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Unal N. Commentary: The relationship between the self-confidence in clean urinary intermittent catheterisation and self-efficacy of home care patients. J Res Nurs 2024; 29:226-227. [PMID: 38883252 PMCID: PMC11179596 DOI: 10.1177/17449871241241798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Affiliation(s)
- Nursemin Unal
- Assistant Professor, Midwifery Department, Faculty of Nursing, Ankara University, Ankara Turkey
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Sari C, Demirbağ BC. Investigation of anxiety levels in caregivers who perform clean intermittent catheterization on their children and affecting factors. Neurourol Urodyn 2024; 43:738-747. [PMID: 38238988 DOI: 10.1002/nau.25388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/20/2023] [Accepted: 12/21/2023] [Indexed: 03/21/2024]
Abstract
PURPOSE The study aimed to determine the anxiety levels of caregivers who performed clean intermittent catheterization (CIC) on their children and the factors affecting them. METHODS This descriptive study was conducted between January 6, and May 29, 2023 with caregivers of 42 patients who were followed up by the pediatric nephrology outpatient clinic of a university for CIC. The study data were collected using the "Participant Information Form" and the "State and Trait Anxiety Scale." RESULTS According to the results, of the children included in the study, 73.8% were female, 64.3% were diagnosed with spina bifida (SB), and 76.2% received CIC applications 4-6 times a day. All the caregivers were mothers, and 76.2% received CIC training from a doctor. However, 78.6% of them found the training insufficient, leading them to rely on self-experimentation when applying CIC to their own children. None of the caregivers received information or training on the CIC application from nurses, and there were no home visits or telephone counseling provided after the hospital discharge. The mean score for the state anxiety scale among the caregivers was 45.90 ± 10.57, while the mean score for the trait anxiety scale was 46.92 ± 8.43. Significantly higher mean trait anxiety scores were observed among caregivers with chronic diseases who did not receive training on the CIC application (p < 0.05). Additionally, caregivers of children who experienced 3-4 urinary tract infections (UTIs) within the last 3 months also had significantly higher mean trait anxiety scores (p < 0.05). The mean trait anxiety level scores of caregivers of children who had 3-4 UTIs in the last 3 months were significantly higher (p < 0.05). CONCLUSIONS It was concluded that caregivers' lack of training on CIC implementation, having chronic disease, and having frequent UTIs in their children were effective on anxiety levels.
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Affiliation(s)
- Canan Sari
- Department of Health Care Services, Elderly Care Program, Tonya Vocational School, Trabzon University, Trabzon, Turkey
| | - Birsel C Demirbağ
- Faculty of Health Sciences, Public Health Nursing AB, Karadeniz Technical University, Trabzon, Turkey
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Levy S, Dequirez PL, Mercier J, Taha F, Goujon A, Seguier D, Mesnard B, Seizilles de Mazancourt E, Joussen G, Margue G, Berchiche W, Anastay V, Deleuze C, Kaulanjan K, Cotte J, Peyrottes A, Gamé X, Peyronnet B. [Current state of knowledge of urology residents and fellows on the neuro-urological management of spina bifida patients in France]. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102580. [PMID: 38417189 DOI: 10.1016/j.fjurol.2024.102580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/04/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVE To assess the current knowledge of French urology residents and fellows about neurogenic lower urinary tract dysfunction and their management in patients with spina bifida. MATERIAL AND METHOD A 7-question questionnaire, covering the responder's experience and the various stages in the neuro-urological management of spina bifida, was drafted by an expert urologist. Responses were collected within 5days of being e-mailed to members of the Association française des urologues en formation (AFUF), and a descriptive analysis was carried out. RESULTS Of the 448 members, 155 completed the questionnaire. Of the participants, 83.8% said they knew the definition of spina bifida, and 76.8% had already had to care for a spina bifida patient. Of the participants, 48.4% correctly estimated the number of spina bifida patients in France. Neurogenic lower urinary tract dysfunction to look for and the specificities of management seemed to have been acquired by a majority of respondents (correct response rates of 70.7% and 75.4%, respectively), unlike the extra-urological aspects (53.9%), and the choice of examinations useful for the initial work-up and follow-up (55.8%). CONCLUSION While the expected neurogenic lower urinary tract dysfunction and the specificities of therapeutic management of spina bifida patients appear to be well known to urologists in training, knowledge of extra-urological symptoms and the choice of examinations could be improved. These results could be used to adjust the teaching given to French urologists in training on the urological management of spina bifida patients. LEVEL OF EVIDENCE Grade 4.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Juliette Cotte
- Hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, université Paris Cité, Paris, France
| | - Arthur Peyrottes
- Hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, université Paris Cité, Paris, France
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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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Nisheljeet S, Azizi AB, Palaniandy K, Ganesan D, Ong TA, Alias A, Rajamanickam R, Atroosh WM, Mohd-Zin SW, Lee-Shamsuddin A, Nivrenjeet S, Lo W, Abdul-Aziz NM. Survey on Untethering of the Spinal Cord and Urological Manifestations among Spina Bifida Patients in Malaysia. CHILDREN 2022; 9:children9071090. [PMID: 35884073 PMCID: PMC9324435 DOI: 10.3390/children9071090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022]
Abstract
The incidence and severity of urinary tract infections (UTIs) due to spina bifida is poorly understood in Malaysia. Tethering of the spinal cord is a pathological fixation of the cord in the vertebral column that can result in neurogenic bladder dysfunction and other neurological problems. It occurs in patients with spina bifida, and the authors of this study sought to investigate the impact of untethering on the urological manifestations of children with a tethered cord, thereby consolidating a previously known understanding that untethering improves bladder and bowel function. Demographic and clinical data were collected via an online questionnaire and convenient sampling techniques were used. A total of 49 individuals affected by spina bifida participated in this study. UTIs were reported based on patients’ observation of cloudy and smelly urine (67%) as well as urine validation (60%). UTI is defined as the combination of symptoms and factoring in urine culture results that eventually affects the UTI diagnosis in spina bifida individuals irrespective of CISC status. Furthermore, 18% of the respondents reported being prescribed antibiotics even though they had no history of UTI. Therefore, indiscriminate prescription of antibiotics by healthcare workers further compounds the severity of future UTIs. Employing CISC (73%) including stringent usage of sterile catheters (71%) did not prevent patients from getting UTI. Overall, 33% of our respondents reported manageable control of UTI (0–35 years of age). All individuals below the age of 5 (100%, n = 14) were seen to have improved urologically after the untethering surgery under the guidance of the Malaysia NTD support group. Improvement was scored and observed using KUB (Kidneys, Ureters and Bladder) ultrasound surveillance before untethering and continued thereafter. Spina bifida individuals may procure healthy bladder and bowel continence for the rest of their lives provided that neurosurgical and urological treatments were sought soon after birth and continues into adulthood.
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Affiliation(s)
- Singh Nisheljeet
- Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.N.); (S.W.M.-Z.); (A.L.-S.); (S.N.)
| | - Abu Bakar Azizi
- Department of Surgery, University Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (A.B.A.); (K.P.)
| | - Kamalanathan Palaniandy
- Department of Surgery, University Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (A.B.A.); (K.P.)
| | - Dharmendra Ganesan
- Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (D.G.); (T.A.O.)
| | - Teng Aik Ong
- Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (D.G.); (T.A.O.)
| | - Azmi Alias
- Department of Neurosurgery, Tunku Abdul Rahman Neuroscience Institute (IKTAR), Hospital Kuala Lumpur, Kuala Lumpur 50586, Malaysia;
- Department of Pediatric Neurosurgery, Women and Children Hospital Kuala Lumpur, Kuala Lumpur 50586, Malaysia
| | | | - Wahib M. Atroosh
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Siti Waheeda Mohd-Zin
- Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.N.); (S.W.M.-Z.); (A.L.-S.); (S.N.)
| | - Andrea Lee-Shamsuddin
- Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.N.); (S.W.M.-Z.); (A.L.-S.); (S.N.)
| | - Singh Nivrenjeet
- Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.N.); (S.W.M.-Z.); (A.L.-S.); (S.N.)
| | - Warren Lo
- Department of Urology, Kuala Lumpur Hospital, Jalan Pahang, Kuala Lumpur 50586, Malaysia
- Correspondence: (W.L.); (N.M.A.-A.)
| | - Noraishah Mydin Abdul-Aziz
- Invertebrate & Vertebrate Neurobiology Lab, Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia; (S.N.); (S.W.M.-Z.); (A.L.-S.); (S.N.)
- Correspondence: (W.L.); (N.M.A.-A.)
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6
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Silva T, T Horliana ACR, Malavazzi TCS, Santos EM, Gonçalves MLL, Fernandes KPS, Mesquita-Ferrari RA, Martimbianco ALC, Bussadori SK. Efficacy and safety of electrical stimulation in the treatment of neurogenic bladder dysfunction in myelomeningocele-Systematic review of randomized clinical trials. Neurourol Urodyn 2021; 41:91-101. [PMID: 34524699 DOI: 10.1002/nau.24792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/23/2021] [Accepted: 08/31/2021] [Indexed: 11/05/2022]
Abstract
AIMS The purpose of this systematic review was to investigate and synthesize the effects (benefits and harms) of electrical stimulation (EE), alone or in association with other interventions, compared with sham and other interventions, for the treatment of neurogenic bladder dysfunction in myelomeningocele. METHODS This systematic review was conducted following the methodological recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and registered at PROSPERO (CRD42020200425). A search was performed in the following electronic databases: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, LILACS, and PEDro. Randomized clinical trials (RCTs) that assessed any EE in children diagnosed with myelomeningocele and neurogenic bladder and/or urinary incontinence were included and reported. RESULTS When comparing EE versus sham groups, some estimated effects showed a wide confidence interval, probably due to the small sample size of the included studies. This indicates an imprecision in these findings. Regarding the safety of this intervention and safety of the lower urinary tract, no adverse events resulting from EE were reported. All the included studies have evaluated the efficacy of EE compared with sham, but different EE parameters and electrode positions among studies make it impossible to perform a meta-analysis. CONCLUSIONS Based on very low certainty evidence, the findings of this systematic review suggested no difference between EE and sham to improve urinary incontinence in children with myelomeningocele. However, the small sample size and the imprecision arising from the wide confidence intervals must be considered. Future RCTs following a rigorous methodology, as recommended by the CONSORT statement, should be conducted to support the use of this intervention in clinical practice.
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Affiliation(s)
- Tamiris Silva
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | - Anna C R T Horliana
- Postgraduate Program in Biophotonics Applied to the Health Sciences, UNINOVE, São Paulo, Brazil
| | - Tainá C S Malavazzi
- Postgraduate Program in Biophotonics Applied to the Health Sciences, UNINOVE, São Paulo, Brazil
| | - Elaine M Santos
- Pro-rectory for Academic Affairs, UNIMES, Santos, Brazil.,Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos, Brazil
| | - Marcela L L Gonçalves
- Postgraduate Program in Biophotonics Applied to the Health Sciences, UNINOVE, São Paulo, Brazil.,Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos, Brazil
| | | | - Raquel A Mesquita-Ferrari
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil.,Postgraduate Program in Biophotonics Applied to the Health Sciences, UNINOVE, São Paulo, Brazil
| | - Ana Luiza C Martimbianco
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos, Brazil.,Center of Health Technology Assessment, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Sandra K Bussadori
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil.,Postgraduate Program in Biophotonics Applied to the Health Sciences, UNINOVE, São Paulo, Brazil
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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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Balhi S, Arfaouni RB, Mrabet A. Intermittent catheterisation: the common complications. Br J Community Nurs 2021; 26:272-277. [PMID: 34105361 DOI: 10.12968/bjcn.2021.26.6.272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intermittent catheterisation (IC) has been in practice for more than 40 years and is considered the gold standard in the management of urinary retention in the neurological bladder. IC has many advantages over indwelling urethral or suprapubic catheterisation, including reducing the risk of infection, protecting the bladder and improving quality of life. However, complications can be caused by the practice of this technique, the most common of which is infection. This review discusses some of the common complications that can occur with the use of intermittent catheterisation, including urinary tract infection (UTIs) and urethral complications. It also highlights the role of the nurse in the management of its complications.
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Affiliation(s)
- Salma Balhi
- Doctor, Department of Epidemiology and Public Health, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Rym Baati Arfaouni
- Doctor, Urodynamics and Functional Exploration Unit, Charles Nicolle Hospital, Tunis, Tunisia
| | - Ali Mrabet
- Doctor, Department of Epidemiology and Public Health, Faculty of Medicine of Tunis, Tunis, Tunisia
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Angermund A, Inglese G, Goldstine J, Iserloh L, Libutzki B. The burden of illness in initiating intermittent catheterization: an analysis of German health care claims data. BMC Urol 2021; 21:57. [PMID: 33827524 PMCID: PMC8028779 DOI: 10.1186/s12894-021-00814-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/17/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Intermittent catheterization (IC) is a common medical technique to drain urine from the bladder when this is no longer possible by natural means. The objective of this study was to evaluate the standard of care and the burden of illness in German individuals who perform intermittent catheterization and obtain recommendations for improvement of care. METHODS A descriptive study with a retrospective, longitudinal cohort design was conducted using the InGef research database from the German statutory health insurance claims data system. The study consisted of individuals with initial IC use in 2013-2015. RESULTS Within 3 years 1100 individuals with initial IC were identified in the database (~ 19,000 in the German population). The most common IC indications were urologic diseases, spinal cord injury, Multiple Sclerosis and Spina Bifida. Urinary tract infections (UTI) were the most frequent complication occurring 1 year before index (61%) and in follow-up (year 1 60%; year 2 50%). Resource use in pre-index including hospitalizations (65%), length of stay (12.8 ± 20.0 days), physician visits (general practitioner: 15.2 ± 29.1), prescriptions of antibiotics (71%) and healthcare costs (€17,950) were high. Comorbidities, complications, and healthcare resource use were highest 1 year before index, decreasing from first to second year after index. CONCLUSIONS The data demonstrated that prior to initial catheterization, IC users experienced UTIs and high healthcare utilization. While this demonstrates a potential high burden of illness prior to initial IC, UTIs also decreased over time, suggesting that IC use may have a positive influence. The findings also showed that after the first year of initial catheterization the cost decreased. Further studies are needed to better understand the extent of the burden for IC users compared to non-IC users.
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Affiliation(s)
| | - Gary Inglese
- Hollister Incorporated, 2000 Hollister Drive, Libertyville, IL, 60048-3781, USA
| | - Jimena Goldstine
- Hollister Incorporated, 2000 Hollister Drive, Libertyville, IL, 60048-3781, USA.
| | - Laura Iserloh
- HGC Healthcare Consultants GmbH, Düsseldorf, Germany
| | - Berit Libutzki
- HGC Healthcare Consultants GmbH, Düsseldorf, Germany
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Outcome of Different Approaches to Reduce Urinary Tract Infection in Patients With Spinal Cord Lesions: A Systematic Review. Am J Phys Med Rehabil 2020; 99:1056-1066. [PMID: 32149818 DOI: 10.1097/phm.0000000000001413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neurogenic bladder disorders are common among patients with spinal cord lesions, which often result in upper and lower urinary tract complications. Urinary tract infection has remained the most frequent type of infection in this population. Our aim is to review systematically the literature on the outcome of different intervention methods to reduce urinary tract infection incidence. A literature search was conducted in the database of Medline, PubMed, Embase, and Scopus. After screening 1559 articles, 42 were included in this review. The intervention methods can be categorized into the four following groups: (1) indwelling catheterization and intermittent catheterization, (2) medications, (3) surgery, and (4) others. Intermittent catheterization is still the most recommended treatment for persons with spinal cord lesions. Hydrophilic catheters are more suitable for adults than children because of complex handling. Bladder management with spontaneous voiding is initially considered for infants and toddlers with spina bifida. Antibiotics treatment should be based on the results of urine cultures. Shortening the course of antibiotics treatment can reduce its adverse effects but may increase urinary tract infection recurrence. Because botulinum toxin injections and bladder surgery can improve urodynamic function, both are conducive toward lowering urinary tract infection incidence.
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Pediatric Neurogenic Bladder and Bowel Dysfunction: Will My Child Ever Be out of Diapers? Eur Urol Focus 2020; 6:838-867. [PMID: 31982364 DOI: 10.1016/j.euf.2020.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 12/02/2019] [Accepted: 01/13/2020] [Indexed: 02/07/2023]
Abstract
CONTEXT Managing patient and parent expectations regarding urinary and fecal continence is important with congenital conditions that produce neurogenic bladder and bowel dysfunction. Physicians need to be aware of common treatment algorithms and expected outcomes to best counsel these families. OBJECTIVE To systematically evaluate evidence regarding the utilization and success of various modalities in achieving continence, as well as related outcomes, in children with neurogenic bladder and bowel dysfunction. EVIDENCE ACQUISITION We performed a systematic review of the literature in PubMed/Medline in August 2019. A total of 114 publications were included in the analysis, including 49 for bladder management and 65 for bowel management. EVIDENCE SYNTHESIS Children with neurogenic bladder conditions achieved urinary continence 50% of the time, including 44% of children treated with nonsurgical methods and 64% with surgical interventions. Patients with neurogenic bowel problems achieved fecal continence 75% of the time, including 78% of patients treated with nonsurgical methods and 73% with surgical treatment. Surgical complications and need for revisions were high in both categories. CONCLUSIONS Approximately half of children with neurogenic bladder dysfunction will achieve urinary continence and about three-quarters of children with neurogenic bowel dysfunction will become fecally continent. Surgical intervention can be successful in patients refractory to nonsurgical management, but the high complication and revision rates support their use as second-line therapy. This is consistent with guidelines issued by the International Children's Continence Society. PATIENT SUMMARY Approximately half of children with neurogenic bladder dysfunction will achieve urinary continence, and about three-quarters of children with neurogenic bowel dysfunction will become fecally continent. Most children can be managed without surgery. Patients who do not achieve continence with nonsurgical methods frequently have success with operative procedures, but complications and requirements for additional procedures must be expected.
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Bladder Self-management in the Transition to Adulthood With Spina Bifida in 3 Countries. J Wound Ostomy Continence Nurs 2019; 46:321-326. [DOI: 10.1097/won.0000000000000545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Context for Practice. J Wound Ostomy Continence Nurs 2019; 46:280-281. [DOI: 10.1097/won.0000000000000558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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: 49] [Impact Index Per Article: 9.8] [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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