OBJECTIVES: External urinary catheters are recommended as alternatives to indwelling urinary catheters to avoid catheter-associated urinary tract infections (CAUTIs). Historically, condom catheters have been the external catheters available to male patients, however, those devices are also associated with infection risk and risk of other complications. Recently, suction-assisted external wicking catheters – similar to those employed with female patients – have been introduced for male patients. The objective of this model is to estimate the per-day cost avoidance impact of EMWCs if they reduce infections in not only patients employing indwelling catheters, but also in patients utilizing condom catheters.

METHODS: A model was constructed evaluating estimated infection reduction, various costs of both CAUTI and non-CAUTI HO-UTI, and the infection incidence rates reported in two prospective studies comparing condom catheters to indwelling urinary catheters.

RESULTS: The daily risk of infection with indwelling urinary catheters were reported to be 3.4% and 11.1% in the two studies reviewed. Infection risk for condom catheters were 2.8% and 6.1% per patient-day in the two studies. Costs evaluated ranged from a cost of CAUTI of $13,793 to the cost of non-CAUTI HO-UTI of $6,101. Based on infection reduction observed with external female wicking catheters, the reduction in infection risk that might be obtained with an EMWC was modeled to be 48%. The smallest potential per-day cost avoidance ranged from $226 to $100 for indwelling catheters for CAUTI and non-CAUTI HO-UTI avoidance, respectively; and from $184 to $81 for condom catheters for CAUTI and non-CAUTI HO-UTI reductions, respectively.

CONCLUSIONS: This model suggests that utilization of EMWCs holds the potential to generate per-day cost avoidance if they reduce the risk of infection in patients with condom catheters and in patients with indwelling urinary catheters. Prospective studies with EMWCs, emulating the designs of the two analyzed studies, should be considered to validate this model.