Indwelling Urinary Catheterization versus Clean Intermittent Catheterization for the Short-Term Management of Hospitalized Patients with Transient Acute Urinary Retention: A Prospective Randomized Trial

Background: Acute urinary retention (AUR) is a common problem in hospitalized patients. Either indwelling urethral catheterization or clean intermittent catheterization (CIC) can be the choice of treatment. Catheter-associated urinary tract infection (CAUTI) is the common complication. Objective: The primary objective of this study was to compare rates of CAUTI between CIC and indwelling urethral catheter technique for the short-term management of patients with transient AUR. Material and Method: One hundred patients hospitalized patients who developed first-time AUR between June 2014 and May 2015 were randomized into CIC and indwelling urethral catheter groups using a sealed-envelope technique. The primary outcomes of the study were catheter-associated asymptomatic bacteriuria and CAUTI. The secondary outcomes were pain, gross hematuria, cloudy urine, and quality of life. Results: There was no statistically significant difference between the CIC and indwelling urethral catheter groups in terms of the rates of CAUTI (10% vs. 8%) and catheter-associated asymptomatic bacteriuria (52% vs. 36%) (p = 0.214). In addition, there was no statistically significant difference in terms of gross hematuria (8% vs. 20%, p = 0.084), cloudy urine (26% vs. 22%, p = 0.640), pain score [0 (range, 0 to 7) vs. 0 (range, 0 to 6), p = 0.246], and quality of life [5 (range, 2 to 5) vs. 5 (range, 2 to 5), p = 0.596]. Conclusion: In hospitalized patients with transient AUR, CIC was not shown to be superior to indwelling urethral catheterization in terms of rates of infections. Quality of life, pain, rates of gross hematuria, and cloudy urine were also similar in both groups. Furthermore, indwelling catheterization is preferable in patients without caretakers.