| Objective: The purpose of this review is to determine if certain bladder irrigation policies are better than others in terms of effectiveness, acceptability, complications, quality of life and economics in Urethral catheterised patients. Methods: A systematic review of all the relevant randomized controlled trials (RCTs) was performed. We searched the Cochrane Incontinence Group Specialised Trials Register (searched January 2008), MEDLINE(1966- January 2008), PUBMED(1966- January 2008), EMBASE (1966- January 2008), CINAHL (1982 - January 2008), CBMdisc (Chinese biological medical database, 1979- January 2008); and handsearched the elevant Chinese and English nursing journals. Additionally, we examined all reference lists of identified trials.RCTs and CCTs of bladder irrigation policies in Urethral catheterised patients were included. Data were extracted by both reviewers independently and compared. The same two reviewers assessed the methodological quality(A, B, C grades) of each trial by recording details of the randomization method, allocation concealment, blinding and the number of patients who were lost to follow-up.Disagreements were resolved by discussion. Data were processed as described in the Cochrane Handbook. RevMan 4.2 were used for data management and analysis, including heterogeneity test, Meta analysis and sensitivity analysis. Results: Eleven trials have been identified(1222 patients), including nine RCTs and two CCTs. All of trials were poor methodological quality. There were two B and nine C. The results of meta-analysis showed that without bladder irrigation before removal of a catheter in adult (including three trials and 330 patients) increase the rates of UTI(RR:0.58, 95%CI:0.40-0.84). With bladder irrigation vs without bladder irrigation during indwelling catheteration (including two trials and 471 patients) has a equal rates of UTI (RR:1.17, 95%CI: 0.81-1.71). Conclusion: There were no statistical difference in the rates of UTI between with or without bladder irrigation during indwelling catheteration. Compared with without bladder irrigation before removal of a catheter in the intermittent catheterisation of adults, bladder irrigation can shorten the delays from the commence of removal catheter to discharge and decrease the rates of UTI. However, it still need to demonstration the same effect in indwelling catheteration patients. Indication of bladder irrigation and the effect of different irrigation solution types and dosage to relative outcomes would be tested by more high-quality, large scale RCT in future. |
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