Do prophylactic catheter washouts reduce catheter associated urinary tract infections and catheter blockage compared to standard care in adults living with long-term catheters?

A systematic review with meta-analysis

Authors

  • E-Shuen Wong University of Aberdeen & NHS Grampian
  • Catriona Young NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary, Glasgow
  • Yuhong Yuan Western University, Dept. of Medicine, Ontario, Canada
  • Mohamed Abdel-Fattah Aberdeen Centre For Women’s Health Research, University of Aberdeen, Aberdeen, United Kingdom
  • Muhammad Imran Omar Academic Urology Unit, University of Aberdeen, Aberdeen, United Kingdom

DOI:

https://doi.org/10.5489/cuaj.9433

Keywords:

Conservative treatment, Incontinence, Indwelling urinary catheter, Prevention, health related quality of life, Catheter-Related Infections, encrustation

Abstract

Introduction: Prophylactic catheter washouts (PCWs) are often recommended to patients with long-term catheters (LTCs) to reduce symptomatic catheter-associated urinary tract infection (S-CAUTI) and catheter blockage. This systematic review summarizes current evidence on the benefits and harms of regular PCWs for adults using LTCs.

Methods: A literature search was conducted using MEDLINE, EMBASE, CINAHL, and CENTRAL (database inception to June 2024) for randomized controlled trials (RCTs) and quasi-RCTs comparing PCWs to standard care, or different catheter washout solutions to each other. The review followed Cochrane Handbook methodology. Certainty of evidence was assessed using GRADE. Detailed protocol registered with PROSPERO (CRD42024553575).

Results: Seven RCTs were included. The review found lower S-CAUTI rates in saline washout groups (SWGs) than no washout groups (NWGs) (mean difference [MD] -0.10, 95% confidence interval [CI] -0.50-0.29; low certainty evidence; p=0.61) and lower S-CAUTI rates in any washout groups (WG) compared to NWGs (MD -0.05, 95% CI -0.42-0.32; low certainty evidence; p=0.79). The review found reduced odds of catheter blockage in acidic washout groups (AWGs) than SWGs (odds ratio [OR] 0.51, 95% CI 0.25-1.03; very low certainty evidence; p=0.06). Airaksinen 1979 also found increased odds of greater encrustation in their NWG compared to their SWG (OR 0.62, 95% CI 0.17-2.25; very low certainty evidence; p=0.46). The review found that WGs had reduced hematuria incidence (relative risk [RR] 0.99, 95% CI 0.87-1.12; moderate certainty evidence; p=0.86) compared to NWGs. Furthermore, WGs had higher EQ-5D-5L scores than NWGs, with SWGs MD -0.056 (97.5% CI -0.022-0.134, p=0.11) and AWGs MD -0.053 (97.5% CI -0.024-0.131, p=0.12), indicating possible improvement in quality of life (QoL).

Conclusions: PCWs may have more benefits and less harms than previously thought and could improve patients' QoL. Tailoring washout solutions to patients' needs may be beneficial. International RCTs abiding by SPIRIT and CONSORT guidelines are recommended, as most outcomes were of low certainty.

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Published

2026-03-16

How to Cite

Wong, E.-S., Young, C., Yuan, Y., Abdel-Fattah, M., & Omar , M. I. (2026). Do prophylactic catheter washouts reduce catheter associated urinary tract infections and catheter blockage compared to standard care in adults living with long-term catheters? : A systematic review with meta-analysis. Canadian Urological Association Journal, 20(7). https://doi.org/10.5489/cuaj.9433

Issue

Vol. 20 No. 7 (2026): CUAJ July

Section

Review

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