Reusable Catheters Found as Safe as Single-Use Catheters in Patients With Urinary Retention: JAMA
In a randomized clinical trial involving patients with urinary retention, reusable catheters were found to be noninferior to single-use catheters with respect to the risk of urinary tract infections (UTIs). Patient-reported outcomes and tolerability varied, emphasizing the importance of individual preferences and the need for design improvements to enhance usability. The findings support the safety of reusable catheters and suggest they may offer a more sustainable and equitable approach to urologic care. The study was published in JAMA Network Open by Felice E. and colleagues.
The study involved patients over 16 years old who needed to perform at least two clean intermittent catheterizations daily, monitoring their status over one year from February 21, 2020, to April 3, 2025. The participants of the study were randomly allocated into a 1:1 ratio to the groups with a reusable catheter and those with a standard single-use catheter. In the reusable group, patients received a strict daily disinfection regimen that included soaking the devices in a 2% solution of sodium hypochlorite, rinsing them prior to and after each use and replacing the physical catheters once in two weeks with the exception of 20% or less of the weekly catheterizations by single-use catheters due to travel convenience. The primary endpoint is the UTI rate per patient-month, where the predefined noninferiority margin was an absolute value of 0.07 UTIs per patient-month.
Key findings:
- For the analyzed patient sample, the average age was 61.4 ± 15.9 years, the majority of subjects were males, making up 243 patients (63%), while the total number of people diagnosed with neurogenic LUTD constituted 139 subjects (36%).
- For the analyzed reusable catheter group, the premature termination of the study occurred in 72 out of 185 patients (39.0%) due to decreased ease of use and increased urethral irritation.
- Among the 326 patients in the modified intention-to-treat group, the number of clinical UTIs was 59 out of 191 (30.9%) in the case of patients using single-use catheters and 40 out of 134 patients (29.9%) who used reusable catheters.
- The verified UTI rate per patient-month was 0.054 UTIs in the case of single-use catheters compared to 0.050 UTIs per patient-month for the latter, producing an absolute difference of −0.004 (95% CI, −0.025 to 0.019), which was clearly within the pre-defined margin of non-inferiority.
- Although there were no differences in terms of severe adverse events, low-grade adverse events (mostly urethral irritation) were reported much more frequently in the case of patients using reusable catheters, affecting 37 patients (20.0%) and 9 (4.7%) patients from the other group, respectively.
In conclusion, the use of reusable catheters is non-inferior to the use of single-use catheters in the management of UTIs. Variability in patient satisfaction and comfort levels stresses the need for patient preference along with design improvements. This study provides irreplaceable evidence-based information for the advancement of sustainable medicine in today’s era. It demonstrates that healthcare organizations can effectively cut down their huge carbon footprint without compromising on the safety of patients.
Reference:
van Veen FEE, Christiaans CHH, Berendsen SA, et al. Single-Use vs Reusable Catheters for Intermittent Catheterization in Patients With Urinary Retention: The COMPARE Randomized Clinical Trial. JAMA Netw Open. 2026;9(6):e2620871. doi:10.1001/jamanetworkopen.2026.20871
