6 Chapter 1 Methods A systematic literature review 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 selfcatheteriz(s)ation, teaching, learning, coaching, infection prevention, urinary tract infection, neuropathic bladder, children, anxiety, pain, complications, disinfection. For the update of 2024, we selected articles between 2014-2023 This information was used to formulate a draft guideline, which was then reviewed and amended by practitioners 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 1 and 2. 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 quasiexperimental 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 1,2 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.
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