Mercado Francisco S, Kop Michaela M, Danko Ana, Zimmerman Heather, Watase Colby
Medicine, Tripler Army Medical Center, Honolulu, USA.
Medicine, University of Hawaii John A. Burns School of Medicine, Honolulu, USA.
Cureus. 2025 Aug 17;17(8):e90264. doi: 10.7759/cureus.90264. eCollection 2025 Aug.
Catheter-associated urinary tract infections (CAUTIs) are a significant cause of morbidity and mortality among hospitalized patients, prompting the implementation of various strategies to reduce their incidence, including the use of male external catheters (MEC). However, the effectiveness of MEC in preventing urinary tract infections (UTIs) remains uncertain. This study aimed to systematically summarize existing research and conduct a meta-analysis to evaluate the impact of MEC on UTI rates and related outcomes. We searched PubMed, Medline, Embase, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform for peer-reviewed articles and clinical trials from inception until June 30, 2024, ultimately including 42 of 1,545 publications in our systematic review, comprising 40 observational studies and two randomized controlled trials (RCTs). Our meta-analysis focused on eight articles with complete methodology and outcomes, revealing a non-significant 27% decrease in UTIs among MEC users (odds ratio 0.73, confidence interval 0.44-1.22) with moderate heterogeneity (I = 58.47%). Additionally, asymptomatic bacteriuria was associated with a non-significant 3% lower risk for MEC (odds ratio 0.97, confidence interval 0.61-1.54) and mild heterogeneity (I = 29.79%). The incidence rate ratio (IRR) for UTIs significantly decreased when comparing MEC users to indwelling urinary catheter (IUC) users (odds ratio, 0.20; 95% confidence interval, -0.03 to 0.43), demonstrating significant heterogeneity (I = 99.98%). Our findings indicated variability in the reporting of secondary outcomes, with a non-significant decrease in UTI and asymptomatic bacteriuria events among MEC users compared to IUC users. However, effect sizes were associated with significant heterogeneity. We recommend standardized reporting of secondary outcomes in future studies to enhance comparability and reliability.
导尿管相关尿路感染（CAUTIs）是住院患者发病和死亡的重要原因，促使人们实施各种策略来降低其发生率，包括使用男性外部导尿管（MEC）。然而，MEC在预防尿路感染（UTIs）方面的有效性仍不确定。本研究旨在系统总结现有研究并进行荟萃分析，以评估MEC对UTI发生率及相关结果的影响。我们检索了PubMed、Medline、Embase、ClinicalTrials.gov和世界卫生组织国际临床试验注册平台，查找从创刊至2024年6月30日的同行评审文章和临床试验，最终在我们的系统评价中纳入了1545篇出版物中的42篇，包括40项观察性研究和两项随机对照试验（RCTs）。我们的荟萃分析聚焦于八篇方法和结果完整的文章，结果显示MEC使用者的UTIs发生率非显著降低27%（优势比0.73，置信区间0.44 - 1.22），异质性中等（I = 58.47%）。此外，无症状菌尿与MEC使用者3%的非显著较低风险相关（优势比0.97，置信区间0.61 - 1.54），异质性轻度（I = 29.79%）。与留置导尿管（IUC）使用者相比，MEC使用者的UTIs发生率比（IRR）显著降低（优势比，0.20；95%置信区间，-0.03至0.43），显示出显著异质性（I = 99.98%）。我们的研究结果表明次要结果报告存在差异，与IUC使用者相比，MEC使用者的UTI和无症状菌尿事件非显著减少。然而，效应大小与显著异质性相关。我们建议在未来研究中对次要结果进行标准化报告，以提高可比性和可靠性。
