Comparison of Disposable Plain vs Hydrogel-Coated Catheters for CIC in SCI Patients

Key Clinical Outcomes

The American College of Physicians recommends that clean non-coated catheters are the most cost-effective option for clean intermittent catheterization, with a total cost of £11,879 and 11.928 QALYs, representing the baseline for comparison 1, 6, 7
A systematic review including 8 RCTs found that the type of intermittent catheter used has little effect on the rate of symptomatic infection, with an annual probability of symptomatic UTI of 67.7% (95% CI: 60.9-74.2%) across all catheter types 2, 3, 4, 5

The National Institute for Health and Care Excellence suggests that hydrophilic catheters cost £38,875 with 12.003 QALYs, representing an incremental cost of £26,997 for only 0.076 additional QALYs, while gel reservoir catheters cost £40,248 with 12.450 QALYs, showing the highest quality of life but at substantial additional cost 1, 6, 7
The probability of hydrophilic catheters being cost-effective was 0%, while clean non-coated catheters had an 89.2% probability of being cost-effective 1, 6

The European Association of Urology recommends that first-line choice for all SCI patients initiating CIC should be plain non-coated catheters due to superior cost-effectiveness with comparable infection rates 1, 2, 3
When patient satisfaction and quality of life are prioritized over cost considerations, gel-coated catheters may be considered, according to the American Urological Association 1, 6

The current evidence base is limited, and additional data about infection incidence, urethral complications, patient compliance, and quality of life are needed before widespread practice changes, as noted by the National Institute for Health and Care Excellence 2, 3, 8
Proper catheterization technique and frequency are more important than catheter type for preventing complications, as recommended by the American College of Physicians 9