1
|
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:S0090-4295(24)00567-3. [PMID: 39025236 DOI: 10.1016/j.urology.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 07/03/2024] [Accepted: 07/06/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVE To evaluate the efficacy of the Aurie System, a preclinical prototype allowing for standardized intermittent catheter (IC) reuse of novel reusable no-touch ICs. Individuals with neurogenic bladder often require single-use ICs to urinate, but urinary tract infection (UTI) is a common cause of morbidity for IC users. Safer no-touch catheters are not easily affordable, and the Aurie System attempts to provide no-touch catheters at a fraction of the price by allowing for standardized and safe IC reuse. METHODS Standard ICs were inoculated with Escherichia coli and Pseudomonas aeruginosa and incubated for 48 hours to assess microbial burden and biofilm formation (the latter using infrared fluorescence imaging). This procedure was repeated with Aurie ICs, focusing on evaluating catheter microbial burden after inoculation and reprocessing with the prototype washer-disinfector. This was repeated with up to 100 cycles to evaluate repetitive use. RESULTS Standard ICs showed bacterial attachment and biofilm development peaking at 24 hours of incubation. The Aurie catheters produced a similar outcome but, after reprocessing, microbial burden was reduced below the level of detection. Repeat cycles showed pathogen clearance to similar levels. One catheter reached 100 cycles and there was no viable pathogen load after reprocessing. CONCLUSION Intermittent urinary catheters, when cleaned inappropriately, can harbor viable bacteria and biofilm. The Aurie System, when used to disinfect novel reusable ICs within a prototype reprocessing device, can reduce microbial burden below level of detection even after 100 cycles. This suggests the Aurie System may be a feasible technology for safe IC reuse.
Collapse
Affiliation(s)
- Alyssa A La Bella
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN
| | - Alex Molesan
- Department of Biological Sciences, University of Notre Dame, Notre Dame, IN
| | - Daniel A Wollin
- CathBuddy, Inc., Syracuse, NY; Department of Urology, Brigham and Women's Hospital, Boston, MA
| | | | | |
Collapse
|
2
|
Wang L, Wang F, Qin H, Hou L, Zhu S, He F, Zeng C. Intermittent Catheterization Continuity Care on Bladder Function Recovery and Quality of Life in Patients After Radical Hysterectomy for Cervical Cancer: A Quasi-Experimental Study. Int J Gen Med 2024; 17:2781-2789. [PMID: 38903651 PMCID: PMC11189298 DOI: 10.2147/ijgm.s463225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 06/09/2024] [Indexed: 06/22/2024] Open
Abstract
Background Bladder dysfunction is a common complication following radical hysterectomy, affecting patients' QOL. Exploring interventions, particularly IC continuity care, is crucial for identifying strategies to enhance postoperative outcomes. This study aimed to assess the impact of continuous intermittent catheterization (IC) care on bladder function recovery and quality of life (QOL) in patients undergoing radical hysterectomy for cervical cancer. Methods The primary outcome measured was the time to bladder function recovery, with secondary outcomes comprising EORTC QLQ-C30 assessments at 3 and 6 months post-surgery, as well as EORTC QLQ-CX24 evaluations. Meanwhile, urinary complications, readmissions, and outpatient follow-up were also compared. Results Among the 128 participants, with 64 in each group, indwelling catheterization durations were similar. However, the IC continuity care group exhibited significantly shorter IC duration and bladder recovery time. This group demonstrated superior QOL, lower occurrence rates post-IC, reduced urethral injuries, and higher readmission and outpatient follow-up rates. Conclusion This study underscores continuous IC care emerges as a beneficial intervention, facilitating accelerated bladder function recovery and improved QOL in patients following radical hysterectomy for cervical cancer.
Collapse
Affiliation(s)
- Lin Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
- Gynecology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Fulan Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
- Gynecology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Hong Qin
- Gynecology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Li Hou
- Gynecology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Shiqiong Zhu
- Gynecology Department, Sichuan Provincial People’s Hospital, Chengdu, Sichuan, 610031, People’s Republic of China
| | - Fang He
- Gynecology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| | - Chao Zeng
- Gynecology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China
| |
Collapse
|
3
|
van Doorn T, Berendsen SA, Scheepe JR, Blok BFM. Single use versus reusable catheters in intermittent catheterisation for treatment of urinary retention: a protocol for a multicentre, prospective, randomised controlled, non-inferiority trial (COMPaRE). BMJ Open 2022; 12:e056649. [PMID: 35410930 PMCID: PMC9003620 DOI: 10.1136/bmjopen-2021-056649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Chronic urinary retention is a common lower urinary tract disorder, mostly neurogenic or idiopathic in origin. The preferred treatment is clean intermittent urinary self-catheterisation (CISC) four to six times a day. In most European countries, virtually all patients use single use catheters, which is in contrast to several countries where the use of reusable catheters is more common. The available literature on the use of reusable catheters is conflicting and until now, no randomised controlled trial with sufficient power has been performed to investigate if reusable catheters for CISC is as safe as single use catheters. METHODS AND ANALYSIS We described this protocol for a prospective, randomised controlled non-inferiority trial to investigate if the use of reusable catheters is as safe as single use catheters for CISC patients, measured by symptomatic urinary tract infections (sUTIs). Secondary objectives are adverse events due to a sUTI, urethral damage, stone formation, quality of life and patient satisfaction. A cost-effectiveness analysis will also be performed. 456 Participants will be randomised into two groups stratified for age, gender, menopausal status and (non-)neurogenic underlying disorder. The intervention group will replace the reusable catheter set every 2 weeks for a new set and replace the cleaning solution every 24 hours. The control group continues to use its own catheters. The primary outcome (amount of sUTIs from baseline to 1 year) will be tested for non-inferiority. Categorical outcome measures will be analysed using χ2 tests and quantitative outcome variables by t-tests or Mann-Whitney U tests. Two-sided p values will be calculated. ETHICS AND DISSEMINATION This protocol was reviewed and approved by the Medical Ethics Committee of the Erasmus MC (MEC 2019-0134) and will be performed according to the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) checklist for non-inferiority trials. The results of this randomised controlled non-inferiority trial will be published in a peer-reviewed journal and will be publicly available. TRIAL REGISTRATION NUMBER NL8296.
Collapse
Affiliation(s)
- Tess van Doorn
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Sophie A Berendsen
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jeroen R Scheepe
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bertil F M Blok
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
4
|
Mitchell BG, Prael G, Curryer C, Russo PL, Fasugba O, Lowthian J, Cheng AC, Archibold J, Robertson M, Kiernan M. The frequency of urinary tract infections and the value of antiseptics in community-dwelling people who undertake intermittent urinary catheterization: A systematic review. Am J Infect Control 2021; 49:1058-1065. [PMID: 33485920 DOI: 10.1016/j.ajic.2021.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND This systematic review had 2 aims. First to identify the incidence of urinary tract infection (UTI) and bacteriuria in people undertaking intermittent catheterization (IC), second to determine the effectiveness of antiseptic cleaning of the meatal area prior to IC in reducing the incidence of UTI and bacteriuria. METHODS A systematic review was conducted. Medline and the Cumulative Index to Nursing and Allied Health Literature electronic databases were systematically searched between January 1, 1990 and January 31, 2020, to identify studies that reported either the incidence of UTI or bacteriuria or the impact of using antiseptics for meatal cleaning prior to IC on incidence of these same outcomes. RESULTS Twenty-five articles were identified for the first aim, 2 articles for the second. The proportion of participants experiencing ≥1 UTIs per year ranged from 15.4% to 86.6%. Synthesis of these studies suggest a combined incidence of 44.2% (95%CI 40.2%-48.5%) of participants having ≥1 UTIs per year. One of the 2 studies exploring the benefit of antiseptics in reducing UTI suggest some potential benefit of using chlorhexidine in reducing UTIs. Both studies have significant limitations, making interpretation difficult. CONCLUSIONS A large proportion of people undertaking IC in the community have UTIs each year. Evidence on the role of antiseptics in the prevention of UTI for people who undertake IC remains unclear.
Collapse
Affiliation(s)
- Brett G Mitchell
- School of Nursing and Midwifery, University of Newcastle, Ourimbah, NSW, Australia; Central Coast Local Health District, Gosford, NSW, Australia.
| | - Grace Prael
- School of Nursing and Midwifery, University of Newcastle, Ourimbah, NSW, Australia
| | - Cassie Curryer
- School of Nursing and Midwifery, University of Newcastle, Ourimbah, NSW, Australia
| | - Philip L Russo
- Cabrini Health, Nursing and Midwifery, Monash University, Clayton, VIC, Australia
| | - Oyebola Fasugba
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne and Australian Catholic University, NSW, Australia
| | - Judy Lowthian
- Bolton Clarke Research Institute, Bolton Clarke, Bentleigh, Australia; Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, QLD, Australia; School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia; Institute of Future Environments, Queensland University of Technology, Brisbane, QLD, Australia
| | - Allen C Cheng
- Infection Prevention and Healthcare Epidemiology Unit, Alfred Health, School of Public Health and Preventive Medicine, Monash University, VIC, Australia
| | - Jemma Archibold
- Central Coast Local Health District, Gosford, NSW, Australia
| | - Mark Robertson
- Central Coast Local Health District, Gosford, NSW, Australia
| | - Martin Kiernan
- School of Nursing and Midwifery, University of Newcastle, Ourimbah, NSW, Australia; Richard Wells Research Centre, University of West London, United Kingdom
| |
Collapse
|
5
|
Berendsen SA, van Doorn T, Blok BFM. Trends in the use and costs of intermittent urinary catheters in the Netherlands from 1997 to 2018: A population-based observational study. Neurourol Urodyn 2021; 40:876-882. [PMID: 33645866 PMCID: PMC8049077 DOI: 10.1002/nau.24643] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 11/07/2022]
Abstract
AIM To obtain insight into the the use and costs of clean intermittent catheterization (CIC) in the Netherlands from 1997 to 2018. METHODS For this population-based study, data on the use and costs of disposable catheters were provided by the Drug Information Project database. This database contains information about the Dutch insured population, which increased from 9.9 to 17.1 million persons between 1997 and 2018 (64%-100% of the Dutch population). The following trends were evaluated: (1) CIC users, (2) distribution of users by gender and age-group, (3) distribution of users by neurogenic and non-neurogenic cause for CIC, (4) total costs, and (5) costs per user. Total users are adjusted for the Dutch population. Costs are corrected for inflation and expressed in euros. RESULTS Extramural use of CIC increased from 14,258 users in 1997 to 45,909 users in 2018. CIC users per 100,000 persons nearly tripled from 92 users to 267 users. Male CIC users almost quadrupled from 92 to 334 per 100,000 insured persons, whereas female users more than doubled from 91 to 201 per 100,000 insured persons. In 2018, 49% of the users had a non-neurogenic cause for CIC. Total costs increased from 16.4 million euros in 1997 to 74.6 million euros in 2018. Costs per user rose from 1151 to 1624 euros (41.1%). CONCLUSIONS The use and costs of disposable catheters in the Netherlands increased substantially over the past two decades. Non-neurogenic bladder patients represent 49% of the population on CIC, which has not been described before in the literature.
Collapse
Affiliation(s)
| | - Tess van Doorn
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands
| | - Bertil F M Blok
- Department of Urology, Erasmus MC, Rotterdam, The Netherlands
| |
Collapse
|
6
|
Shen X, Wang CL, Wu WY, Liang GM, Xia LY. Effects of clean intermittent self-catheterization on late bladder dysfunction after radical hysterectomy in cervical cancer. J Int Med Res 2020; 48:300060519885546. [PMID: 31891274 PMCID: PMC7783279 DOI: 10.1177/0300060519885546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/08/2019] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To identify the benefits of clean intermittent self-catheterization in women who have late bladder dysfunction caused by radical hysterectomy in cervical cancer. METHODS Thirty women who underwent radical hysterectomy with late bladder dysfunction were recruited. A nursing intervention program focusing on clean intermittent self-catheterization and a drinking plan was implemented. We recorded urinary times during the day and night, post-voiding residual urine volume, positive catheter specimen of urine rate, and quality of life instruments for patients with cervical cancer . RESULTS All patients were able to satisfactorily manage clean intermittent self-catheterization following video-based operational training. Bladder function was significantly increased after 3-month intervention compared with before the intervention. Urinary times during the day and night, and post-voiding residual urine volume were greatly decreased post-intervention compared with pre-intervention. The rate of a positive catheter specimen of urine test significantly decreased over time. There was significant improvement in quality of life in five dimensions between weeks 1 and 12 following the intervention. CONCLUSIONS Patients are able to learn the technique of clean intermittent self-catheterization without any difficulty. This technique is effective together with a drinking plan to decrease late bladder dysfunction caused by radical hysterectomy in cervical cancer.
Collapse
Affiliation(s)
- Xia Shen
- Department of Gynecologic Oncology, Zhejiang Cancer Hospital,
Hangzhou, China
| | - Chun-lan Wang
- Department of Gynecologic Oncology, Zhejiang Cancer Hospital,
Hangzhou, China
| | - Wan-ying Wu
- Department of Nursing, Zhejiang Cancer Hospital, Hangzhou,
China
| | - Guan-mian Liang
- Department of Head and Neck Surgery, Zhejiang Cancer Hospital,
Hangzhou, China
| | - Li-yao Xia
- Department of Gynecologic Oncology, Zhejiang Cancer Hospital,
Hangzhou, China
| |
Collapse
|
7
|
|
8
|
van Doorn T, Blok BFM. Multiuse Catheters for Clean Intermittent Catheterization in Urinary Retention: Is There Evidence of Inferiority? Eur Urol Focus 2019; 6:809-810. [PMID: 31606472 DOI: 10.1016/j.euf.2019.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/25/2019] [Indexed: 10/25/2022]
Abstract
In Europe, urinary retention is managed with single-use catheters but there is uncertainty regarding their superiority over multiuse catheters.
Collapse
Affiliation(s)
- Tess van Doorn
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Bertil F M Blok
- Department of Urology, Erasmus Medical Center, Rotterdam, The Netherlands.
| |
Collapse
|
9
|
Pickard R, Chadwick T, Oluboyede Y, Brennand C, von Wilamowitz-Moellendorff A, McClurg D, Wilkinson J, Ternent L, Fisher H, Walton K, McColl E, Vale L, Wood R, Abdel-Fattah M, Hilton P, Fader M, Harrison S, Larcombe J, Little P, Timoney A, N'Dow J, Armstrong H, Morris N, Walker K, Thiruchelvam N. Continuous low-dose antibiotic prophylaxis to prevent urinary tract infection in adults who perform clean intermittent self-catheterisation: the AnTIC RCT. Health Technol Assess 2019; 22:1-102. [PMID: 29766842 DOI: 10.3310/hta22240] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND People carrying out clean intermittent self-catheterisation (CISC) to empty their bladder often suffer repeated urinary tract infections (UTIs). Continuous once-daily, low-dose antibiotic treatment (antibiotic prophylaxis) is commonly advised but knowledge of its effectiveness is lacking. OBJECTIVE To assess the benefit, harms and cost-effectiveness of antibiotic prophylaxis to prevent UTIs in people who perform CISC. DESIGN Parallel-group, open-label, patient-randomised 12-month trial of allocated intervention with 3-monthly follow-up. Outcome assessors were blind to allocation. SETTING UK NHS, with recruitment of patients from 51 sites. PARTICIPANTS Four hundred and four adults performing CISC and predicted to continue for ≥ 12 months who had suffered at least two UTIs in the previous year or had been hospitalised for a UTI in the previous year. INTERVENTIONS A central randomisation system using random block allocation set by an independent statistician allocated participants to the experimental group [once-daily oral antibiotic prophylaxis using either 50 mg of nitrofurantoin, 100 mg of trimethoprim (Kent Pharmaceuticals, Ashford, UK) or 250 mg of cefalexin (Sandoz Ltd, Holzkirchen, Germany); n = 203] or the control group of no prophylaxis (n = 201), both for 12 months. MAIN OUTCOME MEASURES The primary clinical outcome was relative frequency of symptomatic, antibiotic-treated UTI. Cost-effectiveness was assessed by cost per UTI avoided. The secondary measures were microbiologically proven UTI, antimicrobial resistance, health status and participants' attitudes to antibiotic use. RESULTS The frequency of symptomatic antibiotic-treated UTI was reduced by 48% using prophylaxis [incidence rate ratio (IRR) 0.52, 95% confidence interval (CI) 0.44 to 0.61; n = 361]. Reduction in microbiologically proven UTI was similar (IRR 0.49, 95% CI 0.39 to 0.60; n = 361). Absolute reduction in UTI episodes over 12 months was from a median (interquartile range) of 2 (1-4) in the no-prophylaxis group (n = 180) to 1 (0-2) in the prophylaxis group (n = 181). The results were unchanged by adjustment for days at risk of UTI and the presence of factors giving higher risk of UTI. Development of antimicrobial resistance was seen more frequently in pathogens isolated from urine and Escherichia coli from perianal swabs in participants allocated to antibiotic prophylaxis. The use of prophylaxis incurred an extra cost of £99 to prevent one UTI (not including costs related to increased antimicrobial resistance). The emotional and practical burden of CISC and UTI influenced well-being, but health status measured over 12 months was similar between groups and did not deteriorate significantly during UTI. Participants were generally unconcerned about using antibiotics, including the possible development of antimicrobial resistance. LIMITATIONS Lack of blinding may have led participants in each group to use different thresholds to trigger reporting and treatment-seeking for UTI. CONCLUSIONS The results of this large randomised trial, conducted in accordance with best practice, demonstrate clear benefit for antibiotic prophylaxis in terms of reducing the frequency of UTI for people carrying out CISC. Antibiotic prophylaxis use appears safe for individuals over 12 months, but the emergence of resistant urinary pathogens may prejudice longer-term management of recurrent UTI and is a public health concern. Future work includes longer-term studies of antimicrobial resistance and studies of non-antibiotic preventative strategies. TRIAL REGISTRATION Current Controlled Trials ISRCTN67145101 and EudraCT 2013-002556-32. FUNDING This project was funded by the National Institute for Health Research Health Technology Assessment programme and will be published in full in Health Technology Assessment Vol. 22, No. 24. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Robert Pickard
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Thomas Chadwick
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Yemi Oluboyede
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Brennand
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | | | - Doreen McClurg
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Jennifer Wilkinson
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Ternent
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Holly Fisher
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Katherine Walton
- Department of Microbiology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - Elaine McColl
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth Wood
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | | | - Paul Hilton
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Mandy Fader
- Health Sciences, University of Southampton, Southampton, UK
| | - Simon Harrison
- Department of Urology, Mid-Yorkshire Hospitals NHS Trust, Pinderfields Hospital, Wakefield, UK
| | | | - Paul Little
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - Anthony Timoney
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - James N'Dow
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Nicola Morris
- Bristol Urological Institute, North Bristol NHS Trust, Bristol, UK
| | - Kerry Walker
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Nikesh Thiruchelvam
- Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| |
Collapse
|
10
|
Koeter I, Stensröd G, Hunsbedt Nilsen A, Lund R, Haslam C, De Sèze M, Sriram R, Heesakkers J. User perception of a new hydrophilic-coated male urinary catheter for intermittent use. Nurs Open 2019; 6:116-125. [PMID: 30534401 PMCID: PMC6279713 DOI: 10.1002/nop2.193] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 05/29/2018] [Accepted: 07/02/2018] [Indexed: 11/12/2022] Open
Abstract
AIMS This study investigated user perception and adherence related to a hydrophilic-coated urinary catheter (LoFric® Origo™), available for male patients who practice intermittent catheterization. DESIGN The study had a prospective observational design, including patients from 19 European hospitals. METHODS A total of 416 patients were eligible for the study; 179 experienced catheter users and 237 de novo. Two questionnaires were filled out, one describing background data and a second, 8 weeks later, evaluating catheter features. RESULTS The response rate for the second questionnaire was 88% (365 patients). Patients evaluating the new catheter showed a general satisfaction rate of 81% and 72% kept using it. The hygienic grip of the catheter was appreciated by 85% and the foldable feature by 67%. The results show that convenience, ease of use, and hygienic factors are patient-preferred features for a urinary catheter. These factors were confirmed for the evaluated hydrophilic-coated catheter.
Collapse
Affiliation(s)
| | - Gro Stensröd
- Urodynamisk laboratoriumSunnaas Sykehus HFNesoddtangenNorway
| | | | - Rigmor Lund
- Urologisk poliklinikkAkershus Universitetssykehus HFLørenskogNorway
| | - Colette Haslam
- National Hospital for Neurology and Neurosurgery, Queens SquareLondonUK
| | - Marianne De Sèze
- Cabinet de Neuro‐Urologie, Pelvipérinéologie et UrodynamiqueGroupe Urologique de la Clinique Saint AugustinBordeauxFrance
| | - Rajagopalan Sriram
- University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave HospitalCoventryUK
| | | | | |
Collapse
|
11
|
Beauchemin L, Newman DK, Le Danseur M, Jackson A, Ritmiller M. Best practices for clean intermittent catheterization. Nursing 2018; 48:49-54. [PMID: 30134322 DOI: 10.1097/01.nurse.0000544216.23783.bc] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Lisa Beauchemin
- Lisa Beauchemin is a clinical nurse manager at Wellspect Healthcare in Waltham, N.H. Diane K. Newman is an adjunct professor of urology in surgery at the Perelman School of Medicine, University of Pennsylvania in Philadelphia, Pa. Maureen Le Danseur is a clinical nurse specialist at Sharp Memorial Hospital in San Diego, Calif. Angela Jackson is a nurse manager at the University of South Florida Department of Urology in Tampa, Fla. Michael Ritmiller is a neuro-urology physician assistant at Chesapeake Urology Associates, University of Maryland Rehabilitation and Orthopaedic Institute in Baltimore, Md
| | | | | | | | | |
Collapse
|
12
|
A Proof-of-Concept Study of Transcutaneous Magnetic Spinal Cord Stimulation for Neurogenic Bladder. Sci Rep 2018; 8:12549. [PMID: 30135433 PMCID: PMC6105631 DOI: 10.1038/s41598-018-30232-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/25/2018] [Indexed: 01/01/2023] Open
Abstract
Patients with chronic spinal cord injury (SCI) cannot urinate at will and must empty the bladder by self-catheterization. We tested the hypothesis that non-invasive, transcutaneous magnetic spinal cord stimulation (TMSCS) would improve bladder function in individuals with SCI. Five individuals with American Spinal Injury Association Impairment Scale A/B, chronic SCI and detrusor sphincter dyssynergia enrolled in this prospective, interventional study. After a two-week assessment to determine effective stimulation characteristics, each patient received sixteen weekly TMSCS treatments and then received “sham” weekly stimulation for six weeks while bladder function was monitored. Bladder function improved in all five subjects, but only during and after repeated weekly sessions of 1 Hz TMSCS. All subjects achieved volitional urination. The volume of urine produced voluntarily increased from 0 cc/day to 1120 cc/day (p = 0.03); self-catheterization frequency decreased from 6.6/day to 2.4/day (p = 0.04); the capacity of the bladder increased from 244 ml to 404 ml (p = 0.02); and the average quality of life ranking increased significantly (p = 0.007). Volitional bladder function was re-enabled in five individuals with SCI following intermittent, non-invasive TMSCS. We conclude that neuromodulation of spinal micturition circuitry by TMSCS may be used to ameliorate bladder function.
Collapse
|
13
|
Castle AC, Park A, Mitchell AJ, Bliss DZ, Gelfand JA, De EJB. Neurogenic Bladder: Recurrent Urinary Tract Infections—Beyond Antibiotics. CURRENT BLADDER DYSFUNCTION REPORTS 2018. [DOI: 10.1007/s11884-018-0481-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
14
|
Davis C, Rantell A. Selecting an intermittent self-catheter: key considerations. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2018; 27:S11-S16. [PMID: 30088972 DOI: 10.12968/bjon.2018.27.sup15.s11] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article explores the factors that must be considered when assessing patients for intermittent self-catherisation (ISC). It discusses the various types of intermittent catheters and their properties. Key considerations for the health professional when making product recommendations are covered and emphasis is placed on teaching patients the ISC technique. The article also highlights what patients value in terms of product choice and the importance of ongoing support. It concludes by introducing the GentleCath Glide, a new product that incorporates FeelClean™ technology, which leaves less residue on the hands and clothes.
Collapse
Affiliation(s)
- Cathy Davis
- Urogynaecology, Clinical Nurse Specialist, King's College Hospital NHS Foundation Trust
| | - Angie Rantell
- Lead Nurse Urogynaecology/Nurse Cystoscopist, King's College Hospital NHS Foundation Trust
| |
Collapse
|
15
|
Irwin NJ, McCoy CP, McCullough AR, Corbett DJ. Use of in vitro and haptic assessments in the characterisation of surface lubricity. Proc Inst Mech Eng H 2018; 233:84-90. [PMID: 29393009 DOI: 10.1177/0954411918756155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Lubricity is a key property of hydrophilic-coated urinary catheter surfaces. In vitro tests are commonly employed for evaluation of surface properties in the development of novel catheter coating technologies; however, their value in predicting the more subjective feeling of lubricity requires validation. We herein perform a range of in vitro assessments and human organoleptic studies to characterise surface properties of developmental hydrophilic coating formulations, including water wettability, coefficient of friction, dry-out kinetics and lubricity. Significant reductions of up to 40% in the contact angles and coefficient of friction values of the novel coating formulations in comparison with the control poly(vinylpyrrolidone)-coated surfaces were demonstrated during quantitative laboratory assessments. In contrast, no significant differences in the more subjective feeling of lubricity between the novel formulations and the control-coated surfaces were observed when formulations were haptically assessed by the techniques described herein. This study, importantly, highlights the need for optimisation of in vitro and human haptic assessments to more reliably predict patient preferences.
Collapse
Affiliation(s)
- Nicola J Irwin
- 1 School of Pharmacy, Queen's University Belfast, Belfast, UK
| | - Colin P McCoy
- 1 School of Pharmacy, Queen's University Belfast, Belfast, UK
| | - Amanda R McCullough
- 2 Centre for Research in Evidence-Based Practice, Bond University, Robina, QLD, Australia
| | - Dan J Corbett
- 3 China Medical University - The Queen's University of Belfast Joint College, Shenyang, China
| |
Collapse
|
16
|
Watanabe T, Yamamoto S, Gotoh M, Saitoh T, Yokoyama O, Murata T, Takeda M. Cost-Effectiveness Analysis of Long-Term Intermittent Self-Catheterization with Hydrophilic-Coated and Uncoated Catheters in Patients with Spinal Cord Injury in Japan. Low Urin Tract Symptoms 2017; 9:142-150. [PMID: 28868661 DOI: 10.1111/luts.12122] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 09/04/2015] [Accepted: 09/27/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the cost effectiveness of disposable, hydrophilic-coated catheters in Japan. METHODS A Markov decision model previously applied in a European study was used to evaluate the cost effectiveness of intermittent self-catheterization (ISC) with hydrophilic-coated catheters in Japanese spinal cord injury (SCI) patients suffering from chronic urinary retention from a lifetime perspective. To adjust the model to a Japanese setting, relevant Japanese data regarding the baseline risk of urinary tract infection (UTI), the average age at onset of SCI, costs, and general mortality were extracted from published literature, national statistics, or the opinions of Japanese experts. The direct medical costs, quality-adjusted life years (QALYs) and life years gained (LYG) were calculated from the payers' perspective. An annual discount rate of 2% was applied to both the costs and the effects. RESULTS The incremental cost of hydrophilic-coated catheters was 1 279 886 yen (US$ 10 578 at an exchange rate of US$ 1 = 121 yen) per SCI patient, but they yielded an additional 0.334 QALYs and 0.781 LYG compared with uncoated catheters. The incremental cost-effectiveness ratio (ICER) of hydrophilic-coated catheters vs. uncoated catheters was 3 826 351 yen/QALY (US$ 31 623/QALY) gained and 1 639 562 yen/LYG (US$ 13 550/LYG). CONCLUSIONS The ICER of 3.8 million yen (US$ 31 405) falls well within the Japanese societal willingness to pay per QALY gained; therefore, hydrophilic-coated catheters can be considered highly cost-effective in Japan compared with uncoated catheters. However, because of the lack of relevant studies, a number of key parameters could not be based on Japanese data, and further research among people with SCI in Japan is recommended.
Collapse
Affiliation(s)
- Toyohiko Watanabe
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Shingo Yamamoto
- Department of Urology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Osamu Yokoyama
- Department of Urology, University of Fukui Faculty of Medical Sciences, Fukui, Japan
| | | | | |
Collapse
|
17
|
|
18
|
Dray EV, Clemens JQ. Recurrent urinary tract infections in patients with incomplete bladder emptying: is there a role for intravesical therapy? Transl Androl Urol 2017; 6:S163-S170. [PMID: 28791235 PMCID: PMC5522797 DOI: 10.21037/tau.2017.04.08] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 03/26/2017] [Indexed: 11/06/2022] Open
Abstract
The goal of this review article is to discuss the etiology of recurrent urinary tract infections (UTIs) in individuals with impaired bladder emptying, evaluate existing studies regarding UTI prevention strategies in this population, and explore the published experiences with intravesical therapy for the prevention and treatment of recurrent UTIs in patients performing clean intermittent catheterization (CIC). We will also describe the intravesical antibiotic protocol utilized at our institution.
Collapse
Affiliation(s)
- Elizabeth V Dray
- Department of Urology, University of Michigan Health Science Center, Ann Arbor, Michigan, USA
| | - J Quentin Clemens
- Department of Urology, University of Michigan Health Science Center, Ann Arbor, Michigan, USA
| |
Collapse
|
19
|
Shamout S, Biardeau X, Corcos J, Campeau L. Outcome comparison of different approaches to self-intermittent catheterization in neurogenic patients: a systematic review. Spinal Cord 2017; 55:629-643. [PMID: 28117329 DOI: 10.1038/sc.2016.192] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/01/2016] [Accepted: 12/11/2016] [Indexed: 02/08/2023]
Abstract
STUDY DESIGN Systematic review (Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA); http://www.prisma-statement.org). OBJECTIVES Different types of catheters and techniques have been described in the past three decades to identify the best self-intermittent catheterization method. Our aim is to review systematically the literature on the most appropriate material and technique to perform self-intermittent catheterization in the adult neurogenic population. METHODS A systematic review search was performed through PubMed/Medline, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) databases to study all types of self-intermittent catheters, and analyzing their impact on urinary tract infections (UTIs), urethral trauma, cost-effectiveness, quality of life and patient's satisfaction. We used the following keywords: 'intermittent catheterization/catheterisation', 'neurogenic', 'urinary catheters for intermittent use' and 'urethral catheterization/catheterisation' published by November 2015. RESULTS After screening 3768 articles, 31 were included in the final synthesis (level of evidence 1b to 2b). The 2188 trial participants were mainly spinal cord injury adults and women with multiple sclerosis. Hydrophilic-coated catheters tended to decrease the incidence of UTI as well as urethral trauma and improve patient's satisfaction when compared with non-hydrophilic-coated catheters. Similarly, prelubricated catheters were associated with better results in terms of patient satisfaction. Sterile technique seemed to decrease the incidence of recurrent UTI; however, these results are counter-balanced by significantly increasing cost compared with clean catheterization. CONCLUSIONS The present review demonstrated advantages of hydrophilic-coated catheters in decreasing risk of UTI and urethral trauma as well as improving patient's satisfaction. Prelubricated catheters has been shown to be superior to conventional polyvinyl chloride catheters. Randomized controlled trials comparing hydrophilic and prelubricated catheters must be conducted to assess possible superiority and cost-effectiveness.
Collapse
Affiliation(s)
- S Shamout
- Division of Urology, Department of Surgery, Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - X Biardeau
- Division of Urology, Department of Surgery, Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - J Corcos
- Division of Urology, Department of Surgery, Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| | - L Campeau
- Division of Urology, Department of Surgery, Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
| |
Collapse
|
20
|
Abstract
Costs of neurogenic bladder vary widely and depend on a number of factors including severity of disease, symptomatology, patient insurance, and devices required. Recognition of how each treatment strategy will impact the patient financially could help guide selection of treatment as well as improve compliance with the chosen regimen. We have attempted to provide an overview of long term cost considerations for the neurogenic bladder patient. Armed with this information, the practitioner can better help the patient select a bladder care regimen that balances the desire to both minimize symptoms now and preserve urinary tract integrity for the future, yet still remain cost effective.
Collapse
|
21
|
A cost-effectiveness analysis of long-term intermittent catheterisation with hydrophilic and uncoated catheters. Spinal Cord 2015; 54:73-7. [PMID: 26193812 DOI: 10.1038/sc.2015.117] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/29/2015] [Accepted: 06/09/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cost-effectiveness analysisObjective:To establish a model to investigate the cost effectiveness for people with spinal cord injury (SCI), from a lifetime perspective, for the usage of two different single-use catheter designs: hydrophilic-coated (HC) and uncoated (UC). The model includes the long-term sequelae of impaired renal function and urinary tract infection (UTI). SETTING Analysis based on a UK perspective. METHODS A probabilistic Markov decision model was constructed, to compare lifetime costs and quality-adjusted life years, taking renal and UTI health states into consideration, as well as other catheter-related events. UTI event rates for the primary data set were based on data from hospital settings to ensure controlled and accurate reporting. A sensitivity analysis was applied to evaluate best- and worst-case scenarios. RESULTS The model predicts that a 36-year-old SCI patient with chronic urinary retention will live an additional 1.4 years if using HC catheters compared with UC catheters, at an incremental cost of £2100. Moreover, the lifetime number of UTI events will be reduced by 16%. All best- and worst-case estimates were within the UK threshold of being cost effective. CONCLUSION The use of HC catheters for intermittent catheterisation in SCI patients is highly cost effective. The outcome is consistent irrespective of whether UTI data are collected in hospital or community settings.
Collapse
|