: indications, cost implications, complications and quality of life burden

Abstract

Context: Elimination of urine is a basic human function that can be deranged by illness, trauma, and other conditions. Urethral or suprapubic catheterization is used to ensure elimination of urine in patients who are unable to void naturally as a result of disorder of the lower urinary tract. Indwelling lower urinary tract catheter is termed prolonged when it remains in place for more than 14 days. This study aimed to identify the indications for unduly prolonged lower urinary tract catheterization among patients attending the urology clinic, the complications associated with such and the cost implication of this practice.

Methods: This was a descriptive cross sectional study conducted over a period of 3 months at the urology unit of Alex-Ekwueme Federal Universty Teaching Hospital Abakaliki, Ebonyi State, Nigeria. One hundred and eighteen patients presenting to the outpatient clinic were recruited using a consecutive sampling technique .Statistical analysis was performed using IBM statistical package for social Science for windows, version 21.0.

Results: The mean age of participants was years,65.31±14.31 while the mean duration of urethral catheterization was 22.42±32.58 months. The median cost of catheter change was 2800 Naira (interquartile range 1850-4000). The indications for catheter use were benign prostatic hyperplasia (BPH), urethral stricture disease (USD) and carcinoma of the prostate (CaP) in 54.2%, 28.0%, and 17.8% respectively. In one hundred and one (85.6%) patients the reason for prolonged catheterization was lack of funds, nine patients (7.6%) were afraid of surgical therapy and declined consent while eight patients (6.8%) were not fit for surgery. Pain was the most common complication occurring in 15(12.7%) patients. With respect to the quality of life 93 (78.8%) patients expressed sadness, 23 (19.5%) were indifferent while 2% reported they were happy.

Conclusion: Unduly prolonged indwelling urethral catheter is still common among patients attending our out-patients clinic and is commonly due to urinary retention from benign prostatic hyperplasia, urethral stricture disease and cancer of the prostate.