People who cannot empty their bladder on their own may develop chronic urinary retention. If not managed, this condition can lead to serious health problems. Urine that remains in the bladder for too long increases the risk of developing urinary tract infection, bladder damage, and kidney disease. To prevent such problems, children and adults with chronic urinary retention learn to insert a tube, called a catheter, into their body to drain the bladder. This process is called “intermittent” catheterization because people insert and remove the catheter as needed, typically about five times a day.
Catheters come in several types, either prelubricated or noncoated (these need to be lubricated manually). All are sold as “single use” but, due to cost, many people clean and reuse noncoated catheters multiple times (for example, using one per day or one per week). A year’s supply in Ontario can range from about $558, for people who reuse noncoated catheters (using one per day), to about $12,800 for people who use a new hydrophilic catheter each time they empty their bladder. About 33,000 people in Ontario use intermittent catheters as a result of spinal cord injury, multiple sclerosis, stroke, spina bifida or for other reasons. Only a fraction have their supplies covered through various government programs.
This health technology assessment looked at the effectiveness, safety, and cost-effectiveness of different types of intermittent catheter for the management of chronic urinary retention. It also looked at the budget impact of publicly funding intermittent catheters in Ontario and the preferences and values of people whouse intermittent catheters.