Carer-assisted intermittent urethral catheterisation in the management of persistent retention of urine in elderly women.

Carer-assisted clean intermittent urethral catheterisation is an effective and safe treatment option for persistent urinary retention in a study of 56 elderly female patients (aged 65 years and above) with cognitive impairment and other disabilities. With this method of treatment, 54% of the patients were able to void spontaneously and were continent after a median period of 6 weeks with a range of 1 to 40 weeks. Twenty-seven per cent had significant improvement in the symptoms of urinary incontinence and the residual urine volumes became progressively smaller. However, 19% failed the programme. The recovery of spontaneous voiding was found to be significantly influenced by the age of the patient, the carer performing the intermittent catheterisation and the development of catheter-related urinary tract infection. Twenty-five per cent of the study patients developed symptomatic urinary tract infection which was associated with a delay in the recovery of spontaneous voiding. Its development was also found to be significantly associated with the presence of pre-existing diabetes mellitus, the person doing the catheterisation, the presence of dementia and with more predisposing common medical conditions.