The outcome of elderly patients following removal of indwelling urinary catheter

Abstract

The objectives of this study were to examine the documented indications for the insertion of the indwelling urinary catheter in elderly patients before admission to Zammit Clapp Hospital, St. Julians and St Vincent de Paule Residence, Luqa and to study the outcome after attempting removal of the indwelling urinary catheter. 64 patients from Zammit Clapp Hospital and 61 patients from St. Vincent de Paule Residence were studied. In 34 patients (24%), no clear reason for catheterisation prior to admission could be identified. In 46 patients (32 %) catheterisation was performed for severe uncontrollable incontinence. In all, 66 patients had their indwelling urinary catheter removed at some stage. Of these a total of 49 patients were continent 15 days after the removal of the catheter, 33 patients were still continent after 3 months and 29 patients remained continent after one year. With regards’ to continence rate, a poorer outcome was noted in patients with a mental score of less than 5/10, when compared to patients with a mental score of more than 5/10. Continence rates were better in patients from Zammit Clapp Hospital than in patients from St. Vincent de Paule residence. In conclusion, attempts should be made to use long term indwelling urinary catheterisation only if other measures fail. This can be achieved by proper multi-disciplinary team assessment and education of the patient or his carers. Full support from social services and provision and advice about the use of continence aids is necessary.