4. Recommendation: Talk to your doctor about not having a urinary catheter. If a catheter must be used, have it removed as soon as possible (Society of Hospital Medicine).
One in five hospital patients has a catheter, but about half don't need one. Sometimes they're used for incontinence or the convenience of the patient or health care staff.
"Don't get a catheter put in. But if you have to have one, get it out as quickly as you can," says John Bulger, an official with the society that represents hospital physicians. While patients hate it, wetting the bed or intermittent catheterization is far preferable to the continuous use of a catheter, he adds.
Danger: Urinary tract infections from catheters are more prevalent the longer a catheter is in place. Urinary tract infections are the most common hospital-acquired infection, and can be fatal. About 13,000 people a year die as a result of infections from catheters, a study found.
Exceptions: If you have surgery, you may need a catheter. Guidelines call for its removal the next day.
5. Recommendation: Skip the annual Pap test (American College of Obstetricians and Gynecologists and American Academy of Family Physicians).
If you're under 65, get a screening every three years. After 65, if you've had several normal Pap tests, you can stop having them.
"Pap smears annually are a waste of money," says Gerald F. Joseph, M.D., of the OB/GYN group. "In average-risk women, studies show no advantage to annual screenings over those performed at three-year intervals."
Danger: False positive results cause anxiety for patients.
Exception: If you've had cervical cancer or cervical disease, continue annual Pap smears. Cervical cancer is caused by the Human Papillomavirus (HPV), which is transmitted through sexual relations.
6. Recommendation: Don't use testosterone for erectile dysfunction (American Urological Association).
A number of TV ads and men's clinics are pushing this remedy, but most men should skip testosterone supplements if their testosterone levels are normal.
"Anecdotally, we know a lot of prescriptions are being written for testosterone for men with normal testosterone," says Daniel A. Barocas, M.D., assistant professor of urologic surgery at Vanderbilt University Medical Center. But he says the prescription doesn't work for erectile dysfunction.
Danger: Testosterone does not affect the ability to get an erection. It enhances libido or sex drive but not performance. It also reduces fertility and may make prostate cancer blossom. Prostate cancer thrives on testosterone. Gels can irritate the skin; injections can increase red blood cells.
Exception: If you have other symptoms of low testosterone, including loss of muscle mass and body hair, talk to your doctor to see if hormone testing is right for you.
7. Recommendation: Don’t order a blood test for creatinine or upper-tract imaging for patients with an enlarged prostate (American Urological Association).
Most men after age 50 have enlarged prostates, which result in urination that disturbs sleep and a weaker urine stream.
Danger: Even routine tests are not risk-free. Patients spend time and money and may get false positive readings, leading to other tests. CT scans mean radiation exposure.
Exception: Tell your doctor about blood in the urine, pain with urination or urinary retention.
The full list is available at ChoosingWisely.org.
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