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1.
Br J Nurs ; 33(9): S10-S15, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38722003

RESUMEN

Clean intermittent self-catheterisation is a common procedure undertaken by people with bladder dysfunction. However, it is not without its complications, the main one being urinary tract infection. The most common causes of urinary tract infections are poor hygiene, technique and adherence, excessive post-void residual urine and bladder trauma. A catheter with new Micro-hole Zone Technology has been developed, which can potentially improve bladder emptying and minimise these complications. A case study is used to illustrate its effects in practice.


Asunto(s)
Autocuidado , Humanos , Cateterismo Uretral Intermitente/instrumentación , Cateterismo Urinario/métodos , Cateterismo Urinario/instrumentación , Infecciones Urinarias/prevención & control , Diseño de Equipo , Catéteres Urinarios , Femenino , Masculino
2.
Br J Community Nurs ; 29(Sup5): S38-S40, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38728167

RESUMEN

Urinary leakage is prevalent in men. To contain and manage this leakage, men are often advised about urinary devices. However, sometimes this advice does not include penile sheaths. Penile sheaths are a good way of managing urinary leakage if an individual is suitable for sheaths. This article will explore this suitability, advantages to using a sheath, reasons why sheaths may not be suitable, and will discuss optimum fitting to ensure the sheath is a secure drainage device.


Asunto(s)
Incontinencia Urinaria , Humanos , Masculino , Incontinencia Urinaria/enfermería , Incontinencia Urinaria/terapia , Cateterismo Urinario/enfermería , Cateterismo Urinario/instrumentación , Cateterismo Urinario/efectos adversos , Pene , Catéteres Urinarios/efectos adversos
3.
Br J Community Nurs ; 29(Sup5): S16-S22, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38728166

RESUMEN

When an individual has voiding difficulties, the person may require a urinary catheter. Enabling the person to choose an appropriate method of catheterisation and supporting them can have an enormous impact on the individual's health and wellbeing. Indwelling urethral catheters are suitable for some people but for others they can affect a person's lifestyle and lead to depression. Intermittent catheterisation can work well for some people. Intermittent self-catheterisation has been used to manage urinary retention for over 3500 years. It remains the 'gold standard' in terms of bladder drainage, but it is under-used and indwelling catheters remain more common. This article examines the history of intermittent catheterisation, indications for self-catheterisation and how to support people to use self-catheterisation.


Asunto(s)
Cateterismo Uretral Intermitente , Autocuidado , Cateterismo Urinario , Retención Urinaria , Humanos , Retención Urinaria/terapia , Retención Urinaria/enfermería , Cateterismo Urinario/enfermería , Catéteres de Permanencia , Catéteres Urinarios , Masculino
4.
Adv Skin Wound Care ; 37(6): 329-335, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38767425

RESUMEN

OBJECTIVE: Urinary catheter-related meatal pressure injury (UCR-MPI) is a preventable and serious complication of indwelling urinary catheter use. This prospective study aimed to determine the prevalence and risk factors of UCR-MPI in male critical care patients. METHODS: A total of 138 male patients 18 years and older using an indwelling urinary catheter were included in the study. Participants' perineal areas were assessed daily for the development of MPI. RESULTS: The UCR-MPI prevalence was 26.1% (n = 36/138). Most patients (61.1%) had a grade I UCR-MPI with intact skin and mucosa and nonblanchable erythema. Urinary catheter irrigation (P = .001), lower Braden Scale scores (P = .040), lower Glasgow Coma Scale score (P = .002), higher Itaki Fall Risk Scale score (P = .040), higher dependency level (P = .027), hypoalbuminemia (P = .002), and perineal edema (P = .001) were risk factors for UCR-MPI. CONCLUSIONS: The prevalence of UCR-MPI was high in this sample. Providers should take preventive measures to prevent UCR-MPI in patients with a penis including early and frequent risk assessment.


Asunto(s)
Úlcera por Presión , Cateterismo Urinario , Humanos , Masculino , Estudios Prospectivos , Úlcera por Presión/epidemiología , Úlcera por Presión/prevención & control , Úlcera por Presión/etiología , Persona de Mediana Edad , Factores de Riesgo , Cateterismo Urinario/efectos adversos , Anciano , Adulto , Cuidados Críticos/métodos , Catéteres Urinarios/efectos adversos , Catéteres de Permanencia/efectos adversos , Prevalencia , Medición de Riesgo/métodos
5.
Low Urin Tract Symptoms ; 16(3): e12515, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38693055

RESUMEN

OBJECTIVES: To investigate factors associated with symptomatic urinary tract infection (sUTI) in persons with chronic spinal cord lesion (SCL) who were using single-use catheters for intermittent self-catheterization (ISC). METHODS: Among respondents to an internet survey on the burden of illness on persons with SCL who were considered to be able to perform ISC, 111 persons using single-use catheters were included to examine factors associated with self-reported sUTI by univariate as well as multivariable analysis. RESULTS: The incidence of sUTI was significantly higher in males than in females (56.9% vs. 31.6%, p = .011), persons with stocks of antibiotics than those without it (82.9% vs. 28.6%, p < .011), and persons with more frequent bleeding during catheterization than those with less frequent bleeding (100% vs. 46.5%, p = .036). The incidence did not significantly differ between respective groups when various variables were evaluated by other characteristics of the participants, adherence to ISC procedures, and complications. On multivariable analysis, male gender and stocks of antibiotics were significant independent factors for sUTI. CONCLUSIONS: Male gender and stocks of antibiotics were associated with sUTI in persons with SCL who were performing ISC with single-use catheters.


Asunto(s)
Antibacterianos , Cateterismo Uretral Intermitente , Traumatismos de la Médula Espinal , Infecciones Urinarias , Humanos , Masculino , Femenino , Infecciones Urinarias/etiología , Infecciones Urinarias/epidemiología , Persona de Mediana Edad , Adulto , Cateterismo Uretral Intermitente/efectos adversos , Cateterismo Uretral Intermitente/instrumentación , Traumatismos de la Médula Espinal/complicaciones , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Incidencia , Factores Sexuales , Catéteres Urinarios/efectos adversos , Factores de Riesgo , Anciano , Cateterismo Urinario/efectos adversos , Cateterismo Urinario/instrumentación
6.
J Korean Med Sci ; 39(18): e151, 2024 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-38742291

RESUMEN

BACKGROUND: Catheter-associated urinary tract infections (CAUTIs) account for a large proportion of healthcare-associated infections and have a significant impact on morbidity, length of hospital stay, and mortality. Adherence to the recommended infection prevention practices can effectively reduce the incidence of CAUTIs. This study aimed to assess the characteristics of CAUTIs and the efficacy of prevention programs across hospitals of various sizes. METHODS: Intervention programs, including training, surveillance, and monitoring, were implemented. Data on the microorganisms responsible for CAUTIs, urinary catheter utilization ratio, rate of CAUTIs per 1,000 device days, and factors associated with the use of indwelling catheters were collected from 2017 to 2019. The incidence of CAUTIs and associated data were compared between university hospitals and small- and medium-sized hospitals. RESULTS: Thirty-two hospitals participated in the study, including 21 university hospitals and 11 small- and medium-sized hospitals. The microorganisms responsible for CAUTIs and their resistance rates did not differ between the two groups. In the first quarter of 2018, the incidence rate was 2.05 infections/1,000 device-days in university hospitals and 1.44 infections/1,000 device-days in small- and medium-sized hospitals. After implementing interventions, the rate gradually decreased in the first quarter of 2019, with 1.18 infections/1,000 device-days in university hospitals and 0.79 infections/1,000 device-days in small- and medium-sized hospitals. However, by the end of the study, the infection rate increased to 1.74 infections/1,000 device-days in university hospitals and 1.80 infections/1,000 device-days in small- and medium-sized hospitals. CONCLUSION: We implemented interventions to prevent CAUTIs and evaluated their outcomes. The incidence of these infections decreased in the initial phases of the intervention when adequate support and personnel were present. The rate of these infections may be reduced by implementing active interventions such as consistent monitoring and adherence to guidelines for preventing infections.


Asunto(s)
Infecciones Relacionadas con Catéteres , Infecciones Urinarias , Humanos , Infecciones Urinarias/prevención & control , Infecciones Urinarias/epidemiología , Infecciones Relacionadas con Catéteres/prevención & control , Infecciones Relacionadas con Catéteres/epidemiología , Infección Hospitalaria/prevención & control , Infección Hospitalaria/epidemiología , Incidencia , Control de Infecciones/métodos , Cateterismo Urinario/efectos adversos , Catéteres de Permanencia/efectos adversos , Hospitales Universitarios , Catéteres Urinarios/efectos adversos
7.
Medicine (Baltimore) ; 103(15): e37623, 2024 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-38608084

RESUMEN

OBJECTIVE: To emphasize preventive measures and outline management strategies for inadvertent ureteral cannulation. METHODS: We present a case report and conduct a literature review of 39 case reports on ureteral cannulation, examining a total of 48 patients. RESULTS: About 67% of the cases were female, and long-term catheterization was observed in 67% of the cases. Neurological conditions such as spinal cord injury (SCI), stroke, dementia, multiple sclerosis, and myasthenia gravis were the primary factors (48%) in ureteral cannulation. Symptoms included flank pain (46%), fever (31%), oliguria (27%), non-deflatable balloon issues (25%), hematuria (21%), abdominal pain (17%), urine leak (12.5%), and nausea/vomiting (8%). Complications varied, including acute pyelonephritis (35%), acute kidney injury (27%), urosepsis (21%), and ureter rupture (17%). Despite inadvertent catheter placement, 25% of patients had no complications. More than half of the patients (58%) were managed through catheter change, while 27% underwent cysto-ureteroscopy with or without balloon puncture or ureteral stenting. Additionally, 10% received interventional radiology procedures, 6.25% underwent surgical repair, and 4% underwent ultrasound-guided balloon puncture. CONCLUSIONS: Female gender, neurologic conditions, and long-term catheterization were identified as predominant risk factors. Early detection of ureteral cannulation can prevent severe complications, particularly in certain special populations such as patients with neurogenic bladder or SCI, who may have reduced sensation and expression capabilities.


Asunto(s)
Uréter , Humanos , Femenino , Masculino , Catéteres Urinarios/efectos adversos , Punciones , Ureteroscopía , Hematuria
8.
Urologiia ; (1): 35-40, 2024 Mar.
Artículo en Ruso | MEDLINE | ID: mdl-38650404

RESUMEN

AIM: To evaluate the effect of antibacterial prophylaxis using oral fosfomycin during the removal of a urethral catheter after radical prostatectomy on the development of urinary tract infection, severity of leukocyturia and bacteriuria, as well as the severity of lower urinary tract symptoms. MATERIALS AND METHODS: A single-center, non-blind, prospective, randomized controlled trial was carried out. The main group included 40 patients, and the control group included 37 patients. In the group 1, patients received two doses of oral fosfomycin, 3 g, namely in the evening on the day of catheter removal (the first dose) and 48 hours after catheter removal (the second dose). In the group 2, patients did not receive any antibacterial prophylaxis after urethral catheter removal. The endpoints of the study were confirmed episodes of urinary tract infection within 1 month after removal of the urethral catheter, leukocyturia and bacteriuria in urinalysis/urine culture) and severity of the lower urinary tract symptoms assessed by IPSS questionnaire. RESULTS: In the group 2, urinary tract infection was noted in 17.1%, while in the group 2 only in 2.6% of patients (p=0.032). Leukocyturia and bacteriuria were significantly less common in the group receiving antibacterial prophylaxis with fosfomycin (18.4% vs. 48.6%, respectively; p=0.006). Positive urine culture was observed in 7.9% vs. 25.7%, respectively (p=0.035). Four weeks after removal of the urethral catheter, the average IPSS score was significantly higher in the group 2 (13.2 vs. 9.5 points; p=0.002). There were no cases of allergic reaction and pseudomembranous colitis associated with C. difficile in both groups. Diarrhea cured with sorbents was noted in 2 patients (5.2%) in fosfomycin group. CONCLUSION: Antibacterial prophylaxis using two oral doses of fosfomycin 3 g on the day of urethral catheter removal and 48 hours after catheter removal after radical prostatectomy appears to be an effective scheme that reduces the incidence of urinary tract infection and the severity of lower urinary tract symptoms, and is characterized by a minimal risk of adverse events. It is necessary to carried out further research and develop clear recommendations for antibacterial prevention in urological interventions requiring prolonged urethral catheterization.


Asunto(s)
Antibacterianos , Profilaxis Antibiótica , Fosfomicina , Prostatectomía , Catéteres Urinarios , Infecciones Urinarias , Humanos , Fosfomicina/administración & dosificación , Fosfomicina/uso terapéutico , Masculino , Prostatectomía/efectos adversos , Prostatectomía/métodos , Persona de Mediana Edad , Infecciones Urinarias/prevención & control , Anciano , Estudios Prospectivos , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Catéteres Urinarios/efectos adversos , Profilaxis Antibiótica/métodos , Cateterismo Urinario/efectos adversos , Remoción de Dispositivos
9.
Infect Dis Clin North Am ; 38(2): 343-360, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38599895

RESUMEN

This narrative review explores the use of external urinary catheters. These devices are available in various types and materials for male and female patients. The indications for the use of external urinary catheters include managing incontinence linked to overactive bladder and neurogenic lower urinary tract dysfunction. Contraindications to the use of external urinary catheters include urinary obstruction. Proper skin care and proactive infection control measures are necessary to prevent complications. The collection of a urine specimen for culture requires a standardized technique to prevent contamination. Clinician-led patient education on catheter management plays a important role in ensuring patient comfort and safety.


Asunto(s)
Infecciones Relacionadas con Catéteres , Catéteres Urinarios , Infecciones Urinarias , Humanos , Catéteres Urinarios/efectos adversos , Infecciones Urinarias/prevención & control , Infecciones Urinarias/terapia , Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Urinario/efectos adversos , Cateterismo Urinario/métodos , Cateterismo Urinario/instrumentación , Masculino , Femenino , Control de Infecciones/métodos
11.
Urol Clin North Am ; 51(2): 253-262, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38609197

RESUMEN

Urinary catheters have been used for more than 3000 years, although materials have changed from wood to silver to rubber. Research continues to try and find the optimal catheter materials, which improve safety and quality of life. Advantages when comparing newer catheter materials are not always obvious but catheters coated with a hydrophilic layer may reduce urethral trauma and the incidence of urinary tract infections. However, extrapolation of the data is limited by lack of end-point standardization and heterogenous populations.


Asunto(s)
Calidad de Vida , Catéteres Urinarios , Humanos , Catéteres Urinarios/efectos adversos , Uretra
12.
Cir. pediátr ; 37(2): 79-83, Abr. 2024. tab, graf
Artículo en Español | IBECS | ID: ibc-232270

RESUMEN

Introducción: Existen numerosas alternativas en lo que respecta alos cuidados postoperatorios en la cirugía de hipospadias. El objetivo deeste estudio es evaluar la situación actual de estos cuidados en nuestromedio y revisar la evidencia existente al respecto para cirujanos pediátricos que realizan este tipo de intervenciones. Material y métodos: Hemos elaborado y distribuido una encuestaque recoge los principales puntos en el cuidado postoperatorio del hipospadias dirigida a cirujanos pediátricos. Se ha realizado revisión dela evidencia actual publicada al respecto en la especialidad.Resultados: Hemos obtenido un total de 46 respuestas. El 100% delos cirujanos dejan algún tipo de sonda o stent y más del 80% están deacuerdo en retirarlo tras 5 o 7 días. El 87,8% de los encuestados utilizael doble pañal, pero solo el 65,2% da alta precoz en el postoperatorio.Un 60,9% pauta profilaxis antibiótica mientras dure el sondaje y un34,8% antibioterapia a dosis plenas. Discusión: Existe consenso general respecto a la tutorización de lauretroplastia y el uso de apósito compresivo entre los cirujanos pediátricos encuestados. Se detectan más discrepancias en el uso de antibioterapia y el alta precoz. La evidencia actual y la práctica a nivel internacional apunta hacia el uso de la sonda a doble pañal con alta precozy la limitación del uso de antibióticos postoperatorios. En ausencia declara evidencia que favorezca un tipo de cuidado u otro, la experienciadel paciente podría ser utilizada para elegir el mejor protocolo postoperatorio individualizado.(AU)


Introduction: There are many alternatives available regarding postoperative care in hypospadias surgery. The objective of this study wasto assess the current care situation in our environment and to review theevidence available for pediatric surgeons who conduct this procedure. Materials and methods. A survey regarding the main aspects ofhypospadias postoperative care was created and distributed to pediatricsurgeons. In addition, the evidence currently published in this field wasreviewed. Results: A total of 46 replies were achieved. 100% of the surgeonsleave in place a probe or stent, and more than 80% remove it after 5 or7 days. 87.8% of the respondents use a double diaper, but only 65.2%discharge patients early in the postoperative period. 60.9% prescribeantibiotic prophylaxis for as long as the probe remains in place, and34.8% use full-dose antibiotic therapy. Discussion: There was a general consensus regarding urethroplastyguiding and the use of compression dressings among the pediatric surgeons surveyed. However, more discrepancies were found in the use ofantibiotic therapy and early discharge. The currently available evidenceand international practice suggest using a probe with double diaperand early discharge, with postoperative antibiotics being limited. Inthe absence of clear evidence for a specific care type, the patient’sexperience could be used to choose the best postoperative protocol onan individual basis.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Cuidados Posoperatorios , Hipospadias , Enfermedades del Recién Nacido , Catéteres Urinarios , Profilaxis Antibiótica , Pediatría , Cirugía General , Encuestas y Cuestionarios
14.
BJU Int ; 133(6): 638-645, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38438065

RESUMEN

OBJECTIVE: To explore the data comparing single- vs multi-use catheters for clean intermittent catheterisation (CIC), consider if the widespread use of single-use catheters is warranted given the cost and environmental impact, and put forth ideas for future consideration. METHODS: A primary literature review was performed in PubMed over the past 50 years. Studies that performed comparative analysis of single- and multi-use catheters were included in our review. All studies that reported on primary data were narratively summarised. RESULTS: A total of 11 studies were identified that reported on primary data comparing single- and multi-use catheters. There was no appreciable evidence suggesting reusable multi-use catheters were inferior to single-use catheters from an infection or usability standpoint. In addition, the environmental and monetary burden of single-use catheters is significant. CONCLUSIONS: The intermittent catheter landscape in the USA has a complex past: defined by policy, shaped by industry, yet characterised by a paucity of data demonstrating superiority of single-use over multi-use catheters. We believe that the aversion to reusable catheters by many patients and healthcare professionals is unwarranted, especially given the cost and environmental impact. Moving forward, better comparative data and more sustainable practices are needed.


Asunto(s)
Equipo Reutilizado , Humanos , Equipo Reutilizado/economía , Equipos Desechables/economía , Ambiente , Catéteres Urinarios , Cateterismo Uretral Intermitente/instrumentación
15.
Am J Obstet Gynecol ; 230(3S): S696-S715, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38462253

RESUMEN

OBJECTIVE: Several systematic reviews and meta-analyses have been conducted to summarize the evidence for the efficacy of various labor induction agents. However, the most effective agents or strategies have not been conclusively determined. We aimed to perform a meta-review and network meta-analysis of published systematic reviews to determine the efficacy and safety of currently employed pharmacologic, mechanical, and combined methods of labor induction. DATA SOURCES: With the assistance of an experienced medical librarian, we performed a systematic search of the literature using PubMed, EMBASE, and the Cochrane Central Register of Control Trials. We systematically searched electronic databases from inception to May 31, 2021. STUDY ELIGIBILITY CRITERIA: We considered systematic reviews and meta-analyses of randomized controlled trials comparing different agents or methods for inpatient labor induction. METHODS: We conducted a frequentist random-effects network meta-analysis employing data from randomized controlled trials of published systematic reviews. We performed direct pairwise meta-analyses to compare the efficacy of the various labor induction agents and placebo or no treatment. We performed ranking to determine the best treatment using the surface under the cumulative ranking curve. The main outcomes assessed were cesarean delivery, vaginal delivery within 24 hours, operative vaginal delivery, hyperstimulation, neonatal intensive care unit admissions, and Apgar scores of <7 at 5 minutes of birth. RESULTS: We included 11 systematic reviews and extracted data from 207 randomized controlled trials with a total of 40,854 participants. When assessing the efficacy of all agents and methods, the combination of a single-balloon catheter with misoprostol was the most effective in reducing the odds of cesarean delivery and vaginal birth >24 hours (surface under the cumulative ranking curve of 0.9 for each). Among the pharmacologic agents, low-dose vaginal misoprostol was the most effective in reducing the odds of cesarean delivery, whereas high-dose vaginal misoprostol was the most effective in achieving vaginal delivery within 24 hours (surface under the cumulative ranking curve of 0.9 for each). Single-balloon catheter (surface under the cumulative ranking curve of 0.8) and double-balloon catheter (surface under the cumulative ranking curve of 0.9) were the most effective in reducing the odds of operative vaginal delivery and hyperstimulation. Buccal or sublingual misoprostol (surface under the cumulative ranking curve of 0.9) and the combination of single-balloon catheter and misoprostol (surface under the cumulative ranking curve of 0.9) most effectively reduced the odds of abnormal Apgar scores and neonatal intensive care unit admissions. CONCLUSION: The combination of a single-balloon catheter with misoprostol was the most effective method in reducing the odds for cesarean delivery and prolonged time to vaginal delivery. This method was associated with a reduction in admissions to the neonatal intensive care unit.


Asunto(s)
Misoprostol , Oxitócicos , Embarazo , Femenino , Recién Nacido , Humanos , Misoprostol/uso terapéutico , Oxitócicos/uso terapéutico , Metaanálisis en Red , Trabajo de Parto Inducido/métodos , Catéteres Urinarios
16.
J Am Geriatr Soc ; 72(4): 1166-1176, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38401032

RESUMEN

BACKGROUND: Prior studies indicated a link between urinary catheter use and urinary complications, highlighting the need for comprehensive, gender-specific investigations. This study explored the association through a national retrospective cohort, emphasizing gender disparities and long-term outcomes. METHODS: Our study utilized data from the entire population covered by Taiwan's National Health Insurance Research Database from 2000 to 2017. We included 148,304 patients who had undergone Foley catheter placement and their propensity-scores matched controls in the study. We evaluated urinary complications, which encompassed urinary tract cancer, urolithiasis, urethral stricture, obstructive uropathy, reflux uropathy, fistula, diverticulum, caruncle, false passage, prolapsed urethral mucosa, urinary tract rupture, and urinary tract infection. These were assessed using the Fine and Gray sub-distribution proportional hazards model to compare between the Foley and non-Foley groups. Sensitivity analyses were conducted with different matching ratios. RESULTS: In the study, the non-Foley group presented a marginally higher mean age (75.24 ± 10.47 years) than the Foley group (74.09 ± 10.47 years). The mean duration of Foley catheterization was 6.1 ± 4.19 years. Men with Foley catheterization exhibited the highest adjusted sub-distribution hazard ratios for urinary tract cancer (6.57, 95% CI: 5.85-7.37), followed by women with Foley catheterization (4.48, 95% CI: 3.98-5.05), and men without catheterization (1.58, 95% CI: 1.39-1.8) in comparison with women without the procedure. Furthermore, men with Foley catheterization were found to be at the greatest risk for complications such as urolithiasis, urethral stricture, obstructive and reflux uropathy, fistula, diverticulum, caruncle, false passage, prolapsed urethral mucosa, and urinary tract rupture. Conversely, women with urinary catheterization were most susceptible to urinary tract infections. CONCLUSIONS: The evidence confirms that urinary catheterization significantly increases urinary complications, particularly among men. Our study underscores the crucial need for healthcare providers to carefully evaluate the necessity of catheterization, aim to shorten its duration whenever feasible, and strictly adhere to established protocols to minimize complications.


Asunto(s)
Divertículo , Fístula , Estrechez Uretral , Infecciones Urinarias , Sistema Urinario , Urolitiasis , Neoplasias Urológicas , Masculino , Humanos , Femenino , Anciano , Anciano de 80 o más Años , Cateterismo Urinario/efectos adversos , Catéteres Urinarios/efectos adversos , Catéteres de Permanencia/efectos adversos , Estrechez Uretral/etiología , Estrechez Uretral/complicaciones , Estudios Retrospectivos , Infecciones Urinarias/epidemiología , Infecciones Urinarias/etiología , Urolitiasis/complicaciones , Neoplasias Urológicas/complicaciones , Divertículo/complicaciones , Fístula/complicaciones
17.
Urogynecology (Phila) ; 30(6): 550-556, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38373241

RESUMEN

IMPORTANCE: In-office postoperative voiding trials (VTs) increase health care burden for patients and physicians. Adoption of an at-home VT option may decrease burden without increasing adverse events postoperatively. OBJECTIVE: The purpose of this study was to compare 30-day postoperative outcomes between participants who performed an at-home autofill VT after catheter self-discontinuation during the Assessing Healthcare Utilization and Feasibility of Transurethral Catheter Self-discontinuation (FLOTUS) study and a "historic" control cohort of patients who presented to the office for backfill-assisted VT on postoperative day (POD) 1. STUDY DESIGN: This was a retrospective cohort study of women with postoperative urinary retention after urogynecologic surgery between June 2020 and March 2022. Outcomes from the FLOTUS study were compared with a "historic" control cohort of patients that were identified on chart review from the year before FLOTUS initiation. Demographic, medical history, and procedure-related data were collected. Thirty-day outcome data included office calls/messages, office visits, emergency department visits, complications, and catheterization outcomes. RESULTS: Forty-six participants were included in the FLOTUS cohort and 65 participants in the historic cohort. There was no difference in the POD1 VT pass rate, number of office calls/messages, emergency department visits, or postoperative complications between the 2 cohorts. The FLOTUS patients attended 1 less office visit (1 vs 2 office visits, P <0.001), and this difference persisted on regression analysis (-0.87 office visits; 95% CI, -1.18 to -0.56, P <0.001). CONCLUSION: Patients who had backfill-assisted VTs on POD1 attended 1 additional office visit compared with those who removed their catheters at home.


Asunto(s)
Remoción de Dispositivos , Complicaciones Posoperatorias , Cateterismo Urinario , Retención Urinaria , Humanos , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Anciano , Remoción de Dispositivos/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Retención Urinaria/etiología , Retención Urinaria/epidemiología , Cateterismo Urinario/efectos adversos , Cateterismo Urinario/estadística & datos numéricos , Procedimientos Quirúrgicos Ginecológicos/efectos adversos , Catéteres Urinarios/efectos adversos , Autocuidado
18.
Rev. esp. quimioter ; 37(1): 1-6, Feb. 2024. tab
Artículo en Inglés | IBECS | ID: ibc-230418

RESUMEN

The incidence and recent trends of candidemia and the contribution of the COVID-19 pandemic to its evolution are not well documented. The catheter is a major focus of Candida spp. infections, but the methods used to confirm the origin of candidemia are still based on the data generated for bacterial infection. The presence of Candida spp. on the tip of a removed catheter is the gold standard for confirmation but it is not always possible to remove it. Conservative methods, without catheter removal, have not been specifically studied for microorganisms whose times of growth are different from those of bacteria and therefore these results are not applicable to candidemia. The different Candida species do not have a particular tropism for catheter colonization and fungal biomarkers have not yet been able to contribute to the determination of the origin of candidemia. Techniques such Candida T2 Magnetic Resonance (T2MR) has not yet been applied for this purpose. Finally, there is not yet a consensus of how to proceed when Candida spp. is isolated from an extracted catheter and blood cultures obtained from simultaneous peripheral veins are negative. In this lack of firm data, a group of experts has formulated a series of questions trying to answer them based on the literature, indicating the current deficiencies and offering their own opinion. All authors agree with the conclusions of the manuscript and offer it as a position and discussion paper. (AU)


La incidencia y las tendencias recientes de la candidemia y la contribución de la pandemia de COVID-19 a su evolución no están bien documentadas. El catéter es uno de los principales focos de infecciones por Candida spp., pero los métodos empleados para confirmar el origen de la candidemia siguen basándose en los datos generados para la infección bacteriana. La presencia de Candida spp. en la punta de un catéter retirado es el método de referencia para la confirmación, pero no siempre es posible proceder a dicha retirada. Los métodos conservadores, sin retirada del catéter, no han sido estudiados específicamente para microorganismos cuyos tiempos de crecimiento son diferentes a los de las bacterias y, por tanto, estos resultados no son aplicables a la candidemia. Las diferentes especies de Candida spp. no tienen un tropismo particular para la colonización del catéter y los biomarcadores fúngicos, aún no han podido contribuir a la determinación del origen de la candidemia. Técnicas como la resonancia magnética T2MR todavía no se ha empleado para este fin. Por último, todavía no existe un consenso sobre cómo proceder cuando se aísla Candida spp. en un catéter extraído y los hemocultivos obtenidos por venas periféricas simultáneas son negativos. Ante esta falta de datos firmes, un grupo de expertos ha formulado una serie de preguntas y ha tratado de responderlas en base a la literatura, indicando las carencias presentes y ofreciendo su propia opinión. Todos los autores están de acuerdo con las conclusiones del manuscrito y lo ofrecen como documento de posición y discusión. (AU)


Asunto(s)
Humanos , Candidemia/diagnóstico , Candidemia/tratamiento farmacológico , Candidemia/terapia , Catéteres Urinarios/efectos adversos
19.
J Biomed Mater Res B Appl Biomater ; 112(2): e35372, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38359168

RESUMEN

More than 70% of hospital-acquired urinary tract infections are related to urinary catheters, which are commonly used for the treatment of about 20% of hospitalized patients. Urinary catheters are used to drain the bladder if there is an obstruction in the tube that carries urine out of the bladder (urethra). During catheter-associated urinary tract infections, microorganisms rise up in the urinary tract and reach the bladder, and cause infections. Various materials are used to fabricate urinary catheters such as silicone, polyurethane, and latex. These materials allow bacteria and fungi to develop colonies on their inner and outer surfaces, leading to bacteriuria or other infections. Urinary catheters could be modified to exert antibacterial and antifungal effects. Although so many research have been conducted over the past years on the fabrication of antibacterial and antifouling catheters, an ideal catheter needs to be developed for long-term catheterization of more than a month. In this review, we are going to introduce the recent advances in fabricating antibacterial materials to prevent catheter-associated urinary tract infections, such as nanoparticles, antibiotics, chemical compounds, antimicrobial peptides, bacteriophages, and plant extracts.


Asunto(s)
Bacteriuria , Infecciones Urinarias , Humanos , Catéteres Urinarios/efectos adversos , Infecciones Urinarias/prevención & control , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/etiología , Antibacterianos/uso terapéutico , Bacteriuria/complicaciones , Bacteriuria/tratamiento farmacológico , Bacteriuria/prevención & control , Vejiga Urinaria , Cateterismo Urinario
20.
Curr Microbiol ; 81(4): 100, 2024 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-38372801

RESUMEN

This study aimed to assess the activity of AgNPs biosynthesized by Fusarium oxysporum (bio-AgNPs) against multidrug-resistant uropathogenic Proteus mirabilis, and to assess the antibacterial activity of catheters coated with bio-AgNPs. Broth microdilution and time-kill kinetics assays were used to determine the antibacterial activity of bio-AgNPs. Catheters were coated with two (2C) and three (3C) bio-AgNPs layers using polydopamine as crosslinker. Catheters were challenged with urine inoculated with P. mirabilis to assess the anti-incrustation activity. MIC was found to be 62.5 µmol l-1, causing total loss of viability after 4 h and bio-AgNPs inhibited biofilm formation by 76.4%. Catheters 2C and 3C avoided incrustation for 13 and 20 days, respectively, and reduced biofilm formation by more than 98%, while the pristine catheter was encrusted on the first day. These results provide evidence for the use of bio-AgNPs as a potential alternative to combat of multidrug-resistant P. mirabilis infections.


Asunto(s)
Nanopartículas del Metal , Mirabilis , Catéteres Urinarios , Proteus mirabilis , Plata/farmacología , Antibacterianos/farmacología
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