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External Catheters Linked with decreased UTI Risk in Men

also for patients in nursing homes and at home.'

Saint and his colleagues carried out the trial at the VA Puget Sound Health Care System, where it took several years to find a sufficient number of men willing to be randomly assigned to either type of catheter who also met all of the study's criteria. Saint began the project during his Robert Wood Johnson Clinical Scholars fellowship at the University of Washington, working with senior author Benjamin Lipsky, M.D.

In all, 75 men met the study's enrollment criteria, with 41 receiving an indwelling catheter and the rest receiving one of five sizes of a silicone condom catheter. Their health status was tracked for up to 30 days, including regular testing of their urine for bacteria (a pre-UTI condition called bacteriuria) and monitoring for signs of UTI. The men completed questionnaires about discomfort and other feelings related to their catheter.

The researchers recorded medical and demographic information about the men, and nurses assessed their mental status, looking for signs of dementia or other problems with cognition. The data were analyzed in a way that allowed the researchers to assess the incidence and time until onset of bacteriuria, and a combined measure of bacteriuria, symptomatic UTI, and death, while correcting for the effects of other factors.

The study showed that there were 11 new cases of bacteriuria for every 100 days of hospitalization in patients with indwelling catheters, compared to 6 for those with condom catheters. The indwelling catheter users developed the condition faster, on average within 7 days, compared with 13 days for condom catheter users. The same differences were seen for the combined measure of bacteriuria, symptomatic UTI, or death.

A striking difference emerged when the mental status of the patient was taken into account. For patients without dementia, indwelling catheter users were 4.8 times more likely than condom catheter us
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