Rethinking Reuse: The Ongoing Conversation Around Intermittent Catheters

For people who rely on intermittent catheterization (IC), the decision between reusing catheters and using a new one each time isn’t just clinical, it’s personal, practical, and increasingly, environmental. While IC remains a cornerstone for managing neurogenic bladder, the debate around reuse versus single-use catheters has persisted for decades in the U.S.

Why Reuse Became the Norm

Historically, many individuals reused catheters because they had to—insurance coverage was limited, costs were high, and sustainability was a growing concern. In fact, reuse rates in some U.S. regions reached nearly 50%.[1]

Before 2008, both Medicare and the VA often covered as few as 4 to 50 catheters per month. That left many patients with no choice but to clean and reuse them. When Medicare revised its policy in 2008 to allow for up to 200 single-use catheters per month—a change mirrored by the VA—it was aimed at reducing UTI risk and improving safety.[2]

But the results weren’t so clear-cut.

Did Single-Use Catheters Actually Improve Outcomes?

Despite increased access to single-use supplies, a large-scale analysis of the National Spinal Cord Injury Database showed no significant drop in genitourinary hospitalizations or increased IC adoption after 2008 when Medicare revised its policy.[2] What did rise sharply, however, were the associated costs and the volume of plastic waste. What does this actually mean? Well, with increased access to a new catheter for every catheterization, we'd probably expect to see hospitalizations (representing the worst infections) go down over time - if single-use catheterization actually did improve infection rates relative to reusing catheters.

These findings prompted a deeper look at whether single-use catheters truly offered a safety advantage—or whether the story was more nuanced.

What the Research Says

A narrative review by Håkansson found that reused catheters were linked to higher UTI rates (70–80%) compared to single-use hydrophilic ones (40–60%).[1] But those numbers came with a big caveat: the cleaning methods in those studies were all over the map. Some used heat, others chemicals, and most were inconsistent or poorly followed, making it hard to draw firm conclusions.

More recent studies have added to the complexity. A randomized trial in patients with spina bifida showed no meaningful difference in UTI rates between reused and single-use catheters when a standardized reuse technique was used.[3] And a 2024 review echoed that sentiment, finding no strong evidence that reuse compromises safety or usability. It also spotlighted the mounting environmental and economic costs of relying solely on disposable devices.[4]

Looking Ahead: The Case for Smarter Reuse

So where do we go from here?

With no clear-cut winner in the single-use vs. reuse debate, researchers and clinicians are turning their attention to a new approach: safe, standardized catheter reprocessing. The goal is to take the guesswork—and variability—out of manual cleaning by developing automated systems that consistently disinfect catheters between uses.

Early studies show promise. A novel reusable catheter system paired with an antimicrobial reprocessing device showed encouraging lab results for reducing bacterial contamination.[5] (Author's Note: this is a study that Aurie co-authored using an early prototype of the Aurie System!) Other in vitro research supports the notion that specific evidence-based cleaning methods could make reuse safer and more reliable.[6]

A New Direction Rooted in Safety, Sustainability, and Empowerment

There’s no one-size-fits-all answer when it comes to catheter use, but that’s exactly why the conversation matters. With innovation and thoughtful research, the future may bring solutions that balance safety, cost, and environmental stewardship without compromising the independence and confidence that come from managing bladder health with dignity.

This is what we're building at Aurie. And we're not just trying to make reuse as safe as single-use catheterization! We're imagining a world where catheter reuse could unlock possibilities to actually reduce infection rates relative to standard catheters. If you're interested in learning more about our products, please sign up for our mailing list!

References

[1] Håkansson MÅ. Reuse Versus Single-Use Catheters for Intermittent Catheterization: What Is Safe and Preferred? Review of Current Status. Spinal Cord. 2014;52(7):511–6. doi:10.1038/sc.2014.79.

[2] Elliott CS, Dallas K, Shem K, Crew J. Adoption of Single-Use Clean Intermittent Catheterization Policies Does Not Appear to Affect Genitourinary Outcomes in a Large Spinal Cord Injury Cohort. The Journal of Urology. 2022;208(5):1055–1074. doi:10.1097/JU.0000000000002836.

[3] Madero-Morales PA, Robles-Torres JI, Vizcarra-Mata G, et al. Randomized Clinical Trial Using Sterile Single Use and Reused Polyvinylchloride Catheters for Intermittent Catheterization With a Clean Technique in Spina Bifida Cases: Short-Term Urinary Tract Infection Outcomes. The Journal of Urology. 2019;202(1):153–158. doi:10.1097/JU.0000000000000244.

[4] Zhao CC, Comiter CV, Elliott CS. Perspectives on Technology: Single-Use Catheters - Evidence and Environmental Impact. BJU International. 2024;133(6):638–645. doi:10.1111/bju.16313.

[5] La Bella AA, Molesan A, Wollin DA, Paul S, Flores-Mireles AL. Initial Antimicrobial Testing of a Novel Reusable Intermittent Urinary Catheter System and Catheter Reprocessing Device. Urology. 2024;193:8–15. doi:10.1016/j.urology.2024.07.015.

[6] Wilks SA, Morris NS, Thompson R, et al. An Effective Evidence-Based Cleaning Method for the Safe Reuse of Intermittent Urinary Catheters: In Vitro Testing. Neurourology and Urodynamics. 2020;39(3):907–915. doi:10.1002/nau.24296.