There is about a three-fold increase in mortality among nursing home patients who are managed with an indwelling catheter for a year. Antibiotics can temporarily reduce the number of bacteria in the urine, but cannot eradicate infections in patients with indwelling urinary catheters. Excessive use of antibiotics in catheterized patients leads to the selection of antibiotic-resistant microorganisms and accounts for outbreaks of infection with highly resistant bacteria and yeasts. Intermittent catheterization consists of inserting a new catheter into the bladder each time there is a need to void and removing it after the bladder is emptied. It is usually performed three to four times daily depending on the volume of urine in the bladder.
Condom catheters consist of a thin sheath placed around the penis and attached to a drainage tube.
Intermittent self-catheterization has remarkably reduced the frequency of UTIs in children and adults with spinal cord injuries and is a useful temporary measure in men who cannot void because of an enlarged prostate gland. Most UTI's occur in otherwise healthy females. The only factors that have been proven clearly to be associated with UTIs are catheterization, vaginal diaphragms, spermicidal jellies, sexual intercourse in some women who are highly prone to recurrent infection and postmenopausal women not taking estrogens. Many girls and women with recurrent infection do not report an association with sexual intercourse. Nevertheless, Roman Catholic nuns have been shown to have fewer UTIs than married women and some women are convinced that there is a close association between sexual intercourse and UTIs.