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Acute Prostatitis
Catheter Acquired Urinary Tract Infection (CAUTI)
Chronic Pelvic Pain Syndrome / Chronic Prostatitis
Circumcision commissioning policy
Continence
Epididymal Cyst
Erectile dysfunction
Haematospermia
Haematuria
Male Lower Urinary Tract Symptoms
Nocturia
Paraphimosis
Peyronies Disease
Phimosis
Prostatitis suspected
Surgical procedures for the treatment of LUTS caused by BPH
Suspected Renal and Ureteric Stones
Urinary Tract Infection (UTI) in females
Urinary Tract Infection (UTI) in males
Vasectomy
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Catheter Acquired Urinary Tract Infection (CAUTI)
Scope
Managing suspected Catheter Acquired Urinary Tract Infection (CAUTI).
All adult men and non-pregnant adult women with an indwelling supra-pubic or urethral urinary catheter.
- Dipstick urinalysis is not required
- Don't treat asymptomatic CAUTI with antibiotics
- If loin pain – consider renal calculi
- Diagnosis is usually made clinically
Out of Scope
- Children
- Adults performing Clean Intermittent Catheterisation (CIC)
- Pregnant women
Signs and Symptoms
- Pyrexia
- Urgency/Bypassing and bleeding (this can also be a sign of bladder stones)
- Loin pain
- General malaise
- Confusion
- Offensive smelling and cloudy urine. NB changes in urine should not be considered in isolation or to be the driver for prescribing antibiotics as all indwelling catheters will have a biofilm of bacteria within hours of insertion resulting in asymptomatic bacteraemia
History and Examination
- General history
- Assess appearance of urine
- Examine urethral meatus or supra-pubic site for evidence of inflammation, trauma or poor hygiene (this information should be available in community nurse records if catheter has been recently changed)
- If loin pain experienced, consider renal stones and examine urine for grit
Differential Diagnosis
- Systemic infection arising elsewhere (e.g. chest)
- Renal colic
- CAUTI associated with bladder stones
New frank haematuria – see guideline
- Catheter specimen of urine (CSU)
- Dipstick urinalysis is not required (NICE QS90)
Referral Criteria
Refer to urology if bladder stones or renal calculi suspected
Referral Instructions
e-Referral Service Selection
- Specialty: Urology
- Clinic Type: Urinary Calculus
- Service: DRSS-Western-Urology-Devon ICB-15N
Referral Form
Pathway Group
This guideline has been signed off on behalf of the NHS Devon.
Publication Date: April 2019
