The hazards of urethral catheterization are not in the catheter per se but in the indications observed, the technique followed, and the skill of the operator. The authors did not encounter a single instance of infection after catheterization of a functionally normal urinary tract. Even mild degrees of urodysfunction, defined as abnormality of urine transport, were associated with a risk of infection. In recognizing urodysfunction, the static picture afforded by cystoscopy needs to be supplemented by the functional data supplied by such methods as the voiding vesicourethrography used by the authors. The urethral catheter is essential in both diagnosis and treatment. In the opinion of the authors, the catheter and chronic pyelonephritis are not related unless there coexists some degree of urodysfunction.
Lich R, Howerton LW. A Clinical Evaluation of the Urethral Catheter. JAMA. 1962;180(10):813–815. doi:10.1001/jama.1962.03050230015004
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