Med. praxi. 2025;22(2):E1-E7 | DOI: 10.36290/med.2025.013

Long­‑term lower urinary tract catheterization in follow­‑up care

MUDr. Zbyněk Veselský, Ph.D., MBA, MUDr. Róbert Linter, MUDr. Silvestr Zouvala

Léčebna dlouhodobě nemocných Rybitví

Long-term care hospitals are a type of healthcare facility that is defined not only by legislation, but above all by specific treatment procedures. Diagnostic possibilities are limited and the treatment team is mainly required to have experience and comprehensive knowledge of many medical disciplines. Measuring fluid output, assessing its appearance, volume change and character over time in polymorbid patients with polypragmasia is one of the few procedures whose data may be available to follow-up care physicians. In addition to the group of patients with renal pathology unable to objectify fluid output in any other way, the indications for temporary placement of a indwelling urinary catheter include efforts to prevent infection of bedsores or interstitium, treatment of infections requiring lower urinary tract drainage, immobility of patients with anatomic or functional lower urinary tract pathology preventing physiologic evacuation of the bladder, including disturbances of consciousness. Urinary retention due to subvesical obstruction is an imperative indication. Any other indication is outside of European and North American recommendations, as any method of external urinary diversion is viewed as instrumentation with significant risk potential for urinary tract infection with predominantly hospital-acquired multidrug-resistant bacterial strains (Catheter-Associated Urinary Tract Infection (CAUTI).With physiological changes in immunity in the elderly, multiplied by the presence of many life-threatening diagnoses, CAUTIs are directly causal in 40% of deaths. Despite the lege artis indications, the number of patients with permanent lower urinary tract catheter derivation in Czech aftercare units appears to be significantly higher than in comparable units abroad. However, evaluable data from the Czech Republic are lacking. The issue of the necessity of permanent urinary catheter placement and the profit of patients with permanent urinary catheter placement is an important question that must be asked, not only in long-term follow-up care.

Keywords: bladder, permanent urinary catheter, lower urinary tract derivation, long­‑term follow­‑up care, CAUTI

Received: October 1, 2024; Revised: February 20, 2025; Accepted: February 20, 2025; Published: April 30, 2025  Show citation