Intermittent catheterisation with hydrophilic-coated catheters delays the onset of urinary tract infection in patients with acute spinal cord injury: An international, multicenter, randomised controlled trial.

Hypothesis / aims of study Urinary tract infection (UTI) is a major complication of neurogenic bladder dysfunction arising from spinal cord injury (SCI). UTI is a serious health risk to these patients and is a very frequent medical complication during their initial rehabilitation as well as a common cause of morbidity throughout their lifetime. Intermittent catheterisation (IC) is typically the preferred method of bladder management method in SCI patients with neurogenic bladder as there is good evidence that IC decreases the risk of UTI and alleviates other complications associated with permanent indwelling catheterisation (1, 2). However, the challenge remains to further reduce the risk of UTI. Hydrophilic-coated catheters have a polymer substance coating which binds water resulting in a smooth and slippery surface which ensures lubrication throughout the entire length of the urethra. Although current literature suggests that, compared to uncoated IC catheters, hydrophilic-coated catheters reduce the risk of UTI, stronger evidence for this effect needs to be established (3). This randomised controlled trial is the largest to date to investigate the effect of hydrophilic-coated catheters on UTI occurrence. The primary objective of this study was to investigate whether IC using hydrophilic-coated catheters delayed the onset of the first UTI in acutely injured SCI patients as compared to IC using uncoated catheters.