Comparative Outcomes of Indwelling Urethral Versus Suprapubic Catheters in Elderly Patients: A Retrospective Within‐Subject Study

Aims To compare the incidence of catheter‐associated urinary tract infections (CAUTIs), antibiotic resistance, and other complications between indwelling urethral catheters (UCs) and suprapubic catheters (SPCs) in elderly patients. Methods This retrospective cohort study included 37 elderly patients who had used a UC for at least 1 year and subsequently transitioned to an SPC for at least 1 year. Each patient served as their own control. Data were extracted from electronic health records, including CAUTI rates, emergency department visits, catheter obstruction, hematuria, and microbial resistance patterns. McNemar's and Wilcoxon signed‐rank tests were used for statistical analysis. Results SPCs were associated with a significantly lower incidence of CAUTIs (38% vs. 86%, p < 0.001) and reduced emergency department visits (35% vs. 68%, p < 0.001) compared to UCs. SPC use also resulted in fewer catheter obstructions ( p = 0.003), lower hematuria rates ( p = 0.003), and a reduced prevalence of antibiotic‐resistant organisms ( p = 0.015). No significant differences were found in accidental dislodgement or leakage rates. Conclusion Suprapubic catheterization was associated with improved clinical outcomes in elderly patients requiring long‐term catheterization. These findings suggest SPCs may reduce complications and healthcare utilization in this vulnerable population. Prospective studies are warranted to guide practice guidelines.