Evaluating the potential of removing long-term urinary catheters among home care recipients in Taiwan

BackgroundUrinary catheter placement is a common treatment choice for incontinent people. In Taiwan, urinary catheterization is a common care need for people receiving home care services, but the appropriateness of long-term urinary catheterization in this setting deserves extensive evaluation.PurposeThe main purpose of this study is to evaluate the potential of removing long-term placed urinary catheters among home-care recipients.MethodsHome care recipients with long-term urinary catheterization of a tertiary medical centre in Taichung were invited for study. For all participants, urinary catheters were removed for 4 hours before replacing a new catheter. Residual volume was measured to determine the ability of removing urinary catheters.ResultsIn total, 43 home care recipients (mean age: 80.3 ± 10.2 years, 37.2% men) participated in this study, and most of them were physically dependent [Eastern Cooperative Oncology Group (ECOG) Grade 3 for 48.8% and Grade 4 for 51.2%] and 69.8% were long-term catheterized. After removing urinary catheters, no self-voiding was observed and the mean residual-urine volume was 162.5 ± 9.6 cc during 4-hour observation. The mean residual-urine volume of the more dependent participants (ECOG Level 4) was significantly higher than the less dependent recipients (ECOG Level 3) (166.3 ± 12.5 vs. 157.5 ± 8.1 cc, p = 0.004). Comparing recipients with residual urine volume higher and lower than 160 cc, we found that recipients with higher residual-urine volume were more likely to be people with diabetes (72.7% vs. 19.0%, p = 0.001) and higher dependence (ECOG Grade 4) (72.7% vs. 28.6%, p = 0.01).ConclusionIn conclusion, none of the long-term urinary catheterized home care recipients in this study demonstrated the ability of self-voiding, and those who had a residual-urine volume more than 160 cc were more likely to be people with diabetes and physical dependence. Further prospective interventional study is needed to evaluate the possibility of removing long-term urinary catheters among home care recipients in Taiwan.