The growing reputation of the North-east as a centre of excellence in the study of urological cancers and other urological conditions has been recognised with a major funding award to lead a multi-centre trial that will ultimately benefit both patients and the NHS.
About one in four patients in hospital need a urinary catheter for a short while. This may cause a urine infection in about 7% of them, amounting to about 30,000 patients over the course of a year in the UK. These infections slow the patient’s recovery from illness or surgery and can lead to serious consequences such as bloodstream infections.
Recently it has been shown that catheters containing antibiotics or antiseptics reduce colonisation by bacteria and lessen the risk of infection. But these catheters are expensive, and it is not clear how much they benefit individual patients and whether the increased costs are matched by better health.
Now however, thanks to a grant of £1.4 million from the NHS research funding body Health Technology Assessment, the urology research team of the University of Aberdeen and NHS Grampian will lead a major, multi-centre trial involving several large hospitals which provide acute medical and surgical care, to investigate the benefits of using these ‘treated’ catheters.
The NHS has a target to reduce such infections by 15%. This is hard to achieve however, as catheters easily become contaminated with bacteria from the patient’s own skin or bowel. For every day that the catheter is left in, bacteria colonise the urine in about 5% of patients. Simple measures such as general hygiene and removing catheters as soon as possible help to reduce the overall risk of developing a urine infection.
Welcoming the award, Professor James N’Dow, consultant urological surgeon and head of the urology research team at the University, said: “This is a very exciting piece of work and we have assembled a first-class team of clinicians, health service researchers and health economists who have wide experience in this field. We will be comparing the use of standard catheters with those treated with antibiotics or antiseptics in patients who only need a catheter for a short time - less than two weeks. This will involve comparing the benefits and costs of using each type of catheter, which will help the NHS to decide whether, for short-term use, catheters treated antibiotics or antiseptics - rather than standard untreated catheters - will reduce infections, be cost-effective, and result in better patient health.”
Around 6,000 patients who need a catheter as part of their routine care will be randomly allocated to have either a standard or treated catheter. They will then be asked to fill in questionnaires in hospital, and after they go home, to find out whether a urine infection occurred, and if this affected their health, treatment, or hospital stay.
The researchers will also study patients who are especially vulnerable to severe infection, such as the elderly and those in intensive care, to see whether treated catheters might particularly benefit them.
Urological cancers are among the most common cancers. They include cancers of the prostate, bladder, kidney and testis. Urological cancers make up one in three cancers in men and one in five of all cancers in men and women. 50,000 urological cancers are diagnosed every year in the UK and over 18,000 people in the UK die every year of urological cancer. In Grampian, over 5,000 people are referred to hospital every year with a suspected urological cancer.
James N’Dow is also co-founder and managing director of local charity UCAN, which has raised half a million pounds in its first year thanks to the support of local businesses and communities. UCAN will use this money to help raise awareness of urological cancers, add further value to NHS services in terms of patient and family support, and help establish the North of Scotland as a centre of excellence in research, treatment and care for the growing number of people who are affected by these cancers. For more information about UCAN see http://www.ucanhelp.org.uk/