{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T02:57:14Z","timestamp":1791341834432,"version":"4.3.1"},"reference-count":72,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24000734_as1\"><jats:title>Background:<\/jats:title><jats:p>Female patients using indwelling urinary catheters (IUCs) are disproportionately at risk for developing catheter-associated urinary tract infections (CAUTIs) compared to males. Female external urine wicking devices (FEUWDs) have emerged as potential alternatives to IUCs for incontinence management.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000734_as2\"><jats:title>Objectives:<\/jats:title><jats:p>To assess the clinical risks and benefits of FEUWDs as alternatives to IUCs.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000734_as3\"><jats:title>Methods:<\/jats:title><jats:p>Ovid MEDLINE, Embase, Scopus, Web of Science Core Collection, CINAHL Complete, and ClinicalTrials.gov were searched from inception to July 10, 2023. Included studies used FEUWDs as an intervention and reported measures of urinary tract infections and secondary outcomes related to incontinence management.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000734_as4\"><jats:title>Results:<\/jats:title><jats:p>Of 2,580 returned records, 50 were systematically reviewed. Meta-analyses assessed rates of indwelling CAUTIs and IUC utilization. Following FEUWD implementation, IUC utilization rates decreased 14% (RR = 0.86, 95% CI\u00a0=\u00a0[0.76, 0.97]) and indwelling CAUTI rates nonsignificantly decreased up to 32% (IRR = 0.68, 95% CI\u00a0=\u00a0[0.39, 1.17]). Limited only to studies that described protocols for implementation, the incidence rate of indwelling CAUTIs decreased significantly up to 54% (IRR = 0.46, 95% CI\u00a0=\u00a0[0.32, 0.66]). Secondary outcomes were reported less routinely.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24000734_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Overall, FEUWDs nonsignificantly reduced indwelling CAUTI rates, though reductions were significant among studies describing FEUWD implementation protocols. We recommend developing standard definitions for consistent reporting of non-indwelling CAUTI complications such as FEUWD-associated UTIs, skin injuries, and mobility-related complications.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.73","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T05:37:13Z","timestamp":1714973833000},"page":"1121-1129","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":10,"title":["Clinical outcomes of female external urine wicking devices as alternatives to indwelling catheters: a systematic review and meta-analysis"],"prefix":"10.1017","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6998-8669","authenticated-orcid":false,"given":"Nicholas","family":"Pryor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JiCi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4749-9369","authenticated-orcid":false,"given":"Whitney","family":"Townsend","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6348-9937","authenticated-orcid":false,"given":"Jessica","family":"Ameling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3879-2942","authenticated-orcid":false,"given":"James","family":"Henderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9503-0293","authenticated-orcid":false,"given":"Jennifer","family":"Meddings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"S0899823X24000734_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306801"},{"key":"S0899823X24000734_ref3","doi-asserted-by":"publisher","DOI":"10.1086\/650482"},{"key":"S0899823X24000734_ref13","doi-asserted-by":"publisher","DOI":"10.5195\/jmla.2020.834"},{"key":"S0899823X24000734_ref62","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2020.06.067"},{"key":"S0899823X24000734_ref72","doi-asserted-by":"publisher","DOI":"10.1016\/S1553-7250(09)35062-X"},{"key":"S0899823X24000734_ref34","doi-asserted-by":"publisher","DOI":"10.4037\/ccn2023317"},{"key":"S0899823X24000734_ref8","first-page":"10669","article-title":"How I do it: PureWick female external catheter: a non-invasive urine management system for incontinent women","volume":"28","author":"Uhr","year":"2021","journal-title":"Can J Urol"},{"key":"S0899823X24000734_ref37","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2018.04.027"},{"key":"S0899823X24000734_ref39","first-page":"S220","article-title":"Impact of external female urinary catheter use on routine urine test results","volume":"70","author":"Cassone","year":"2020","journal-title":"J Am Geriatr Soc"},{"key":"S0899823X24000734_ref47","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2020.06.152"},{"key":"S0899823X24000734_ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2020.06.047"},{"key":"S0899823X24000734_ref19","unstructured":"19. 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Newton, C , Call, E , Chan, KSL. Measuring safety, effectiveness and ease of use of PureWick in the management of urinary incontinence in bedbound women: case studies. 2016. https:\/\/docplayer.net\/54084269-Measuring-safety-effectiveness-and-ease-of-use-of-purewick-in-the-management-of-urinary-incontinence-in-bedbound-women-case-studies.html. Accessed January 18, 2024."},{"key":"S0899823X24000734_ref24","first-page":"11216","article-title":"Patient and caretaker satisfaction with the PureWick system","volume":"29","author":"Khosla","year":"2022","journal-title":"Can J Urol"},{"key":"S0899823X24000734_ref12","unstructured":"12. PrimaFit\u00ae External Urine Management System for Females \u2013 Sage Products LLC. Sageproducts.com. Published 2019. https:\/\/sageproducts.com\/primafit-external-urine-management-system-for-females\/. 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