RESUMO
Our objective was to determine which clean intermittent catheterization (CIC) methods and supplies were used by patients with pediatric onset neurogenic bladders and to relate methodology and materials to reported urinary tract infections. Data were collected via questionnaires distributed by mail and at clinic visits at our university tertiary care outpatient pediatric rehabilitation clinic. Questionnaires were given to 165 patients. Fifty-nine percent were returned (68 patients with myelomeningocele, 27 with pediatric onset spinal cord injury (SCI) and two with other diagnoses). Mean age was 12 years (range 1-27). Fifty-four percent of patients participated in their own CIC. Only two percent used sterile catheterization technique, whereas 98 percent used CIC. A sterile catheter was employed with clean technique by 22 percent. Catheters were reused by 76 percent. Subjects used a wide ranging number of catheters per month, with a median of 5.3. There was no correlation between the number of urinary tract infections (UTIs) per year and the type of catheter used or the use of prophylactic antibiotics. Compared with patients with myelomeningocele, subjects with SCI were significantly more likely to use sterile catheters (p = 0.04), > 10 catheters per month (p = 0.01) and gloves (p < 0.001). Subjects who used gloves or more catheters were more likely to experience UTI. These data suggest that clean reused supplies are not related to an increased likelihood of UTI and should be considered a way to lower costs in these populations.
Assuntos
Bexiga Urinaria Neurogênica/epidemiologia , Bexiga Urinaria Neurogênica/terapia , Infecções Urinárias/etiologia , Adolescente , Adulto , Idade de Início , Cateterismo , Criança , Pré-Escolar , Hipersensibilidade a Drogas/etiologia , Feminino , Humanos , Incidência , Lactente , Reembolso de Seguro de Saúde , Látex/imunologia , Masculino , Meningomielocele/complicações , Traumatismos da Medula Espinal/complicações , Bexiga Urinaria Neurogênica/etiologia , Cateterismo Urinário/efeitos adversos , Cateterismo Urinário/instrumentação , Cateterismo Urinário/métodos , Infecções Urinárias/epidemiologiaRESUMO
Tissue engineering, long a matter of myth and dream throughout the history of medicine, is now a practical reality. A wide spectrum of biological materials are used in the field of urology to treat disease and to overcome human disabilities, including tissue grafts and organ transplantation. Laboratory-engineered bioproducts for the off-the-shelf replacement and reconstruction of tissue is now almost at hand. This article presents a glimpse into the past by highlighting a number of early pioneering works in the field of tissue transplantation and cell culture technologies.