Intermittent catheterisation in children September 2016 CHAPTER 1 Methods A systematic review of the literature was conducted using the databases: Cochrane, Medline, Pubmed and Cinahl searching literature between the dates 1998 and 2014 in both the Dutch and English languages. Relevant textbooks and existing guidelines and protocols were also reviewed. The following search terms were used: urinary catheteriz(s)ation, intermittent catheteriz(s)ation, intermittent self-catheteriz(s)ation, teaching, learning, coaching, infection prevention, urinary tract infection, neuropathic bladder, children, anxiety, pain, complications, disinfection. This information was used to formulate a draft guideline which was then reviewed and amended by practitioners from a range of practitioners and from a wide range of European countries. Grading and level of evidence The evidence used to support these guidelines has been graded according to the type and quality of the evidence as indicated in tables 4 and 5. This grading system is utilised throughout the document. Table 1 Level of Evidence Level of evidence Type of evidence 1a Evidence obtained from meta-analysis of randomised trials 1b Evidence obtained from at least one randomised trial 2a Evidence obtained from one well-designed controlled study without randomisation 2b Evidence obtained from at least one other type of well-designed quasi-experimental study 3 Evidence obtained from well-designed non-experimental studies, such as comparative studies, correlation studies and case reports 4 Evidence obtained from expert committee reports or opinions or from the clinical experience of respected authorities Table 2 Grade of Recommendation Grade of recommendation Type of evidence Nature of recommendation A Based on clinical studies of good quality and consistency addressing the specific recommendations and including at least one randomised trial B Based on well-conducted clinical studies, but without randomised clinical trials C Made despite the absence of directly applicable clinical studies of good quality Terminology Aseptic technique This technique is performed with a sterile catheter, sterile gloves and sterile lubricant (if the catheter is not pre-lubricated). The genitals are cleansed. Bacteriuria Asymptomatic bacteriuria is a UTI without symptoms .2 Bladder neck stenosis A bladder neck stenosis is defined as an abnormal narrowing of the bladder neck.
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