Would you recommend temporary urinary catheter placement for a patient with recurrent nephrolithiasis who is unable to adequately complete a 24 hour urine study due to incontinence?
A practical question! My answer is nuanced. If serial imaging, preferably CT, shows an increase in stone volume on their current treatment program (metabolic stone activity), yes. I think the benefit of controlling their stone formation outweighs the risks and inconvenience of a urinary catheter. I ...
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In practice, I leave this decision to the urologist attending the patient. I never independently make this recommendation.
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No, I would be concerned, even limiting to 24h, about CAUTI. I would measure spot urine calcium, oxalate, citrate if possible instead, or if necessary, treat empirically with fluids, dietary modification and citrate supplements.
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I would try external catheters before internal catheters for this. I would do these only in very select individuals who, despite empiric therapy, continue to have stones and have controlled for infections and other precipitating factors. 24-hour urines are helpful but not very precise and can be ver...
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