Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/24723
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dc.contributor.authorSinclair, Lesleyen_UK
dc.contributor.authorHagen, Suzanneen_UK
dc.contributor.authorCross, Stephenen_UK
dc.date.accessioned2016-12-21T01:51:01Z-
dc.date.available2016-12-21T01:51:01Zen_UK
dc.date.issued2011-09en_UK
dc.identifier.urihttp://hdl.handle.net/1893/24723-
dc.description.abstractBackground: People requiring long-term bladder draining with an indwelling catheter can experience catheter blockage. Regimens involving different solutions can be used to wash out catheters with the aim of preventing blockage.  Objectives: To determine if certain washout regimens (including no washout) are better than others in terms of effectiveness, acceptability, complications, quality of life, and economics for the management of long-term indwelling urinary catheters in adults.  Search Methods: We searched the Cochrane Incontinence Group Specialized Trials Register (searched April 30, 2009), MEDLINE (January 1966 to April 2009), MEDLINE In-Process (April 30, 2009), EMBASE (January 1980 to April 2009), and CINAHL (December 1981 to April 2009). Additionally, we examined all reference lists of identified trials and contacted manufacturers and researchers in the field.  Selection Criteria: All randomized and quasi-randomized trials comparing catheter washout policies (e.g., washout vs. no washout, different washout solutions, frequency, duration, volume, concentration, method of administration) in adults (16 years and above) in any setting (i.e., hospital, nursing/residential home, community) with an indwelling urethral or suprapubic catheter in place for more than 28 days.  Data Collection and Analysis: Data were extracted by three reviewers independently and compared. Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook. If the trial data were not fully reported, clarification was sought from the authors. For categorical outcomes, the numbers reporting an outcome were related to the numbers at risk in each group to derive a risk ratio (RR). For continuous outcomes, means, and standard deviations were used to derive weighted mean differences (WMD). No meta-analysis of study results was possible.  Results: Five trials met the inclusion criteria involving 242 patients (132 completed) in two cross-over and three parallel-group randomized controlled trials. Only three of the eight comparisons pre-stated in the review protocol were addressed in these trials. Some trials addressed more than one comparison (e.g., washout vs. no washout and one type of washout solution vs. another). The analyses reported for the two cross-over trials were inappropriate as they were based on differences between groups rather than differences within individuals receiving sequential interventions. Two parallel-group trials had limited value: one combined results for suprapubic and urethral catheters and one had data on only four participants. Only one trial was free of significant methodological limitations, but its sample size was small.  Three trials compared no washout with one or more washout solution (saline or acidic solutions) and authors tended to conclude no difference in clinical outcomes between washout and no washout. In the one trial which had data of sufficient quality to allow interpretation, no difference was detected between washout and no washout groups in the rate of symptomatic urinary tract infection or time to first catheter change.  Three trials compared different types of solution: saline versus acidic solutions (two trials); saline versus acidic solution versus antibiotic solution (one trial). Authors tended to report no difference between different washout solutions but the data were too few to support their conclusions. The one trial which warranted consideration concluded no difference between saline and an acidic solution in terms of symptomatic urinary tract infections or time to first catheter change.  Conclusions: The data from five trials comparing differing washout policies were sparse and trials were generally of poor quality or poorly reported. The evidence was too scant to conclude whether or not washouts were beneficial. Further rigorous, high quality trials with adequate power to detect any benefit from washout rather than no washout being performed are required in the first instance. After that, trials comparing different washout solutions, washout volumes, frequencies/timings, and routes of administration are needed.en_UK
dc.language.isoenen_UK
dc.publisherWiley-Blackwellen_UK
dc.relationSinclair L, Hagen S & Cross S (2011) Washout policies in long-term indwelling urinary catherterization in adults: a short version Cochrane review. Neurourology and Urodynamics, 30 (7), pp. 1208-1212. https://doi.org/10.1002/nau.21063en_UK
dc.rightsThe publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.en_UK
dc.rights.urihttp://www.rioxx.net/licenses/under-embargo-all-rights-reserveden_UK
dc.titleWashout policies in long-term indwelling urinary catherterization in adults: a short version Cochrane reviewen_UK
dc.typeJournal Articleen_UK
dc.rights.embargodate2999-12-12en_UK
dc.rights.embargoreason[Sinclair_et_al-2011-Neurourology_and_Urodynamics.pdf] The publisher does not allow this work to be made publicly available in this Repository therefore there is an embargo on the full text of the work.en_UK
dc.identifier.doi10.1002/nau.21063en_UK
dc.identifier.pmid21563211en_UK
dc.citation.jtitleNeurourology and Urodynamicsen_UK
dc.citation.issn1520-6777en_UK
dc.citation.issn0733-2467en_UK
dc.citation.volume30en_UK
dc.citation.issue7en_UK
dc.citation.spage1208en_UK
dc.citation.epage1212en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.author.emaill.a.sinclair@stir.ac.uken_UK
dc.citation.date11/05/2011en_UK
dc.contributor.affiliationInstitute for Social Marketingen_UK
dc.contributor.affiliationGlasgow Caledonian Universityen_UK
dc.contributor.affiliationEast Cheshire NHS Trusten_UK
dc.identifier.isiWOS:000294727800002en_UK
dc.identifier.scopusid2-s2.0-80052055165en_UK
dc.identifier.wtid555604en_UK
dc.contributor.orcid0000-0002-2210-8181en_UK
dc.date.accepted2010-12-31en_UK
dcterms.dateAccepted2010-12-31en_UK
dc.date.filedepositdate2016-12-20en_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorSinclair, Lesley|0000-0002-2210-8181en_UK
local.rioxx.authorHagen, Suzanne|en_UK
local.rioxx.authorCross, Stephen|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2999-12-12en_UK
local.rioxx.licencehttp://www.rioxx.net/licenses/under-embargo-all-rights-reserved||en_UK
local.rioxx.filenameSinclair_et_al-2011-Neurourology_and_Urodynamics.pdfen_UK
local.rioxx.filecount1en_UK
local.rioxx.source0733-2467en_UK
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