This protocol addresses patients with overactive bladder in whom standard OAB therapies are contraindicated, have proven ineffective, or are no longer desired by the patient — and for whom a chronic indwelling catheter is being considered through shared decision-making.
Management in this situation centres on a catheter-based drainage strategy. One specific catheter route is generally preferred over another due to differences in long-term urethral risk — the complete protocol specifies which approach and the structured decision criteria involved.
DOI: 10.1097/JU.0000000000003985
Clinicians should only recommend chronic indwelling urethral or suprapubic catheters to patients with OAB when OAB therapies are contraindicated, ineffective, or no longer desired by the patient and always in the context of shared decision-making due to risk of harm.
Suprapubic tubes (SPT) are the preferred chronic indwelling catheter option due to the reduced likelihood of urethral damage.
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