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Schnipper J, Azawi N, Størling Z, Simonsen KS, Andersen K. Switching from intermittent catheterization with single-use catheter to a reusable catheter has a negative impact on quality of life. Neurourol Urodyn 2024. [PMID: 39032094 DOI: 10.1002/nau.25556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/06/2024] [Indexed: 07/22/2024]
Abstract
PURPOSE It has been proposed that reusable catheters are more cost effective and environmentally sustainable than single-use catheters intended for intermittent catheterization (IC). However, the aspect of individuals' well-being and preference for catheter type is not considered. In this study, we investigated the impact on individuals' health-related quality of life (HR-QoL) when testing a reusable catheter. MATERIALS AND METHODS The study was an open-labeled, single-arm, multicenter investigation with a treatment period of 28 days. Forty subjects using single-use hydrophilic catheters were accustomed to a reusable catheter for managing IC. HR-QoL was evaluated by the Intermittent-Self Catheterization Questionnaire (ISC-Q). Additionally, satisfaction was evaluated by the Intermittent Catheterization Satisfaction Questionnaire (InCaSa-Q). The difference in total score was analyzed using a mixed linear model. Furthermore, preference for IC (single-use vs. reusable) was assessed and microbial evaluation of the catheters was performed. RESULTS The total ISC-Q score measuring HR-QoL decreased significantly by 28% (p < 0.001). Two of the four subdomains (ease-of-use and discreetness) also decreased significantly (p < 0.001). The total InCaSa-score and all four subdomains evaluating satisfaction decreased significantly (p < 0.005). The primary study results were supported by the fact that 90.9% of subjects preferred to use a single-use catheter for IC. Furthermore, 50% of reusable catheters were contaminated with bacteria. CONCLUSION Switching from single-use to reusable IC resulted in a significant decrease in HR-QoL and satisfaction. Moreover, the vast majority preferred the single-use catheter due to handling and convenience. The users' rights to their preferred bladder management method should be acknowledged.
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Affiliation(s)
| | - Nessn Azawi
- Department of Urology, Sjællands Universitetshospital, Roskilde, Denmark
| | | | | | - Karin Andersen
- Department of Urology, Odense Universitetshospital, Odense, Denmark
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Schrøder B, Tentor F, Miclăuş T, Stærk K, Andersen TE, Spinelli M, Rendeli C, Del Popolo G, Bagi P, Nielsen LF. New micro-hole zone catheter reduces residual urine and mucosal microtrauma in a lower urinary tract model. Sci Rep 2024; 14:2268. [PMID: 38280939 PMCID: PMC10821950 DOI: 10.1038/s41598-024-52505-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/19/2024] [Indexed: 01/29/2024] Open
Abstract
Urinary tract infections (UTIs) are the main complication associated with clean intermittent catheterization (CIC) and are facilitated by post-void residual urine and trauma to the mucosa during voiding. The risk of UTI may be diminished by reducing the residual volumes and preventing microtrauma caused by mucosal suction through the eyelets of conventional eyelet catheters (CEC). A new micro-hole zone catheter (MHZC) was developed and tested in an ex vivo porcine lower urinary tract model and in vivo, in pigs, against a CEC. It was shown that, irrespective of the micro-hole diameter, the new catheter ensured increased flowrates and significantly lower residual volumes at the first flow-stop. Furthermore, with a micro-hole diameter of 0.4 mm, mucosal suction was virtually eliminated, regardless of the insertion depth or simulated intra-abdominal pressure mimicking sitting or standing humans. Pressure profile experiments and endoscopy studies indicated that the bladder gradually folds against the drainage tip of the new catheter, without blocking the flow, and, unlike with the CEC, sharp pressure variations and flow-stops did not occur during voiding. The MHZC outperformed the CEC in all tested scenarios and decreased residual volumes, thus potentially decreasing the risk of UTIs.
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Affiliation(s)
| | - Fabio Tentor
- Coloplast A/S, Holtedam 1, 3050, Humlebaek, Denmark
| | | | - Kristian Stærk
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | - Thomas Emil Andersen
- Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark
- Research Unit of Clinical Microbiology, University of Southern Denmark, Odense, Denmark
| | | | - Claudia Rendeli
- Department of Pediatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giulio Del Popolo
- Neuro-Urology Department, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Per Bagi
- Department of Urology, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Fernandez-Lasquetty Blanc B, Hernández Martínez A, Lorenzo García C, Baixauli Puig M, Estudillo González F, Martin Bermejo MV, Ortega Checa MA, Alcaraz Zomeño E, Torres Bacete A, Ferrández Franco G, Benito Santos B, Fernández Llorente G, Guerrero Andrádes MC, Rodríguez Diaz M, Louis Lauture MP, Jiménez Mayorga I, Serrano-Abiétar R, Garrido Mora MA, Barcia Barrera F, Asensio Malo G, Morcillo Marín M, Lluesma Martinez V, Valero Escribá ML, Tendero Ruiz S, Romay Cea RA, Marín Valero M, Rodríguez-Almagro J. Evolution of Quality of Life and Treatment Adherence after One Year of Intermittent Bladder Catheterisation in Functional Urology Unit Patients. J Clin Med 2023; 12:jcm12082928. [PMID: 37109264 PMCID: PMC10145256 DOI: 10.3390/jcm12082928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE To determine patient difficulties and concerns when performing IBC (Intermittent Bladder Catheterisation), as well as the evolution of adherence, quality of life, and emotional state of patients one year after starting IBC. METHOD A prospective, observational, multicentre study conducted in 20 Spanish hospitals with a one-year follow-up. Data sources were patient records and the King's Health Questionnaire on quality of life, the Mini-Mental State Examination (MMSE), and the Hospital Anxiety and Depression Scale (HADS). Perceived adherence was measured using the ICAS (Intermittent Catheterization Adherence Scale) and perceived difficulties with IBC were assessed using the ICDQ (Intermittent Catheterization Difficulty Questionnaire). For data analysis, descriptive and bivariate statistics were performed for paired data at three points in time (T1: one month, T2: three months, T3: one year). RESULTS A total of 134 subjects initially participated in the study (T0), becoming 104 subjects at T1, 91 at T2, and 88 at T3, with a mean age of 39 years (standard deviation = 22.16 years). Actual IBC adherence ranged from 84.8% at T1 to 84.1% at T3. After one year of follow-up, a statistically significant improvement in quality of life (p ≤ 0.05) was observed in all dimensions with the exception of personal relationships. However, there were no changes in the levels of anxiety (p = 0.190) or depression (p = 0.682) at T3 compared to T0. CONCLUSIONS Patients requiring IBC exhibit good treatment adherence, with a significant proportion of them performing self-catheterisation. After one year of IBC, a significant improvement in quality of life was noted, albeit with a significant impact on their daily lives and their personal and social relationships. Patient support programmes could be implemented to improve their ability to cope with difficulties and thus enhance both their quality of life and the maintenance of their adherence.
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Affiliation(s)
| | - Antonio Hernández Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
| | - Carlos Lorenzo García
- Department of Nursing, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | | | | | | | | | - Elena Alcaraz Zomeño
- Department of Nursing, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | | | | | | | | | | | - Monica Rodríguez Diaz
- Department of Nursing, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | | | | | - Rosario Serrano-Abiétar
- Department of Nursing, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain
| | | | | | - Gemma Asensio Malo
- Department of Nursing, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
| | | | | | | | - Silvia Tendero Ruiz
- Department of Nursing, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | | | - Julián Rodríguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
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A Multicenter, Open-Label, Observational Study Evaluating the Quality of Life After Using a Hydrophilic-Coated Catheter (SpeediCath) With Self-Intermittent Catheterization. Int Neurourol J 2022; 26:308-316. [PMID: 36599339 PMCID: PMC9816440 DOI: 10.5213/inj.2244146.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/30/2022] [Indexed: 12/31/2022] Open
Abstract
PURPOSE We evaluated the change in patient quality of life after the use of a hydrophilic-coated catheter (SpeediCath) in adults requiring intermittent catheterization (IC). METHODS This was a multicenter, open-label, observational study using the Patient Perception of Intermittent Catheterization (PPIC) questionnaire and the Intermittent Self-Catheterization questionnaire (ISC-Q) and safety at 12 and 24 weeks in adult patients who had already used other type of catheters prior to switching to SpeediCath or in patients undergoing self-IC for the first time for any reason. RESULTS Among a total of 360 subjects, 215 (59.7%) were women, and the mean age was 62.0±13.2 years. At 24 weeks, the satisfaction rate after using SpeediCath was 84.1%, and 80% of patients responded that they could easily perform IC. In total, 81.6% of patients were willing to continue using SpeediCath. The mean ISC-Q score was 54.90±18.65 at 24 weeks. Men found less interference in their daily life by performing IC than women and found it easier to handle the catheter before it was inserted into the urethra. At week 12, the mean change in ISC-Q was significantly greater in patients <65 years (20.24±23.55) than in those ≥65 years (7.57±27.70, P=0.049), but there was no difference at 24 weeks. The most common adverse events were urinary tract infection in 9.72%, gross hematuria in 2.78%, and urethral pain in 1.39%. CONCLUSION The use of a SpeediCath provided good quality of life for patients who needed self-IC regardless of age or sex.
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Chen SF, Lee YK, Kuo HC. Satisfaction with Urinary Incontinence Treatments in Patients with Chronic Spinal Cord Injury. J Clin Med 2022; 11:jcm11195864. [PMID: 36233731 PMCID: PMC9571409 DOI: 10.3390/jcm11195864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/12/2022] [Accepted: 09/30/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose: To investigate the long-term satisfaction and complications in chronic spinal cord injury (SCI) patients after various bladder management strategies and surgical procedures for the treatment of urinary incontinence. Methods: Patients at a single institution with chronic SCI who received bladder management treatment or surgical procedure to improve urinary continence were retrospectively assessed. Thorough urological examinations and videourodynamic studies were performed. Patients were treated either through conservative approaches including medical treatment, clean intermittent catheterization (CIC), cystostomy, and indwelling urethral catheter, or through surgical procedures including detrusor botulinum toxin (Botox) injections, augmentation, ileal conduit, Kock pouch diversion, continent cystostomy, suburethral sling, and artificial urethral sphincter (AUS) implantation. The patients’ satisfaction with urinary continence improvement, causes of dissatisfaction, long-term complications, and overall satisfaction with bladder and voiding condition were assessed. Results: A total of 700 consecutive patients were enrolled in this study. High satisfaction rates were noted after detrusor Botox injection (81.1%), augmentation enterocystoplasty (91.4%), autoaugmentation (80%), Kock pouch diversion, and continent cystostomy (all 100%). Fair satisfaction rates were noted after ileal conduit diversion (66.7%), suburethral sling (64.3%), and AUS implantation (66.7%). Patients who received conservative treatment with medicines, CIC, cystostomy, or an indwelling urethral catheter all had less-satisfactory outcomes (all < 40%). Conclusion: Overall satisfaction with surgical procedures aimed to improve urinary continence in chronic SCI patients was higher than with conservative bladder management (35.4%). Appropriate surgical procedures for chronic SCI patients with neurogenic lower urinary tract dysfunction (NLUTD) and urological complications yielded satisfaction with both urinary continence improvement and with overall bladder and voiding condition.
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Affiliation(s)
| | | | - Hann-Chorng Kuo
- Correspondence: ; Tel.: +886-3-8561825 (ext. 2117); Fax: +886-3-8560794
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Dodd W, Motwani K, Small C, Pierre K, Patel D, Malnik S, Lucke-Wold B, Porche K. Spinal cord injury and neurogenic lower urinary tract dysfunction: what do we know and where are we going? JOURNAL OF MEN'S HEALTH 2022; 18:24. [PMID: 35106100 PMCID: PMC8803268 DOI: 10.31083/j.jomh1801024] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
One of the well reported but difficult to manage symptoms of spinal cord injury (SCI) is neurogenic lower urinary tract dysfunction (NLUTD). The type of NLUTD is variable based on location and extent of injury. SCI affects more males and NLUTD is especially debilitating for men with incomplete injury. This review summarizes the anatomical basis of NLUTD in SCI and discusses current diagnostic and management strategies that are being utilized clinically. The last two sections address new innovations and emerging discoveries with the goal of increasing scientific interest in improving treatment options for people with SCI. Areas warranting further investigation are pinpointed to address current gaps in knowledge and/or appropriate technology.
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Affiliation(s)
- William Dodd
- Department of Neurosurgery, University of Florida,
Gainesville, FL 32601, USA
| | - Kartik Motwani
- Department of Neurosurgery, University of Florida,
Gainesville, FL 32601, USA
| | - Coulter Small
- Department of Neurosurgery, University of Florida,
Gainesville, FL 32601, USA
| | - Kevin Pierre
- Department of Neurosurgery, University of Florida,
Gainesville, FL 32601, USA
| | - Devan Patel
- Department of Neurosurgery, University of Florida,
Gainesville, FL 32601, USA
| | - Samuel Malnik
- Department of Neurosurgery, University of Florida,
Gainesville, FL 32601, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida,
Gainesville, FL 32601, USA
| | - Ken Porche
- Department of Neurosurgery, University of Florida,
Gainesville, FL 32601, USA
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Wong BTH, Kan SCF, Lo AHK, Ho LY, Kan RWM, Lai C. Asian guidelines for UTIs & STIs UTI section: Complicated UTIs with neurogenic bladder. J Infect Chemother 2021; 28:6-9. [PMID: 34702637 DOI: 10.1016/j.jiac.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 09/24/2021] [Accepted: 10/13/2021] [Indexed: 10/28/2022]
Abstract
EPIDEMIOLOGY AND PATHOGENESIS Urinary tract infection (UTI) in patients with neurogenic bladder causes significant morbidity and mortality. DIAGNOSIS UTI in neurogenic bladder causes atypical symptomatology. Urine tests are pivotal in confirming or excluding UTI, and in guiding appropriate antibiotic treatment. TREATMENT 1. Symptomatic UTI warrants appropriate antibiotic treatment with reference to culture results and local antibiotic resistance patterns. Asymptomatic bacteriuria should not be treated, and antibiotic prophylaxis is generally not recommended.2. Adequate bladder drainage is essential in reducing the occurrence of urinary tract infections.3. Recurrent UTI in neurogenic bladder may necessitate the treatment of neurogenic detrusor overactivity and the restoration of low bladder pressure during bladder storage and voiding by drugs or surgery.
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Affiliation(s)
| | - Stanley Chi Fai Kan
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | | | - Lap Yin Ho
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | - Raymond Wai Man Kan
- Division of Urology, Department of Surgery, Queen Elizabeth Hospital, Kowloon, Hong Kong.
| | - Christopher Lai
- Department of Microbiology, Chinese University of Hong Kong, Hong Kong
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Blanc BFL, Rodríguez-Almagro J, Lorenzo-García C, Alcaraz-Zomeño E, Fernandez-Llorente G, Baixauli-Puig M, Martín-Bermejo MV, Estudillo-González F, Ortega-Checa MA, Lluesma-Martinez V, Ferrández-Franco G, Benito-Santos B, Rodríguez-Díaz M, Torres-Bacete A, Guerrero-Andrades MC, Louis-Lauture MP, Jiménez-Mayorga I, Serrano-Abielar R, Garrido-Mora MA, Barcia-Barrera F, Asensio-Malo G, Morcillo-Marín M, Tendero-Ruiz S, Hernández-Martínez A. Quality of Life and Autonomy in Patients with Intermittent Bladder Catheterization Trained by Specialized Nurses. J Clin Med 2021; 10:3909. [PMID: 34501357 PMCID: PMC8432259 DOI: 10.3390/jcm10173909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022] Open
Abstract
Intermittent bladder catheterization (IBC) involves regular urine draining using a catheter, which is removed immediately after urinary elimination. It allows for the patient's urological health to be managed and their renal function to be preserved, and it promotes autonomy. Compliance with the prescribed number of daily catheterizations, which must be conducted by the patient, and infection prevention measures are crucial. To identify the patients requiring IBC, and to determine their adherence (whether they followed the prescribed guidelines and their difficulty in carrying out the procedure, as well as to assess how the IBC influences their quality of life and state of mind after receiving self-care training from a specialized nurse), we carried out a prospective, multicenter observational study in 24 Spanish hospitals with one month of monitoring and a sample of 99 patients. The sources of information were the patients' clinical records, the King's Health Questionnaire, the Mini-Mental State Examination (MMSE), and the hospital anxiety and depression scale (HADS). Descriptive and bivariate statistics were used to analyses the paired data. After recruitment (n = 99), 79 patients completed the questionnaire at a mean age of 35.2 years (SD = 20.5 years). In total, 53.5% (53) of the sample consisted of men and 32.3% (32) had neurological damage as the reason for prescription; 67% (67.7) performed self-catheterization and 86.7% adhered to the IBC. After one month of monitoring, a statistically significant improvement in quality of life was observed in all criteria, with the exception of personal relationships (p < 0.005), as well as an improvement in anxiety and depression levels (p < 0.001). Patients who require IBC show good adherence to the IBC with a significant percentage of self-catheterization. After one month of IBC, a significant improvement in the patients' quality of life and mood was observed. These results could be attributed to adequate patient training and adequate personalization of the IBC materials by the specialized nurses.
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Affiliation(s)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Carlos Lorenzo-García
- Department of Nursing, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain;
| | - Elena Alcaraz-Zomeño
- Department of Nursing, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | | | | | | | | | | | - Vicenta Lluesma-Martinez
- Department of Nursing, Hospital Universitari I Politecnic La Fe, 46026 Valencia, Spain; (M.A.O.-C.); (V.L.-M.)
| | | | - Begoña Benito-Santos
- Department of Nursing, Hospital General Universitario de Alicante, 03010 Alicante, Spain; (G.F.-F.); (B.B.-S.)
| | - Mónica Rodríguez-Díaz
- Department of Nursing, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
| | | | | | | | | | - Rosario Serrano-Abielar
- Department of Nursing, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain;
| | | | | | - Gemma Asensio-Malo
- Department of Nursing, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain;
| | | | - Silvia Tendero-Ruiz
- Department of Nursing, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain;
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
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Campeau L, Shamout S, Baverstock RJ, Carlson KV, Elterman DS, Hickling DR, Steele SS, Welk B. Canadian Urological Association Best Practice Report: Catheter use. Can Urol Assoc J 2020; 14:E281-E289. [PMID: 32432528 DOI: 10.5489/cuaj.6697] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Lysanne Campeau
- Division of Urology, Department of Surgery, Montreal Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Samer Shamout
- Division of Urology, Department of Surgery, Montreal Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Richard J Baverstock
- vesia [Alberta Bladder Centre] and Division of Urology, Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Kevin V Carlson
- vesia [Alberta Bladder Centre] and Division of Urology, Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Dean S Elterman
- Division of Urology, University Health Network, Toronto, ON, Canada
| | - Duane R Hickling
- Division of Urology, Department of Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | | | - Blayne Welk
- Division of Urology, Department of Surgery, University of Western Ontario, London, ON, Canada
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10
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Rühs PA, Malollari KG, Binelli MR, Crockett R, Balkenende DWR, Studart AR, Messersmith PB. Conformal Bacterial Cellulose Coatings as Lubricious Surfaces. ACS NANO 2020; 14:3885-3895. [PMID: 32150387 DOI: 10.1021/acsnano.9b09956] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We report a versatile method to form bacterial cellulose coatings through simple dip-coating of 3D objects in suspensions of cellulose-producing bacteria. The adhesion of cellulose-secreting bacteria on objects was promoted through surface roughness and chemistry. Immobilized bacteria secreted highly porous hydrogels with high water content directly from the surface of a variety of materials. The out-of-plane orientation of cellulose fibers present in this coating leads to high mechanical stability and energy dissipation with minimal cellulose concentration. The conformal, biocompatible, and lubricious nature of the in situ grown cellulose surfaces makes the coated 3D objects attractive for biomedical applications.
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Affiliation(s)
- Patrick A Rühs
- Complex Materials, Department of Materials, ETH-Zurich/Swiss Federal Institute of Technology, 8093 Zurich, Switzerland
- Department of Bioengineering, University of California, Berkeley, Berkeley, California 94720-1760, United States
| | - Katerina G Malollari
- Department of Mechanical Engineering, University of California, Berkeley, Berkeley, California 94720-1760, United States
| | - Marco R Binelli
- Complex Materials, Department of Materials, ETH-Zurich/Swiss Federal Institute of Technology, 8093 Zurich, Switzerland
| | - Rowena Crockett
- Nanoscale Materials Science, Swiss Federal Laboratories for Materials Science and Technology, Zurich 8600, Switzerland
| | - Diederik W R Balkenende
- Department of Bioengineering, University of California, Berkeley, Berkeley, California 94720-1760, United States
| | - André R Studart
- Complex Materials, Department of Materials, ETH-Zurich/Swiss Federal Institute of Technology, 8093 Zurich, Switzerland
| | - Phillip B Messersmith
- Department of Bioengineering, University of California, Berkeley, Berkeley, California 94720-1760, United States
- Department of Materials Science and Engineering, University of California, Berkeley, Berkeley, California 94720-1760, United States
- Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720-1760, United States
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11
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Duta OC, Ţîţu AM, Marin A, Ficai A, Ficai D, Andronescu E. Surface Modification of Poly(Vinylchloride) for Manufacturing Advanced Catheters. Curr Med Chem 2020; 27:1616-1633. [DOI: 10.2174/0929867327666200227152150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 06/11/2018] [Accepted: 10/08/2018] [Indexed: 11/22/2022]
Abstract
Polymeric materials, due to their excellent physicochemical properties and versatility found
applicability in multiples areas, including biomaterials used in tissue regeneration, prosthetics (hip,
artificial valves), medical devices, controlled drug delivery systems, etc. Medical devices and their
applications are very important in modern medicine and the need to develop new materials with improved
properties or to improve the existent materials is increasing every day. Numerous reasearches
are activated in this domain in order to obtain materials/surfaces that does not have drawbacks such as
structural failure, calcifications, infections or thrombosis. One of the most used material is
poly(vinylchloride) (PVC) due to its unique properties, availability and low cost. The most common
method used for obtaining tubular devices that meet the requirements of medical use is the surface
modification of polymers without changing their physical and mechanical properties, in bulk. PVC is a
hydrophobic polymer and therefore many research studies were conducted in order to increase the hydrophilicity
of the surface by chemical modification in order to improve biocompatibility, to enhance
wettability, reduce friction or to make lubricious or antimicrobial coatings. Surface modification of
PVC can be achieved by several strategies, in only one step or, in some cases, in two or more steps by
applying several techniques consecutively to obtain the desired modification / performances. The most
common processes used for modifying the surface of PVC devices are: plasma treatment, corona discharge,
chemical grafting, electric discharge, vapour deposition of metals, flame treatment, direct
chemical modification (oxidation, hydrolysis, etc.) or even some physical modification of the roughness
of the surface.
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Affiliation(s)
- Oana Cristina Duta
- University POLITEHNICA of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Aurel Mihail Ţîţu
- “Lucian Blaga” University of Sibiu, Faculty of Engineering, Industrial Engineering and Management Departament, 4 Emil Cioran Street, Sibiu, Romania
| | - Alexandru Marin
- University POLITEHNICA of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Anton Ficai
- University POLITEHNICA of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Denisa Ficai
- University POLITEHNICA of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Ecaterina Andronescu
- University POLITEHNICA of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
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12
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Craven BC, Alavinia SM, Gajewski JB, Parmar R, Disher S, Ethans K, Shepherd J, Omidvar M, Farahani F, Hassouna M, Welk B. Conception and development of Urinary Tract Infection indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. J Spinal Cord Med 2019; 42:205-214. [PMID: 31573440 PMCID: PMC6781249 DOI: 10.1080/10790268.2019.1647928] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Context: Urinary tract infections (UTI) are the most frequent secondary health condition following spinal cord injury or disease (SCI/D) that adversely impact overall health and quality of life, and often result in rehabilitation service interruptions, emergency department visits, and urinary sepsis. Methods: Experts in Urohealth and/or UTI recognition and management and the SCI-High Project Team used a combination of evidence synthesis and consensus methods for developing the UTI indicators. A systematic search and a Driver diagram analysis were applied to identify key factors influencing UTI. This Driver diagram guided the UTI Working Group when defining the construct, specifying the aim for the UTI SCI/D quality indicators, and developing the UTI diagnostic checklist and fever definition. Results: The structure indicator was the proportion of patients with a health care professional (i.e. family physician or urologist) able to follow-up with the patient regarding urine culture and sensitivity results within 48-72 h of collection. The Working Group knowingly adopted a single checklist for UTI diagnosis, recognizing the stark contrast in the complexity of diagnosis in acute versus community settings. The process indicator is the proportion of SCI/D rehabilitation inpatients with UTI as defined by the UTI diagnostic checklist. The outcome indicator is the proportion of SCI/D rehabilitation inpatients with inappropriate antibiotic prescription. Conclusion: UTI can be diagnosed using the developed symptoms and signs checklist. These structure, process, and outcome quality indicators will ultimately reduce inappropriate antibiotic therapy for UTI and the rising incidence of antibiotic resistance among community-dwelling individuals with chronic SCI/D.
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Affiliation(s)
- B. Catharine Craven
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada,Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Correspondence to: B. Catharine Craven, KITE – Toronto Rehab – University Health Network, 206-H 520 Sutherland Drive, Toronto, Ontario M4G3V9, Canada; Ph: 416-597-3422 x6122.
| | - S. Mohammad Alavinia
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Raj Parmar
- Spinal Cord Injury Rehabilitation Clinic, Foothills Medical Centre, Calgary, Canada
| | - Sandi Disher
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Karen Ethans
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Manitoba, Winnipeg, Canada
| | - John Shepherd
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada,Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Maryam Omidvar
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada
| | - Farnoosh Farahani
- KITE, Toronto Rehab – University Health Network, Toronto, Ontario, Canada
| | - Magdy Hassouna
- Department of Surgery, Division of Urology, University of Toronto, Toronto, Ontario, Canada,Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Blayne Welk
- Department of Surgery (Urology), Schulich School of Medicine & Dentistry, Western University, London, Canada
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13
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Kennelly M, Thiruchelvam N, Averbeck MA, Konstatinidis C, Chartier-Kastler E, Trøjgaard P, Vaabengaard R, Krassioukov A, Jakobsen BP. Adult Neurogenic Lower Urinary Tract Dysfunction and Intermittent Catheterisation in a Community Setting: Risk Factors Model for Urinary Tract Infections. Adv Urol 2019; 2019:2757862. [PMID: 31065264 PMCID: PMC6466920 DOI: 10.1155/2019/2757862] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/05/2019] [Indexed: 01/11/2023] Open
Abstract
A risk factor model for urinary tract infections in patients with adult neurogenic lower urinary tract dysfunction performing clean intermittent catheterisation was developed; it consists of four domains, namely, (1) general (systemic) conditions in the patient, (2) individual urinary tract conditions in the patient, (3) routine aspects related to the patient, and (4) factors related to intermittent catheters per se. The conceptual model primarily concerns patients with spinal cord injury, spina bifida, multiple sclerosis, or cauda equina where intermittent catheterisation is a normal part of the bladder management. On basis of several literature searches and author consensus in case of lacking evidence, the model intends to provide an overview of the risk factors involved in urinary tract infections, with specific emphasis to describe those that in daily practice can be handled and modified by the clinician and so come to the benefit of the individual catheter user in terms of fewer urinary tract infections.
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Affiliation(s)
- Michael Kennelly
- Department of Urology, Carolinas Medical Center, Charlotte, NC, USA
| | | | | | | | | | | | | | - Andrei Krassioukov
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
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14
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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.
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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
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15
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Romo PGB, Smith CP, Cox A, Averbeck MA, Dowling C, Beckford C, Manohar P, Duran S, Cameron AP. Non-surgical urologic management of neurogenic bladder after spinal cord injury. World J Urol 2018; 36:1555-1568. [PMID: 30051263 DOI: 10.1007/s00345-018-2419-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 07/19/2018] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To review the available data on non-surgical management for neurogenic bladder in patients with spinal cord injury (SCI). Before the introduction of urinary catheters and antibiotics, neurogenic bladder was one of the main culprits for death in those patients with SCI. Currently, the management of neurogenic bladder is focused in improving quality of life and preserving renal function. METHODS A literature review was performed and therapeutic management for neurogenic bladder was divided in six sections: (1) intermittent bladder catheterization; (2) indwelling catheters; (3) condom catheter drainage; (4) reflex voiding and bladder expression with Valsalva or Credé; (5) oral drug therapy of the spinal cord injured bladder; and (6) botulinum neurotoxin (BoNT). RESULTS Intermittent catheterization is recommended as the preferable method for management of neurogenic bladder in patients with SCI based on limited high-quality data. However, this may not be feasible or available to all and other alternative options include condom catheter drainage or indwelling catheters such as urethral catheters or suprapubic tube, reflex voiding, and bladder expression with Valsalva or Credé. Non-invasive medical therapies are the key to improve incontinence, urodynamic parameters, and quality of life in this population. Botulinum neurotoxin has revolutionized the management of neurogenic bladder in the last two decades decreasing the need for reconstruction or diversion. CONCLUSION The Joint SIU-ICUD (Société Internationale d'Urologie) (International Consultation on Urological Diseases) International Consultation reviewed the available presented data and provided specific conclusions and recommendations for each non-surgical urologic method to address neurogenic bladder after SCI.
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Affiliation(s)
| | | | - Ashley Cox
- Dalhousie University, Halifax, NS, Canada
| | | | | | | | | | - Sergio Duran
- National Institute of Rehabilitation, Mexico City, Mexico
| | - Anne P Cameron
- University of Michigan, Ann Arbor, MI, USA. .,Division of Neurourology and Pelvic Reconstructive Surgery, Department of Urology, The University of Michigan Medical Center, 1500 East Medical Center Drive, Taubman Center 3875, Ann Arbor, MI, 48109-5330, USA.
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16
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Arab Hassani F, Mogan RP, Gammad GGL, Wang H, Yen SC, Thakor NV, Lee C. Toward Self-Control Systems for Neurogenic Underactive Bladder: A Triboelectric Nanogenerator Sensor Integrated with a Bistable Micro-Actuator. ACS NANO 2018; 12:3487-3501. [PMID: 29630352 DOI: 10.1021/acsnano.8b00303] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Aging, neurologic diseases, and diabetes are a few risk factors that may lead to underactive bladder (UAB) syndrome. Despite all of the serious consequences of UAB, current solutions, the most common being ureteric catheterization, are all accompanied by serious shortcomings. The necessity of multiple catheterizations per day for a physically able patient not only reduces the quality of life with constant discomfort and pain but also can end up causing serious complications. Here, we present a bistable actuator to empty the bladder by incorporating shape memory alloy components integrated on flexible polyvinyl chloride sheets. The introduction of two compression and restoration phases for the actuator allows for repeated actuation for a more complete voiding of the bladder. The proposed actuator exhibits one of the highest reported voiding percentages of up to 78% of the bladder volume in an anesthetized rat after only 20 s of actuation. This amount of voiding is comparable to the common catheterization method, and its one time implantation onto the bladder rectifies the drawbacks of multiple catheterizations per day. Furthermore, the scaling of the device for animal models larger than rats can be easily achieved by adjusting the number of nitinol springs. For neurogenic UAB patients with degraded nerve function as well as degenerated detrusor muscle, we integrate a flexible triboelectric nanogenerator sensor with the actuator to detect the fullness of the bladder. The sensitivity of this sensor to the filling status of the bladder shows its capability for defining a self-control system in the future that would allow autonomous micturition.
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Affiliation(s)
- Faezeh Arab Hassani
- Department of Electrical and Computer Engineering, Faculty of Engineering , National University of Singapore , 4 Engineering Drive 3 , #05-45, Singapore 117583 , Singapore
- Singapore Institute for Neurotechnology , National University of Singapore , 28 Medical Drive , #05-COR, Singapore 117456 , Singapore
- Center for Intelligent Sensors and MEMS , National University of Singapore , 5 Engineering Drive 1 , E6 #05-11F, Singapore 117608 , Singapore
| | - Roshini P Mogan
- Singapore Institute for Neurotechnology , National University of Singapore , 28 Medical Drive , #05-COR, Singapore 117456 , Singapore
| | - Gil G L Gammad
- Singapore Institute for Neurotechnology , National University of Singapore , 28 Medical Drive , #05-COR, Singapore 117456 , Singapore
| | - Hao Wang
- Department of Electrical and Computer Engineering, Faculty of Engineering , National University of Singapore , 4 Engineering Drive 3 , #05-45, Singapore 117583 , Singapore
- Singapore Institute for Neurotechnology , National University of Singapore , 28 Medical Drive , #05-COR, Singapore 117456 , Singapore
- Center for Intelligent Sensors and MEMS , National University of Singapore , 5 Engineering Drive 1 , E6 #05-11F, Singapore 117608 , Singapore
- Hybrid-Integrated Flexible Electronic Systems (HIFES) Program , National University of Singapore , 5 Engineering Drive 1 , E6 #05-4, Singapore 117608 , Singapore
| | - Shih-Cheng Yen
- Department of Electrical and Computer Engineering, Faculty of Engineering , National University of Singapore , 4 Engineering Drive 3 , #05-45, Singapore 117583 , Singapore
- Singapore Institute for Neurotechnology , National University of Singapore , 28 Medical Drive , #05-COR, Singapore 117456 , Singapore
| | - Nitish V Thakor
- Department of Electrical and Computer Engineering, Faculty of Engineering , National University of Singapore , 4 Engineering Drive 3 , #05-45, Singapore 117583 , Singapore
- Singapore Institute for Neurotechnology , National University of Singapore , 28 Medical Drive , #05-COR, Singapore 117456 , Singapore
| | - Chengkuo Lee
- Department of Electrical and Computer Engineering, Faculty of Engineering , National University of Singapore , 4 Engineering Drive 3 , #05-45, Singapore 117583 , Singapore
- Singapore Institute for Neurotechnology , National University of Singapore , 28 Medical Drive , #05-COR, Singapore 117456 , Singapore
- Center for Intelligent Sensors and MEMS , National University of Singapore , 5 Engineering Drive 1 , E6 #05-11F, Singapore 117608 , Singapore
- Hybrid-Integrated Flexible Electronic Systems (HIFES) Program , National University of Singapore , 5 Engineering Drive 1 , E6 #05-4, Singapore 117608 , Singapore
- NUS Graduate School for Integrative Science and Engineering , National University of Singapore , Singapore 117456 , Singapore
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17
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Current and future international patterns of care of neurogenic bladder after spinal cord injury. World J Urol 2018; 36:1613-1619. [PMID: 29605828 DOI: 10.1007/s00345-018-2277-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 03/24/2018] [Indexed: 10/17/2022] Open
Abstract
PURPOSE We aim to summarize the literature on international patterns of care for patients with neurogenic bladder (NGB) from spinal cord injury (SCI). METHODS We performed a PubMed database search, hand review of references, communication with professional societies, and registry evaluations for pertinent data. RESULTS Established patterns of care, including SCI registries and specialty centers, are available in high-resource countries such as the US and UK. As such, mortality rates from complications of NGB/SCI are lower. Access to intermittent catheterization supplies, among other resources, may be inadequate in many low-income regions. Cultural and religious beliefs may also hinder integration of proper bladder management in SCI patients. While guidelines exist in many parts of the world, it is unclear how rigorously they are disseminated or followed. CONCLUSIONS While there is a paucity of high-level evidence, the differences in patterns of care are closely related to socioeconomic status and resources of the geographic area. Future research efforts should focus on improving access to diagnostic modalities, supplies, and specialists in these areas.
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18
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Previnaire JG, Le Berre M, Hode E, Dacquet V, Bordji H, Denys P, Soler JM. A 5-day antibiotic course for treatment of intermittent catheter-associated urinary tract infection in patients with spinal cord injury. Spinal Cord Ser Cases 2017; 3:17017. [PMID: 28503324 PMCID: PMC5425963 DOI: 10.1038/scsandc.2017.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 03/13/2017] [Accepted: 03/19/2017] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION This was a retrospective monocentric study conducted at Centre Calvé, France, with the objective of evaluating the effectiveness of a 5-day course of antibiotics for symptomatic (mild urinary tract infection, UTI) or asymptomatic (aBact) bacteriuria in patients with spinal cord injury on intermittent catheterization. CASE PRESENTATION This study was conducted from May 2013 to September 2016. Antibiotic selection always followed culture collection and analysis of antibiograms. Patients with febrile UTI (>38°5) or recent history of urolithiasis were excluded. DISCUSSION Fifty-seven patients underwent 111 5-day courses of antibiotics. The two main bacteria involved were Escherichia coli and Klebsiella Pneumoniae. Most commonly prescribed antibiotics were cephalosporins, cotrimoxazole, fluoroquinolones and nitrofurantoins. On day 4 of the antibiotic course, bacteria were eradicated in 99% of cases. Clinical cure occurred in all patients by day 5 (end of treatment). After treatment, recurrence of UTI occurred in 16% of patients at week 3, 38% at week 6 and 50% at week 9. This rate was not significantly different from patients initially treated for aBact (20%, 35% and 44%, respectively). The UTI-free period was significantly shorter after treatment for aBact (45.5 days) than after treatment for UTI (53.7 days). None of the following characteristics were found to be risk factors for UTI: level or severity of lesion, gender, voiding mode, use of anticholinergic drugs and time since lesion. Results of this study support the use of a short 5-day course of antibiotics to treat mild UTI in patients with spinal cord injury, and provide further evidence against treatment of aBact.
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Affiliation(s)
| | - Morgane Le Berre
- Spinal Department, Centre Calvé, Fondation Hopale, Berck-sur-Mer, France
| | - Elisabeth Hode
- Spinal Department, Centre Calvé, Fondation Hopale, Berck-sur-Mer, France
- Department of Urology, Centre Calot, Fondation Hopale, Berck-sur-Mer, France
| | - Vincent Dacquet
- Spinal Department, Centre Calvé, Fondation Hopale, Berck-sur-Mer, France
- Infectious Disease Unit, Centre Calot, Fondation Hopale, Berck-sur-Mer, France
| | - Hemanou Bordji
- Spinal Department, Centre Calvé, Fondation Hopale, Berck-sur-Mer, France
| | - Pierre Denys
- Hôpital Raymond Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
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Validity of urine dipstick test to assess eradication of urinary tract infection in persons with spinal cord injury. Prog Urol 2017; 27:424-430. [PMID: 28479108 DOI: 10.1016/j.purol.2017.03.009] [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] [Received: 12/09/2016] [Revised: 02/26/2017] [Accepted: 03/30/2017] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To prospectively study the predictive value (PV) of urine nitrite (NIT) dipstick testing against urine cultures during antibiotic treatment for urinary tract infection (UTI), and other situations, in patients with spinal cord injury (SCI). METHODS Inpatients with SCI on intermittent catheterisation (IC) or a Foley indwelling catheter (FC) were included. Urine specimens were collected in patients without symptoms (routine), with symptoms of UTI (suspicion), and on day 4 of a 5-day antibiotic treatment (ATB+3). RESULTS A total of 157 urine samples were collected in 61 patients: 34 were on IC (95 samples) and 27 on FC (62 samples). The prevalence of asymptomatic bacteriuria in the urine cultures was 89% in routine (70 samples). At ATB+3, microbiological cure was found in 27/30 specimens (IC group) and 2/6 (FC group). In the routine condition, the specificity and positive PV of the NIT tests was 1.00 and sensitivity 0.63. The negative PV was low in both groups. In suspicion of UTI, the sensitivity was between 0.69 and 0.55, the positive PV was 1.00 and the negative PV 0.00 for both groups. At ATB+3, the negative PV and sensitivity was 1.00, specificity 0.85 and positive PV 0.43 in the IC group, and in the FC group, specificity was 1.00, negative PV 0.33 and sensitivity 0.00. CONCLUSION In the SCI population on intermittent or indwelling catheters with high prevalence of bacteriuria, dipstick testing helped assess the eradication of germs during antibiotic treatment, but showed no value in the decision making process for UTI. LEVEL OF EVIDENCE 3.
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20
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Svihra J, Krhut J, Zachoval R, Svihrova V, Luptak J. Impact of clean intermittent catheterization on quality adjusted life years (QALYs) in spinal cord injury patients with neurogenic urinary incontinence. Neurourol Urodyn 2017; 37:250-256. [PMID: 28407301 DOI: 10.1002/nau.23283] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/19/2017] [Indexed: 11/11/2022]
Abstract
AIMS The impact of clean intermittent catheterization (CIC) on quality adjusted life years (QALYs) gained in adults' spinal cord injury population with neurogenic urinary incontinence (UI). METHODS Patients were recruited from the national registry January-June 2014. The inclusion criteria were adults, neurogenic UI due to spinal cord injury (SCI), use of collection devices and CIC for more than 6 months. The exclusion criteria were inability to perform CIC, cancer of the lower urinary tract and fistulas formation. Measurement tools were the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and an estimation of life expectancy by the national registry. The calculation of the weighting factor (WF) was obtained by linear transformation of the ICIQ-UI SF total score. A score was transformed to the range from 0 (worst impact) to 1 (no impact). The QALYs was calculated as the weighting factor × life expectancy in years. RESULTS A total of 229/365 patients were involved in this study (63%). Patients before CIC reached an ICIQ mean score of 14.83, WF of 0.29, and QALYs of 9.02 during life expectancy. After 6 months of follow-up using CIC, ICIQ reached 9.12, WF 0.57 and QALYs 17.45. The number of QALYs increased by 93.5% and UI evaluated with the ICIQ-UI SF decreased by 38.5% (P < 0.01). CONCLUSIONS The CIC of the urinary bladder statistically significantly increased the number of QALYs and reduced the degree of UI in SCI patients.
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Affiliation(s)
- Jan Svihra
- Department of Urology, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic
| | - Jan Krhut
- Department of Urology, University Hospital, Ostrava, Czech Republic
| | - Roman Zachoval
- Department of Urology, Thomayer Hospital and Department of Urology, 1st and 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Viera Svihrova
- Department of Public Health, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic
| | - Jan Luptak
- Department of Urology, Jessenius Faculty of Medicine, Comenius University Bratislava, Martin, Slovak Republic
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Guinet-Lacoste A, Kerdraon J, Rousseau A, Gallien P, Previnaire JG, Perrouin-Verbe B, Amarenco G. Intermittent catheterization acceptance test (I-CAT): A tool to evaluate the global acceptance to practice clean intermittent self-catheterization. Neurourol Urodyn 2017; 36:1846-1854. [DOI: 10.1002/nau.23195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 11/25/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Amandine Guinet-Lacoste
- Sorbonne Universités; UPMC Univ Paris 06, GRC 01, GREEN; Group of Clinical Research in Neuro-Urology; Paris France
- AP-HP, Hôpital Tenon; Neuro-urologie et Explorations Périnéales; Paris France
| | | | - Alexandra Rousseau
- Department of Clinical Pharmacology and Unité de Recherche Clinique (URCEST); AP-HP, Hôpital Saint Antoine; Paris France
| | | | | | | | - Gérard Amarenco
- Sorbonne Universités; UPMC Univ Paris 06, GRC 01, GREEN; Group of Clinical Research in Neuro-Urology; Paris France
- AP-HP, Hôpital Tenon; Neuro-urologie et Explorations Périnéales; Paris France
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22
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Wyndaele JJ. The management of neurogenic lower urinary tract dysfunction after spinal cord injury. Nat Rev Urol 2016; 13:705-714. [PMID: 27779229 DOI: 10.1038/nrurol.2016.206] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The management of patients with neurogenic bladder has changed substantially over the past decades. Obtaining balanced lower urinary tract function has become possible in most patients, although, urological complications remain among the most serious complications these patients are likely to have and, even today, these can have a negative effect on quality of life. To this extent, patients with spinal cord injury (SCI) are likely to develop neurogenic bladder, and data are available on most aspects of neurogenic bladder in these patients. Data on physiology and pathophysiology form the basis of our understanding of patients' symptoms, and also provide a basis for the management of these patients. The use of conservative, and/or more invasive treatment measures, their complications and measures to prevent these complications, are all important clinical aspects that merit discussion. Considerable progress has been made in the urological management of patients with SCI over the past decades, but opportunities remain to make diagnosis more accurate and therapy more successful.
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Affiliation(s)
- Jean-Jacques Wyndaele
- University of Antwerp, Antwerp, SIRATE32 GCV, Bredabaan 32, 2930 Brasschaat, Belgium
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23
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Duncan D. Intermittent self-catheterisation for urolgical problems caused by FGM. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2016; 25:S26-S31. [PMID: 27734726 DOI: 10.12968/bjon.2016.25.18.s26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This is the fourth and final article in a series on female genital mutilation (FGM). It describes the complications of FGM, with a focus on the urinary ones. FGM refers to all procedures that involve partial or total removal of the external female genitalia and/or damage to other female genital organs for non-medical reasons. The World Health Organization (WHO) has classified FGM into four types (1-4). Women who have type 3 commonly experience long-term complications of their urological tract. The first-line treatment for type 3 FGM involves surgical defibulation, but this is not always successful and women can be left with neurogenic bladder dysfunction and urethral stricture disease. Intermittent self-catheterisation (ISC) enables these women to have control of their bladder function.
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Affiliation(s)
- Debbie Duncan
- Senior Nurse Lecturer, Buckinghamshire New University
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24
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Peršolja M. Varna tehnika dolgotrajne intermitentne samokatetrizacije. OBZORNIK ZDRAVSTVENE NEGE 2016. [DOI: 10.14528/snr.2016.50.2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: Intermitentna samokatetrizacija je prednostna metoda praznjenja sečnega mehurja pri pacientih z zastojem urina. Medicinska sestra običajno pacienta nauči čiste ali aseptične tehnike samokatetrizacije. Namen prispevka je s pregledom literature ugotoviti, ali obstaja optimalna tehnika intermitentne samokatetrizacije, ki bi jo medicinske sestre priporočale pacientom.
Metode: Uporabljen je bil sistematični pregled literature v bazah podatkov: CINAHL, Medline, ProQuest, COBIB.SI in Cochrane Library. Vključena je bila literatura od prve omembe samokatetrizacije leta 1972 do leta 2016. S selekcijo prvotnih 350 virov smo glede na njihovo skladnost z namenom raziskave izbrali 67 enot literature.
Rezultati: Osemnajst referenc, izbranih z orodjem CASP, je bilo objavljenih med letoma 1992 in 2015: šest randomiziranih kliničnih in pet kohortnih raziskav ter šest sistematičnih pregledov literature in ena kritika. Ključne spremenljivke analize zbranih podatkov so bile sterilnost katetra, vrsta vlažilnega gela in higiena periuretralnega področja.
Diskusija in zaključek: Nobena tehnika intermitentne samokatetrizacije se ne izkaže kot optimalna. Ob upoštevanju značilnosti in sposobnosti pacienta je za slovenske razmere najboljša uporaba sterilnega materiala za enkratno uporabo (katetra in vlažilnega gela), higiena periuretralnega področja s sterilno solucijo in tamponi ter tehnika nedotikanja.
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Bardsley A. Intermittent catheterisation: an option for managing bladder dysfunction. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2016; 25:S16-8. [PMID: 27172502 DOI: 10.12968/bjon.2016.25.9.s16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alison Bardsley
- Senior Lecturer, Course Director for Non-Medical Prescribing, Coventry University discusses the role of intermittent catheterisation and considerations for health professionals and the individual concerned
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Anti-biofilm effect of nanometer scale silver (NmSAg) coatings on glass and polystyrene surfaces against P. mirabilis, C. glabrata and C. tropicalis strains. J Appl Biomater Funct Mater 2015; 13:e351-5. [PMID: 26450636 DOI: 10.5301/jabfm.5000248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2015] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Nowadays, in order to terminate biofilm associated infections, coating of particular biomaterial surfaces with particular substances, via some nanotechnological tools, is being applied. Therefore, in the present study, investigation of anti-biofilm effects of nanometer scale silver (NmSAg) coatings on glass and polystyrene surfaces against clinical strains of Proteus mirabilis, Candida glabrata and Candida tropicalis was aimed. METHODS In this study, glass and polystyrene slabs with 1.5 cm × 1.5 cm × 0.3 mm dimensions were cleaned by using surface plasma technology, covered with NmSAg by using a physical vapor deposition machine, and biofilm inhibition was determined by crystal violet binding assay. RESULTS According to our results, 32 nm of silver layer on a glass slab decreased biofilm formation of P. mirabilis strain to a maximum amount of 88.1% and caused 20.9% inhibition in biofilm formation of C. glabrata strain. On the other hand, NmS coating of Ag on a polystyrene slab caused 34.4% and 20% inhibitions, respectively, in biofilm formations of C. glabrata and C. tropicalis strains. Although biofilm inhibition of NmSAg layer on polystyrene slab was more (34.4%) than biofilm inhibition caused by NmSAg layer on glass slab (20.9%), C. glabrata strain's biofilm formation on uncoated glass slab was lower than both uncoated and NmSAg-coated polystyrene slabs. CONCLUSIONS Our results show that glass surfaces with NmSAg coatings can be used as a new surface material of various indwelling devices on which P. mirabilis colonizations frequently occur and in order to avoid C. glabrata-associated biofilm infections, it is more useful to choose a surface material of glass rather than choosing a surface material of polystyrene.
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Liao L. Evaluation and Management of Neurogenic Bladder: What Is New in China? Int J Mol Sci 2015; 16:18580-600. [PMID: 26266405 PMCID: PMC4581261 DOI: 10.3390/ijms160818580] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 07/23/2015] [Accepted: 07/23/2015] [Indexed: 11/16/2022] Open
Abstract
Neurogenic bladder (NB) or neurogenic lower urinary tract dysfunction (NLUTD), a dysfunction of the urinary bladder and urethra due to disease of the central nervous system or peripheral nerves, is a major global medical and social problem. Numerous nervous system abnormalities, such as: stroke, Alzheimer's and Parkinson's diseases, traumatic spinal cord injury, spinal cord tumors, congenital spina bifida, and diabetes, can cause NB/NLUTD. There are two major types of bladder control problems associated with NB/NLUTD: the bladder becomes either overactive or underactive depending on the nature, level, and extent of nerve damage. This review specifically focuses on the diagnosis and management of NB/NLUTD in China as well as on recent efforts to treat this disease.
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Affiliation(s)
- Limin Liao
- Department of Urology, China Rehabilitation Research Center, Beijing 100068, China.
- Department of Urology, Capital Medical University, Beijing 100069, China.
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing 100068, China.
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing 100068, China .
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Averbeck MA, Madersbacher H. Follow-up of the neuro-urological patient: a systematic review. BJU Int 2015; 115 Suppl 6:39-46. [PMID: 25891319 DOI: 10.1111/bju.13084] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES To systematically review the long-term urological follow-up strategies for patients with neurogenic lower urinary tract dysfunction (NLUTD), focusing on three main groups of neurological diseases: (i) spinal cord injuries, (ii) spinal dysraphism, and (iii) multiple sclerosis. PATIENTS AND METHODS Data acquisition comprised electronic search on the Medical Literature Analysis and Retrieval System Online (MEDLINE) database and the EMBASE database in August 2014 to retrieve English language studies. MEDLINE and EMBASE search included the following medical subject heading (MeSH) terms: (i) neurogenic bladder and (ii) neurogenic bladder dysfunction. Each of these terms was crossed with (i) long-term care and (ii) long-term surveillance. Only studies related to NLUTD and urological follow-up were included. Studies were also identified by hand search of reference lists and review articles. RESULTS Initial records identified through database searching included 265 articles. In all, 23 articles were included in the quantitative synthesis. The proposed time schedule of investigations as well as the amount and type of investigation were different according to specific neurological lesions. They depend on the dysfunctional pattern of the lower urinary tract (LUT) and its risk profile. However, there is a lack of high-evidence level studies to support an optimal long-term follow-up protocol. CONCLUSIONS The goal of neuro-urological management is the best possible preservation of upper urinary tract (UUT) and LUT function in relation to the individual neurological disorder. Regular and risk adapted controls ('urochecks') allow detection of risk-factors in time before irreversible changes of the LUT and UUT have occurred. With risk- and patient-oriented lifelong regular urological care an optimised quality of life and life-expectancy can be achieved, although there is a complete lack of high-evidence level studies on this topic.
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Kanaheswari Y, Kavitha R, Rizal AMM. Urinary tract infection and bacteriuria in children performing clean intermittent catheterization with reused catheters. Spinal Cord 2014; 53:209-212. [DOI: 10.1038/sc.2014.210] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 10/13/2014] [Accepted: 10/26/2014] [Indexed: 11/09/2022]
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Guinet-Lacoste A, Jousse M, Tan E, Caillebot M, Le Breton F, Amarenco G. Intermittent catheterization difficulty questionnaire (ICDQ): A new tool for the evaluation of patient difficulties with clean intermittent self-catheterization. Neurourol Urodyn 2014; 35:85-9. [DOI: 10.1002/nau.22686] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 09/02/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Amandine Guinet-Lacoste
- Service de Neuro-Urologie et Explorations Périnéales; Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie); Paris France
| | - Marylène Jousse
- Service de Neuro-Urologie et Explorations Périnéales; Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie); Paris France
| | - Eliane Tan
- Service de Neuro-Urologie et Explorations Périnéales; Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie); Paris France
| | - Murielle Caillebot
- Service de Neuro-Urologie et Explorations Périnéales; Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie); Paris France
| | - Frédérique Le Breton
- Service de Neuro-Urologie et Explorations Périnéales; Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie); Paris France
| | - Gérard Amarenco
- Service de Neuro-Urologie et Explorations Périnéales; Hôpital Tenon, APHP, GREEN (Group of clinical REsEarch in Neurourology, University Pierre and Marie Curie); Paris France
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Clinical guidelines for the diagnosis and management of neurogenic lower urinary tract dysfunction. Tzu Chi Med J 2014. [DOI: 10.1016/j.tcmj.2014.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Wyndaele J. Self-intermittent catheterization in multiple sclerosis. Ann Phys Rehabil Med 2014; 57:315-320. [DOI: 10.1016/j.rehab.2014.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 05/19/2014] [Indexed: 10/25/2022]
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Håkansson MÅ. Reuse versus single-use catheters for intermittent catheterization: what is safe and preferred? Review of current status. Spinal Cord 2014; 52:511-6. [DOI: 10.1038/sc.2014.79] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/31/2014] [Accepted: 04/13/2014] [Indexed: 01/21/2023]
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Bladder management and urological complications in patients with chronic spinal cord injuries in Taiwan. Tzu Chi Med J 2014. [DOI: 10.1016/j.tcmj.2013.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Bermingham SL, Hodgkinson S, Wright S, Hayter E, Spinks J, Pellowe C. Intermittent self catheterisation with hydrophilic, gel reservoir, and non-coated catheters: a systematic review and cost effectiveness analysis. BMJ 2013; 346:e8639. [PMID: 23303886 PMCID: PMC3541473 DOI: 10.1136/bmj.e8639] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2012] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the most effective and cost effective type of catheter for patients performing intermittent self catheterisation in the community. DESIGN Systematic review and meta-analysis. Results were incorporated into a probabilistic Markov model to compare lifetime costs and quality adjusted life years (QALYs). DATA SOURCES We searched Medline, Embase, and Cochrane and Cinahl databases from 2002 to 18 April 2011 to identify studies comparing hydrophilic, gel reservoir, and non-coated intermittent catheters. Earlier guidelines were used to identify papers published before 2002. To capture studies comparing clean and sterile non-coated intermittent self catheterisation, each database was searched from its date of inception to 18 April 2011. MAIN OUTCOME MEASURES Clinical outcomes included symptomatic urinary tract infection (UTI), bacteraemia, mortality, patient preference or comfort, and number of catheters used. The economic model included downstream complications of UTI and cost effectiveness was calculated as incremental cost per QALY gained. RESULTS Eight studies were included in the systematic review. Most were conducted in patients with spinal cord injuries, and most of the included patients were men. People using gel reservoir and hydrophilic catheters were significantly less likely to report one or more UTIs compared with sterile non-coated catheters (absolute effect for gel reservoir = 149 fewer per 1000 (95% confidence interval -7 to 198), P=0.04; absolute effect for hydrophilic = 153 fewer per 1000 (-8 to 268), P=0.04). However, there was no difference between hydrophilic and sterile non-coated catheters when outcomes were measured as mean monthly UTIs (mean difference = 0.01 (-0.11 to 0.09), P=0.84) or total UTIs at 1 year (mean difference = 0.18 (-0.50 to 0.86), P=0.60). There was little difference in the incidence of one or more UTIs for people using clean versus sterile non-coated catheters (absolute effect = 12 fewer per 1000 (-134 to 146), P=0.86). Although the most effective, gel reservoir catheters cost >£54,350 per QALY gained and are therefore not cost effective compared with clean non-coated self catheterisation. CONCLUSION The type of catheter used for intermittent self catheterisation seems to make little difference to the risk of symptomatic UTI. Given large differences in resource use, clean non-coated catheters are most cost effective. However, because of limitations and gaps in the evidence base and the designation of non-coated catheters as single use devices, we recommend a precautionary principle should be adopted and that patients should be offered a choice between hydrophilic and gel reservoir catheters.
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Affiliation(s)
- Sarah L Bermingham
- Royal College of Physicians, National Clinical Guideline Centre, London NW1 4LE, UK
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Abstract
Together with comprehension and therapy of neurogenic failure of the storage function of the urinary bladder, intermittent catheterization as a pressure-free voiding method without residual urine, represents a major principle of therapy in lower urinary tract dysfunction. Aseptic intermittent catheterization is recommended in Germany and Europe and seems to be acceptable even in long-term application with low complication rates. It is a precondition that patients are seen for clinical and urodynamic reevaluation at risk-adapted time intervals. The major focus is on early recognition and avoidance of threatening complications. The most important preventive measures are the motivation and compliance of the well-educated patient and the use of careful catheterization techniques with individually optimized catheters.Although aseptic intermittent catheterization has been used effectively for many years there is still a lack of randomized controlled studies for some important questions of details and an optimal catheter has still to be defined. Furthermore, valid conclusions based on well-conducted studies on the self-estimated quality of life of patients with intermittent catheterization, especially those with catheterization by attendant, are urgently needed. Intermittent catheterization is never a ready-made solution but always an individually tailored treatment for patients with lower urinary tract dysfunction.
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Affiliation(s)
- R Böthig
- Abteilung Neuro-Urologie, Querschnittgelähmtenzentrum, Berufsgenossenschaftliches Unfallkrankenhaus Hamburg, Bergedorfer Straße 10, 21033 Hamburg, Deutschland.
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Parsons BA, Narshi A, Drake MJ. Success rates for learning intermittent self-catheterisation according to age and gender. Int Urol Nephrol 2012; 44:1127-31. [PMID: 22350836 DOI: 10.1007/s11255-012-0136-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 01/31/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE Voiding dysfunction becomes increasingly prevalent with ageing. Clean intermittent self-catheterisation (ISC) is associated with a lower morbidity than indwelling transurethral or suprapubic catheterisation. However, doctors and patients sometimes fail to consider ISC as an option because of a perception it will be unmanageable or poorly tolerated. This study aimed to determine how age and gender affect the success rates of patients being taught ISC. METHODS Six years retrospective study (January 2004-January 2010) of non-neurogenic patients referred to be taught ISC by urology specialist nurses in a tertiary referral hospital. Patients were sent information about ISC in advance of their appointment, were given additional information at the appointment, received training under supervision and had access to follow-on support. Successful patients were those who continued to perform the technique independently at 6-week follow-up. RESULTS Three hundred and nine patients (209 men, 100 women) with a mean age of 63 years (range 17-95 years) were taught ISC during the study period and had documented follow-up. The main reasons for needing ISC were incomplete bladder emptying (46%), urethral stricture disease (20%) and inability to void (18%). The overall ISC success rate was 84% for all age groups, 86% for patients under the age of 65 and 82% for those aged 65 years and over. Men had a higher success rate than women (88 and 76%, respectively). CONCLUSIONS Older patients can successfully be taught ISC in a high proportion, and it can be offered as an alternative to an indwelling catheter irrespective of age.
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Affiliation(s)
- Brian A Parsons
- Bristol Urological Institute, Southmead Hospital, Bristol, BS10 5NB, UK.
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Hagen EM, Faerestrand S, Hoff JM, Rekand T, Gronning M. Cardiovascular and urological dysfunction in spinal cord injury. Acta Neurol Scand 2011:71-8. [PMID: 21711260 DOI: 10.1111/j.1600-0404.2011.01547.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE A spinal cord injury (SCI) above the sixth thoracic vertebra interrupts the supraspinal control of the sympathetic nervous system causing an imbalance between the sympathetic and the parasympathetic nervous system. This article focuses on the symptoms, treatment and examination of autonomic disturbances of the cardiovascular and the urinary system after a SCI. METHODS A non-systematic literature search in the PubMed database. RESULTS Frequent complications in the acute phase of cervical and high thoracic SCI are bradyarrhythmias, hypotension, hypothermia/hyperthermia, increased neurogenic shock, vagovagal reflex, supraventricular/ventricular ectopic beats, vasodilatation and congestion. Serious complications in the chronic phase of SCI are orthostatic hypotension, impaired cardiovascular reflexes, autonomic dysreflexia (AD), reduced sensation of cardiac pain, loss of reflex cardiac acceleration, quadriplegic cardiac atrophy due to loss of left ventricular mass and pseudo-myocardial infarction. AD is associated with a sudden, uncontrolled sympathetic response, triggered by stimuli below the injury. It may cause mild symptoms like skin rash or slight headache, but also severe hypertension, cerebral haemorrhage and death. Early recognition and prompt treatment are important. Urinary autonomic dysfunctions include hyperreflexia or areflexia of detrusor and/or sphincter of the bladder. CONCLUSIONS Patients with SCI have a high risk of cardiovascular complications, AD and urinary autonomic dysfunction both in the acute phase and later, affecting their prognosis and quality of life. Knowledge of cardiovascular and urological complications after SCI is important for proper diagnosis and treatment.
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Affiliation(s)
- E M Hagen
- Department of Neurology, Haukeland University Hospital, Bergen, Norway Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
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Current Concepts in Female Neurogenic Voiding Dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2011. [DOI: 10.1007/s11884-011-0092-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Clinical evaluation of a newly developed catheter (SpeediCath Compact Male) in men with spinal cord injury: residual urine and user evaluation. Spinal Cord 2011; 49:817-21. [DOI: 10.1038/sc.2011.14] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Amarenco G, Guinet A, Jousse M, Verollet D, Ismael SS. Pencil and Paper Test: A New Tool to Predict the Ability of Neurological Patients to Practice Clean Intermittent Self-Catheterization. J Urol 2011; 185:578-82. [DOI: 10.1016/j.juro.2010.09.106] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Indexed: 10/18/2022]
Affiliation(s)
- Gerard Amarenco
- Service de Neuro-Urologie et d'Explorations Périnéales, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Er 6, Université Pierre et Marie Curie, Paris, France
| | - Amandine Guinet
- Service de Neuro-Urologie et d'Explorations Périnéales, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Er 6, Université Pierre et Marie Curie, Paris, France
| | - Marylene Jousse
- Service de Neuro-Urologie et d'Explorations Périnéales, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Er 6, Université Pierre et Marie Curie, Paris, France
| | - Delphine Verollet
- Service de Neuro-Urologie et d'Explorations Périnéales, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Er 6, Université Pierre et Marie Curie, Paris, France
| | - Samer Sheikh Ismael
- Service de Neuro-Urologie et d'Explorations Périnéales, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Er 6, Université Pierre et Marie Curie, Paris, France
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Adams J, Watts R, Yearwood M, Watts A, Hartshorn C, Simpson S, Continence Nurse Consultant KA, Denison S, Hardcastle B. Strategies to promote intermittent self-catheterisation in adults with neurogenic bladders: A comprehensive systematic review. ACTA ACUST UNITED AC 2011; 9:1392-1446. [PMID: 27819976 DOI: 10.11124/01938924-201109340-00001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
EXECUTIVE SUMMARY Background Clean intermittent self-catheterisation is the gold standard in the management of neurogenic/neuropathic bladder disorders, providing independence, alleviating symptoms and complications of the urinary tract.Objectives The objective of this systematic review was to establish the best available evidence on strategies to promote intermittent urethral self-catheterisation in adults with neurogenic/neuropathic bladders.Methods The search strategy identified published and unpublished studies reported from 1970 to 2009. Individual search strategies were developed for the 12 databases accessed and search alerts established. The review considered qualitative and quantitative studies, mixed methods and case studies. Interventions, programs and strategies preparing adults to self-catheterise included education, suitability for selfcatheterisation and interventions promoting compliance and continuity. Outcomes of interest were the quality of life and depression, long-term compliance, advantages/disadvantages of urethral self-catheterisation and limitations to selfcatheterisation.Standardised critical appraisal instruments developed by the Joanna Briggs Institute were used by two independent reviewers to assess the quality of eligible studies for inclusion in the review. Standardised Joanna Briggs Institute tools were also used to extract data. Criteria developed by Yin were employed to assess case studies. Qualitative findings were synthesised. As statistical pooling of the quantitative results was not possible, these results were presented in narrative form.Results From the 18 studies reviewed, three interventions (education and preparation, suitability to self-catheterise, and interventions promoting compliance/continuity), and three outcomes (effect of self-catheterisation on quality of life and depression, and longterm compliance) were addressed with multiple studies in each intervention and outcome. The results are discussed under four headings: (i) education essentials for selfcatheterisation (ii) factors promoting compliance and continuity with self-catheterisation, (iii) factors influencing quality of life and (IV) diagnostic sub-groups of people with a neurogenic bladder. CONCLUSION The narrative and synthesised data from the 18 included studies identified findings to provide a basis for strategies to promote clean intermittent self-catheterisation in adults. These include an extended education program with a pre-education component, ongoing support and skills training. All aspects of education should reflect sound research findings related to quality of life issues.Implications for Practice The implications for clinical practice are the development of a comprehensive standardised education program that includes background information, skills training and follow-up support.Implications for Research The review highlights the need for further experimental research to confirm factors that will promote self-catheterisation in adults with neurogenic/neuropathic bladders, with particular reference specific sub-groups.
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Affiliation(s)
- Jillian Adams
- 1 a Joanna Briggs Institute Evidence Synthesis Group, Royal Perth Hospital, Perth, Western Australia affiliated with the WACEIHP 2 Director, WACEIHP 3. Royal Perth Hospital Box X2213 GPO Perth 6847, Western Australia
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Adams J, Watts R, Yearwood M, Watts A, Hartshorn C, Simpson S, Continence Nurse Consultant KA, Denison S, Hardcastle B. Strategies to promote intermittent self-catheterisation in adults with neurogenic bladders: A comprehensive systematic review. ACTA ACUST UNITED AC 2011. [DOI: 10.11124/jbisrir-2011-128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Biering-Sørensen F, Hansen HV, Nielsen PN, Looms D. Residual urine after intermittent catheterization in females using two different catheters. ACTA ACUST UNITED AC 2009; 41:341-5. [PMID: 17763228 DOI: 10.1080/00365590601068983] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the ability of a new 7-cm long female catheter (SpeediCath Compact; Coloplast A/S, Humlebaek, Denmark) to drain the urinary bladder compared to standard-length female catheters. MATERIAL AND METHODS This was a prospective, single-blind, randomized, crossover study. Twenty-four female intermittent catheter users with neurogenic bladder dysfunction took part. Each test person catheterized three times with the test catheter on one day and three times with a standard-length female catheter on another day. The residual urine (RU) volume in the bladder after catheterization was measured by means of ultrasound. Furthermore, participants were asked to evaluate the length and handling of the test catheter during insertion, and to rate their overall satisfaction with the test catheter. RESULTS There was no difference between the catheters in terms of volume of RU. One test person could not use the SpeediCath Compact catheter. Twenty-three participants found handling the SpeediCath Compact very easy or easy and rated their overall satisfaction with it as either very satisfying or satisfying. CONCLUSION In most females, the SpeediCath Compact catheter is at least as efficient at emptying the bladder as more conventional female catheters.
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Affiliation(s)
- Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, The NeuroScience Centre, Rigshospitalet, Copenhagen University Hospital, Hornbaek, Denmark
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Lugo LH, Salinas F, García HI. Out-patient rehabilitation programme for spinal cord injured patients: Evaluation of the results on motor FIM score. Disabil Rehabil 2009; 29:873-81. [PMID: 17577722 DOI: 10.1080/09638280701455494] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The aim of this study was to evaluate an out-patient attention programme based on a short in-patient phase followed by an out-patient interdisciplinary rehabilitation programme. METHODS A prospective quasi-experimental before-and-after study was carried out; a phase 2 trial. The study population consisted of 42 patients who met the inclusion criteria. The Functional Independence Measurement (FIM) was the main outcome, and the American Spinal Injury Association (ASIA) motor scores and morbidity the secondary ones. The intervention was a two-phase goal-based interdisciplinary programme which consisted of a hospital and an ambulatory phase. After an evaluation upon admission to hospital, follow-up was carried out 1, 3, 6, 12 and 18 months later. RESULTS Initially, 208 patients were evaluated and only 42 completed the study. The in-patient phase was short (average: 13.5 days) and the out-patient phase lasted 18 months. Motor FIM scores progressively increased from 25/91 up to 69/91 (p < 0.01). Some 25% of the patients had pressure sores at 1 month, and 11.9% still had them after 18 months. Pain was the most frequent complication, in 80% of patients by the third month. Urinary and fecal continence improved during follow-up (74% at 18 months and 81.1% at 12 months, respectively). CONCLUSIONS Good functional evolution of SCI patients and low morbidity can be obtained with a low-cost out-patient rehabilitation programme. Such a programme must emphasize patient and family education concerning self-care and possible SCI complications.
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Affiliation(s)
- Luz Helena Lugo
- Physical Medicine and Rehabilitation, Rehabilitation on Health Group, University of Antioquia, Medellin, Colombia.
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Everaert K, Lumen N, Kerckhaert W, Willaert P, van Driel M. Urinary tract infections in spinal cord injury: prevention and treatment guidelines. Acta Clin Belg 2009; 64:335-40. [PMID: 19810421 DOI: 10.1179/acb.2009.052] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES AND METHODS The literature on prevention and therapy of urinary tract infection (UTI) in patients with spinal cord injury (SCI) was reviewed using 3 levels of evidence. RESULTS Antibiotic therapy is only indicated in symptomatic bacteriuria or in symptomatic exacerbations of chronic UTI. During the acute phase of a SCI, UTI's are more prevalent and bacteria are different and more resistant to antibiotics compared with the chronic phase of SCI. In SCI in general, routine screening urine cultures are not valuable as a high species turn over is seen. Intermittent catheterisation, tapping or Crédé manoeuvre coincide significantly with lower frequency of UTI compared to permanent catheter drainage. No measures are proven efficient in the long term in prevention of bacteriuria or UTI. Methenamine salts are perhaps useful in the prevention of UTI but not in patients with a permanent catheter (level III). Antibiotic prophylaxis was found useful in reducing asymptomatic bacteriuria but not in the prevention of symptomatic infections (level I). However, during prophylaxis a doubling of antibiotic resistance was found. In patients with augmented bladder antibiotic prophylaxis is useless (level II). In chronic SCI the first choice antibiotics are nitrofurantoin or trimethoprim, the second choice are fluoroquinolones (level III) whereas in acute SCI a higher resistance profile to antibiotics is frequent and therefore fluoroquinolones or cefuroxime are suggested (level III). There is no consensus in the literature but we suggest 5 days of antibiotic treatment in UTI during chronic SCI without fever, 7 days in acute SCI without fever and a minimum of 14 days in patients with UTI and fever (level III).
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Affiliation(s)
- K Everaert
- Department of Urology, Ghent University hospital, Ghent, Belgium.
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Dicianno BE, Arva J, Lieberman JM, Schmeler MR, Souza A, Phillips K, Lange M, Cooper R, Davis K, Betz KL. RESNA Position on the Application of Tilt, Recline, and Elevating Legrests for Wheelchairs. Assist Technol 2009; 21:13-22; quiz 24. [DOI: 10.1080/10400430902945769] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Stöhrer M, Blok B, Castro-Diaz D, Chartier-Kastler E, Del Popolo G, Kramer G, Pannek J, Radziszewski P, Wyndaele JJ. EAU guidelines on neurogenic lower urinary tract dysfunction. Eur Urol 2009; 56:81-8. [PMID: 19403235 DOI: 10.1016/j.eururo.2009.04.028] [Citation(s) in RCA: 331] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 04/09/2009] [Indexed: 12/23/2022]
Abstract
CONTEXT Most patients with neurogenic lower urinary tract dysfunction (NLUTD) require life-long care to maintain their quality of life (QoL) and to maximise life expectancy. OBJECTIVE To provide a summary of the 2008 version of the European Association of Urology (EAU) guidelines on NLUTD and to assess the effectiveness of currently available diagnostic tools, particularly ultrasound imaging and urodynamics. EVIDENCE ACQUISITION The recommendations provided in the 2008 EAU guidelines on NLUTD are based on a review of the literature, using online searches of Medline and other source documents published between 2004 and 2007. A level of evidence and/or a grade of recommendation have been assigned to the guidelines where possible. EVIDENCE SYNTHESIS NLUTD encompasses a wide spectrum of pathologies, and patients often require life-long, intensive medical care to maximise their life-expectancy and to maintain their QoL. Treatment must be tailored to the needs of the individual patient and, in many cases, involves a multidisciplinary team of experts. Timely diagnosis and treatment are essential if irreversible deterioration of both the upper and lower urinary tracts are to be avoided. Therapeutic decisions are made on the basis of a comprehensive medical assessment, including urodynamics to identify the type of dysfunction. Advances in investigative technologies have facilitated the noninvasive and conservative management of patients who have NLUTD. CONCLUSIONS The diagnosis and treatment of NLUTD, which is a highly specialised and complex field involving both urology and medicine, requires up-to-date expert advice to be readily available. The current guidelines are designed to fulfil this need.
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Bonniaud V, Leroy J, Kleinclauss F, Look PY, Bévalot J, Parratte B. Prescrire des autosondages intermittents propres. Presse Med 2009; 38:392-6. [DOI: 10.1016/j.lpm.2008.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2008] [Revised: 11/21/2008] [Accepted: 12/01/2008] [Indexed: 11/28/2022] Open
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Kessler TM, Ryu G, Burkhard FC. Clean intermittent self-catheterization: A burden for the patient? Neurourol Urodyn 2009; 28:18-21. [DOI: 10.1002/nau.20610] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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