This study employed a retrospective review of the literature examining the use of PureWick catheters in both acute care and home settings. Additionally, the author conducted a survey of acute care and neurologic physiotherapists to assess their perceptions of functional issues associated with PureWick catheter use. The study further explores general physiotherapy perspectives on this device, as well as the potential functional implications of its long-term use

A retrospective review of the literature was conducted to understand the urologic and patient satisfaction implications of the Pure Wick catheter. The author then conducted a survey of acute care and outpatient physiotherapists and occupational therapists in a large city-based hospital system to understand attitudes, beliefs, and issues with the Pure Wick catheters. The survey results are presented alongside the retrospective literature review to understand the differing beliefs and long-term functional implications of using this device.

Physiotherapists overwhelmingly express opposition to the use of the PureWick catheter in both acute care and outpatient settings, regardless of the presence or absence of neurologic dysfunction. From a rehabilitation perspective, physiotherapists prioritize the promotion of mobility and patient safety; however, the use of the PureWick device may inadvertently encourage sedentary behavior and contribute to patient refusal of physiotherapy interventions.

In contrast, much of the existing literature portrays the PureWick catheter favorably, frequently reporting a reduction in the incidence of urinary tract infections. Patient and caregiver perspectives are also generally positive, with reported benefits including ease of use and improved sleep quality for both parties.

Despite these favorable perceptions, closer examination of the limited available data suggests that the incidence of urinary tract infections may, in fact, increase with the use of this external urinary collection device. Furthermore, the promotion of sedentary behavior associated with its use may elevate the risk of additional complications, including deep vein thrombosis and constipation.

Although patients and caregivers may perceive the female external catheter as a means of reducing caregiver burden and improving sleep quality, its use may inadvertently predispose patients to secondary complications and suboptimal physiotherapy outcomes. Routine activities such as ambulating to the bathroom represent valuable opportunities to promote mobility, particularly in acute care or recently hospitalized populations, where even minimal physical activity can support functional recovery.

From a physiotherapy perspective, facilitating bathroom-related mobility is preferred as a strategy to enhance overall strength, endurance, and independence, rather than relying on external catheter devices that may discourage movement and contribute to functional decline.

Further research, including large-scale clinical trials, is necessary to more comprehensively evaluate the functional implications associated with the use of these catheter devices. Clinical decision-making should incorporate a multidisciplinary approach, ensuring that input from various healthcare professionals is considered alongside a broad range of patient-specific factors.

Khosla, L., Sani, J. M., & Chughtai, B. (2022). Patient and caretaker satisfaction with the PureWick system. The Canadian journal of urology, 29(4), 11216–11223.
Medina, J. C., Fakih, M., Khalsa, S., Redmond, D., & Kennelly, M. J. (2025). Safety, Efficacy, and Patient-Reported Outcomes of the PureWick™ System Versus Comparator for Nocturnal Urinary Incontinence in the Home Setting: Results of a Randomized Trial. Journal of clinical medicine, 14(24), 8699. https://doi.org/10.3390/jcm14248699
Jasperse, N., Hernandez-Dominguez, O., Deyell, J. S., Prasad, J. P., Yuan, C., Tomy, M., Kuza, C. M., Grigorian, A., & Nahmias, J. (2022). A single institution pre-/post-comparison after introduction of an external urinary collection device for female medical patients. Journal of infection prevention, 23(4), 149–154. https://doi.org/10.1177/17571774211060423