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1.
Sci Rep ; 14(1): 15035, 2024 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-38951580

RESUMO

Intermittent catheterization (IC) utilizing conventional eyelets catheters (CECs) for bladder drainage has long been the standard of care. However, when the tissue of the lower urinary tract comes in close proximity to the eyelets, mucosal suction often occurs, resulting in microtrauma. This study investigates the impact of replacing conventional eyelets with a drainage zone featuring multiple micro-holes, distributing pressure over a larger area. Lower pressures limit the suction of surrounding tissue into these micro-holes, significantly reducing tissue microtrauma. Using an ex vivo model replicating the intra-abdominal pressure conditions of the bladder, the intra-catheter pressure was measured during drainage. When mucosal suction occurred, intra-catheter images were recorded. Subsequently affected tissue samples were investigated histologically. The negative pressure peaks caused by mucosal suction were found to be very high for the CECs, leading to exfoliation of the bladder urothelium and breakage of the urothelial barrier. However, a micro-hole zone catheter (MHZC) with a multi-eyelet drainage zone showed significantly lower pressure peaks, with over 4 times lower peak intensity, thus inducing far less extensive microtraumas. Limiting or even eliminating mucosal suction and resulting tissue microtrauma may contribute to safer catheterizations in vivo and increased patient comfort and compliance.


Assuntos
Bexiga Urinária , Cateteres Urinários , Cateteres Urinários/efeitos adversos , Animais , Humanos , Pressão , Mucosa/lesões , Suínos , Sistema Urinário , Cateterismo Uretral Intermitente , Sucção , Urotélio , Cateterismo Urinário/efeitos adversos , Cateterismo Urinário/métodos , Cateterismo Urinário/instrumentação
2.
BMC Urol ; 24(1): 122, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867233

RESUMO

BACKGROUND: Neurogenic bladder dysfunction is a major problem for spinal cord injury (SCI) patients not only due to the risk of serious complications but also because of the impact on quality of life. The main aim of this study is to compare the rate of urinary tract infection (UTI) associated with hydrophilic-coated catheters versus uncoated polyvinyl chloride (PVC) catheters among SCI patients presenting with functional neurogenic bladder sphincter disorders. METHODOLOGY: This was a retrospective cohort study from 2005 to 2020 including adult male or female patients who have an SCI at least more than 1 month ago with neurogenic bladder dysfunction and were using intermittent catheterization (single-use hydrophilic-coated or the standard-of-care polyvinyl chloride uncoated standard catheters) at least 3 times a day to maintain bladder emptying. RESULTS: A total of 1000 patients were selected and recruited through a stratified random sampling technique with 467 (47.60%) patients in the uncoated catheter arm and 524 (52.60%) in the coated catheter groups. The three outcome measures, namely: symptomatic UTI, Bacteriuria, and pyuria were significantly higher in the group using uncoated polyvinyl chloride (PVC) catheters compared to hydrophilic-coated catheters at the rate of 79.60% vs.46.60%, 81.10% vs. 64.69, and 53.57% versus 41.79% respectively. Males, elder patients, longer duration, and severity of SCI were associated with increased risk of symptomatic UTI. CONCLUSIONS: The results indicate a beneficial effect regarding clinical UTI when using hydrophilic-coated catheters in terms of fewer cases of symptomatic UTI. Bacteriuria is inevitable in patients with long-term catheterization, however, treatment should not be started unless the clinical symptoms exist. More attention should be given to the high-risk group for symptomatic UTIs.


Assuntos
Traumatismos da Medula Espinal , Bexiga Urinaria Neurogênica , Infecções Urinárias , Humanos , Estudos Retrospectivos , Traumatismos da Medula Espinal/complicações , Masculino , Feminino , Infecções Urinárias/etiologia , Infecções Urinárias/epidemiologia , Pessoa de Meia-Idade , Adulto , Cateteres Urinários/efeitos adversos , Cateterismo Uretral Intermitente/efeitos adversos , Interações Hidrofóbicas e Hidrofílicas , Cloreto de Polivinila , Estudos de Coortes , Idoso , Cateterismo Urinário/efeitos adversos , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/etiologia
3.
Trials ; 25(1): 422, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38943177

RESUMO

BACKGROUND: Bladder dysfunction, notably urinary retention, emerges as a significant complication for cervical cancer patients following radical hysterectomy, predominantly due to nerve damage, severely impacting their postoperative quality of life. The challenges to recovery include insufficient pelvic floor muscle training and the negative effects of prolonged postoperative indwelling urinary catheters. Intermittent catheterization represents the gold standard for neurogenic bladder management, facilitating bladder training, which is an important behavioral therapy aiming to enhance bladder function through the training of the external urethral sphincter and promoting the recovery of the micturition reflex. Nevertheless, gaps remain in current research regarding optimal timing for intermittent catheterization and the evaluation of subjective symptoms of bladder dysfunction. METHODS: Cervical cancer patients undergoing laparoscopic radical hysterectomy will be recruited to this randomized controlled trial. Participants will be randomly assigned to either early postoperative catheter removal combined with intermittent catheterization group or a control group receiving standard care with indwelling urinary catheters. All these patients will be followed for 3 months after surgery. The study's primary endpoint is the comparison of bladder function recovery rates (defined as achieving a Bladder Function Recovery Grade of II or higher) 2 weeks post-surgery. Secondary endpoints include the incidence of urinary tract infections, and changes in urodynamic parameters, and Mesure Du Handicap Urinaire scores within 1 month postoperatively. All analysis will adhere to the intention-to-treat principle. DISCUSSION: The findings from this trial are expected to refine clinical management strategies for enhancing postoperative recovery among cervical cancer patients undergoing radical hysterectomy. By providing robust evidence, this study aims to support patients and their families in informed decision-making regarding postoperative bladder management, potentially reducing the incidence of urinary complications and improving overall quality of life post-surgery. TRIAL REGISTRATION: ChiCTR2200064041, registered on 24th September, 2022.


Assuntos
Remoção de Dispositivo , Histerectomia , Cateterismo Uretral Intermitente , Laparoscopia , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica , Bexiga Urinária , Cateteres Urinários , Neoplasias do Colo do Útero , Humanos , Histerectomia/efeitos adversos , Histerectomia/métodos , Feminino , Bexiga Urinária/fisiopatologia , Laparoscopia/efeitos adversos , Neoplasias do Colo do Útero/cirurgia , Cateterismo Uretral Intermitente/efeitos adversos , Fatores de Tempo , Remoção de Dispositivo/efeitos adversos , Resultado do Tratamento , Qualidade de Vida , Urodinâmica , Pessoa de Meia-Idade , Retenção Urinária/etiologia , Retenção Urinária/terapia , Retenção Urinária/fisiopatologia , Adulto , Cateterismo Urinário , Cateteres de Demora
4.
Br J Community Nurs ; 29(Sup5): S16-S22, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38728166

RESUMO

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.


Assuntos
Cateterismo Uretral Intermitente , Autocuidado , Cateterismo Urinário , Retenção Urinária , Humanos , Retenção Urinária/terapia , Retenção Urinária/enfermagem , Cateterismo Urinário/enfermagem , Cateteres de Demora , Cateteres Urinários , Masculino
5.
Br J Nurs ; 33(9): S10-S15, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38722003

RESUMO

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.


Assuntos
Autocuidado , Feminino , Humanos , Masculino , Desenho de Equipamento , Cateterismo Uretral Intermitente/instrumentação , Cateterismo Urinário/métodos , Cateterismo Urinário/instrumentação , Cateteres Urinários , Infecções Urinárias/prevenção & controle
7.
Low Urin Tract Symptoms ; 16(3): e12515, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38693055

RESUMO

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.


Assuntos
Antibacterianos , Cateterismo Uretral Intermitente , Traumatismos da Medula Espinal , Infecções Urinárias , Humanos , Masculino , Feminino , Infecções Urinárias/etiologia , Infecções Urinárias/epidemiologia , Pessoa de Meia-Idade , Adulto , Cateterismo Uretral Intermitente/efeitos adversos , Cateterismo Uretral Intermitente/instrumentação , Traumatismos da Medula Espinal/complicações , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Incidência , Fatores Sexuais , Cateteres Urinários/efeitos adversos , Fatores de Risco , Idoso , Cateterismo Urinário/efeitos adversos , Cateterismo Urinário/instrumentação
8.
Br J Nurs ; 33(9): S4-S8, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38722016

RESUMO

Clean intermittent self-catheterisation (CISC) is considered the preferred option to an indwelling catheter for emptying the bladder in people with a range of voiding dysfunctions. CISC has a lower risk of complications and urinary tract infections. This narrative review of previous qualitative research explores the quality-of-life impacts and highlights the challenges that men face. It will provide nurses who teach CISC with some useful insights into the male experience and the issues of concordance and adherence. This will help to better inform and guide clinical practice in this specialist area of nursing practice.


Assuntos
Cateterismo Uretral Intermitente , Qualidade de Vida , Autocuidado , Humanos , Masculino , Cateterismo Urinário/enfermagem , Cateterismo Urinário/métodos , Pesquisa Qualitativa
9.
BJU Int ; 133(6): 638-645, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38438065

RESUMO

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.


Assuntos
Reutilização de Equipamento , Humanos , Reutilização de Equipamento/economia , Equipamentos Descartáveis/economia , Meio Ambiente , Cateteres Urinários , Cateterismo Uretral Intermitente/instrumentação
10.
Neurourol Urodyn ; 43(4): 1019-1024, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38516982

RESUMO

Children with a neurogenic bladder are at risk of developing recurrent urinary tract infections and long-term kidney failure. Due to an altered lower urinary tract, children may be overtreated for simple bacteriuria or undertreated for a potentially severe urinary tract infection. This group of patients represent high users of healthcare, and are at risk of colonization and development of antibiotic resistance. Bladder washouts with non-antibiotic electrochemically activated solutions are a potential new prophylactic option for patients with bladder dysfunction when clean intermittent catheterization has resulted in chronic bacteriuria.


Assuntos
Bacteriúria , Cateterismo Uretral Intermitente , Bexiga Urinaria Neurogênica , Infecções Urinárias , Criança , Humanos , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinária , Infecções Urinárias/etiologia , Cateterismo Urinário/efeitos adversos
11.
J Pediatr Urol ; 20(3): 481.e1-481.e9, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38413297

RESUMO

INTRODUCTION: Children and adolescents with neurogenic bladder often need clean intermittent catheterization (CIC) over a long period. Our study aimed to identify factors that affect CIC compliance and to determine if CIC compliance affected short-term urological outcomes among patients in Malaysia. STUDY DESIGN: 50 patients aged 2-18 years who perform CIC were included in this cohort study. Patient compliance with CIC was evaluated using the validated Intermittent Catheterization Adherence Scale (ICAS). CIC difficulties were assessed using the validated Intermittent Catheterization Difficulty Questionnaire (ICDQ). Data was obtained on patients' co-morbidity, caregiver factors, socio-economic factors, CIC technique, access to catheters and facilities, urinary tract infections, incontinence, urology tests and treatment. Statistical analysis was performed. RESULTS: Mean age was 6.68 ± 4.34 years. 32 (64%) patients commenced CIC within the first month of life. Mean daily CIC frequency was 4.70 ± 1.33.30 (60%) participants showed strong adherence to CIC. 39 (78%) participants were able to catheterize with no or minor difficulties. Pain (6, 12%), transient blocking sensation (6.12%), and urinary incontinence (3, 6%) were the predominant difficulties encountered. CIC performed by caregiver was associated with improved adherence compared to patient self-catheterization (p = 0.039). The mean age of participants who self-catheterized was 10.7 ± 3.7 years. Strong adherence was also observed among patients who purchased their own CIC catheters (p = 0.007). Participants with lower ICDQ score were more likely to be compliant with CIC (p = 0.007). CIC adherence was not affected by patient's age, gender, co-morbidity, mobility, caregiver factors, socio-economic factors, and age at initiation of CIC. There was no significant association between CIC adherence and febrile urinary tract infections, upper tract deterioration, and bladder stones at 6 months follow-up. DISCUSSION: There is lower CIC adherence when a child begins to self-catheterize and healthcare providers should be alert during this period of transition. Though most patients with spina bifida have decreased urethral sensation, some patients do experience significant pain during CIC which may impact their compliance. These patients would need a review of their catheterization techniques to improve adherence. The limitations of our study are its modest sample size from a single center and short study period. Our study provides insights into the feasibility of instituting CIC in developing countries. CONCLUSION: Strong CIC adherence was observed among patients who were catheterized by their caregiver, purchased their own CIC catheters, and encountered minimal difficulties during catheterization. CIC adherence had no effect on short-term urological outcomes.


Assuntos
Cateterismo Uretral Intermitente , Cooperação do Paciente , Disrafismo Espinal , Bexiga Urinaria Neurogênica , Humanos , Bexiga Urinaria Neurogênica/terapia , Bexiga Urinaria Neurogênica/etiologia , Criança , Masculino , Feminino , Pré-Escolar , Adolescente , Disrafismo Espinal/complicações , Cooperação do Paciente/estatística & dados numéricos , Malásia/epidemiologia , Meningocele/terapia , Inquéritos e Questionários , Meningomielocele/complicações , Anormalidades Múltiplas , Região Sacrococcígea/anormalidades
12.
Neurourol Urodyn ; 43(3): 738-747, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38238988

RESUMO

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.


Assuntos
Cateterismo Uretral Intermitente , Bexiga Urinaria Neurogênica , Infecções Urinárias , Criança , Humanos , Feminino , Masculino , Cateterismo Uretral Intermitente/efeitos adversos , Cateterismo Uretral Intermitente/métodos , Cuidadores , Cateterismo Urinário/métodos , Ansiedade/etiologia
13.
Sci Rep ; 14(1): 2268, 2024 01 27.
Artigo em Inglês | MEDLINE | ID: mdl-38280939

RESUMO

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.


Assuntos
Cateterismo Uretral Intermitente , Retenção Urinária , Infecções Urinárias , Humanos , Animais , Suínos , Bexiga Urinária , Infecções Urinárias/prevenção & controle , Infecções Urinárias/etiologia , Cateterismo Uretral Intermitente/efeitos adversos , Catéteres/efeitos adversos
14.
Neurourol Urodyn ; 43(2): 464-478, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38196237

RESUMO

AIMS: To confirm the improved performance of the micro-hole zone catheter (MHZC) compared to a conventional eyelet catheter (CEC) in male users of clean intermittent catheterizations (CICs). METHODS: Male self-catheterizing subjects, who used hydrophilic sleeved soft/flexible CIC as the only bladder emptying method, were enrolled into a multi-center, randomized, cross-over study performed across six European sites. Subjects tested the MHZC, featuring a drainage zone with 120 micro-holes and a CEC with two eyelets. The study consisted of four study visits (V0-V3), during which endpoints related to catheter performance (urinary flow-stops, bladder emptying, and intra-catheter pressure) were measured and two 4-week test periods at home (T1 and T2) where dipstick hematuria and user perception between catheters were evaluated. RESULTS: Seventy-three male subjects with non-neurogenic and neurogenic bladder dysfunction (3:2) were enrolled. On average, catheterizations with the MHZC led to close to mean zero flow-stops compared to ≥1 flow-stops with the CEC, during both HCP- and self-led catheterizations (both p < 0.001). Residual urine at first flow-stop was significantly reduced for the MHZC compared to CEC (p = 0.001 and p = 0.004, for HCP- and self-led catheterizations, respectively). This was substantiated by a significantly smaller pressure peak at first flow-stop, a proxy for minimized mucosal suction (both HCP- and self-led catheterizations, p < 0.001). After home-use catheterizations, dipstick hematuria was comparable between catheters, whereas catheterizations were associated with significantly improved perception in favor of MHZC regarding bladder emptying, less blocking sensation, and improved hygienic catheterization compared to the CEC. CONCLUSION: This study confirmed the evidence of improved bladder emptying with the MHZC compared to a CEC without the need to reposition the catheter. The MHZC therefore offers an enhanced benefit for the dependent CIC user securing complete bladder emptying in an uninterrupted free flow and reducing the need to reposition the catheter during emptying.


Assuntos
Cateterismo Uretral Intermitente , Bexiga Urinaria Neurogênica , Infecções Urinárias , Adulto , Humanos , Masculino , Estudos Cross-Over , Hematúria , Cateterismo Uretral Intermitente/métodos , Cateteres Urinários , Cateterismo Urinário/métodos , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinaria Neurogênica/terapia
15.
Neurourol Urodyn ; 43(2): 459-463, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38078751

RESUMO

BACKGROUND: Clean intermittent self-catheterisation (CISC or ISC) is used by patients/carers to empty the bladder if needed. Sometimes the urethral lumen leading out of the bladder is blocked; sometimes, the bladder (detrusor) muscle itself or the autonomic motor nerves innervating the bladder are damaged, resulting in a failure of the detrusor muscle to work, leading to a failure of the bladder being able to empty adequately. Prior consensus as to the indications and timing of CISC has yet to be provided. This article aims to provide a multidisciplinary consensus view on this subject. CONCLUSION: It is evident that every patient needs to be considered individually, bearing in mind the symptoms and investigations to be considered. We emphasise the importance of considering the term Bladder Voiding Efficiency (BVE). One group of patients who might find CISC helpful are those with a neurological disorder; these include spinal injury patients, multiple sclerosis, Parkinson's, and a condition called cauda equina. Sometimes bladder problems are treated with anticholinergics, and others may be treated with Botox. These may cause the bladder not to empty at all, which is good for leaks but needs self-catheterisation to empty the bladder. In the past, hospitals used a permanent catheter called an 'indwelling' or a 'suprapubic' catheter. These can have side effects, including infections, stones, and pain. For CISC, disposable catheters are the best option for patients as they come in different sizes and styles to provide individualised care. In conclusion, we would like hospitals to consider each patient separately and not use a general 'one-size-fits-all' bladder function for these patients.


Assuntos
Cateterismo Uretral Intermitente , Bexiga Urinaria Neurogênica , Humanos , Cateterismo Urinário/efeitos adversos , Cateterismo Uretral Intermitente/efeitos adversos , Bexiga Urinaria Neurogênica/etiologia , Bexiga Urinaria Neurogênica/terapia , Catéteres , Dor/etiologia
16.
Br J Nurs ; 32(Sup18): S5-S7, 2023 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-38010969

RESUMO

Intermittent self-catheterisation with hydrophilic coated catheters carries the risk of trauma, bleeding and infection. However, evidence suggest that these risks can be minimised with a new generation of catheters that stay lubricated over time, allowing for comfortable and safe insertion and withdrawal.


Assuntos
Cateterismo Uretral Intermitente , Infecções Urinárias , Humanos , Cateterismo Urinário , Catéteres , Infecções Urinárias/etiologia , Infecções Urinárias/prevenção & controle
18.
J Wound Ostomy Continence Nurs ; 50(5): 400-405, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37713351

RESUMO

PURPOSE: This study sought to determine health-related quality of life and self-reported complications associated with clean intermittent catheterization (CIC). DESIGN: Observational, cross-sectional study. SUBJECTS AND SETTING: The target population was patients cared for by the urology department at Hospital 12 de Octubre in Madrid, Spain, undergoing CIC for chronic urinary retention of any etiology (neurogenic bladder dysfunction, neobladder, and other). The sample comprised 50 respondents with a mean age of 49 years; a majority (66%, n = 33) were female. Participants performed an average of 4 CICs. METHODS: All participants completed the ISC-Q (Intermittent Self-Catheterization Questionnaire) and a questionnaire about CIC-associated complications. Data were collected in February 2019. RESULTS: A vast majority of respondents (98%, n = 49) indicated preparation for catheterization was simple, and 76% (n = 38) indicated the catheter was easy to insert. One in 5 (20%, n = 10) considered carrying catheters and supplies inconvenient, though 58% (n = 29) indicated it was easy to dispose of the catheters outside the home. Most respondents (98%, n = 49) indicated they felt self-conscious about their need to self-catheterize, and 16% (n = 8) felt that CIC created limitations when visiting friends and family. The most frequent complication was symptomatic urinary tract infections (UTIs); participants reported an average of 1.7 UTIs in the last year. Additional complications, such as epididymo-orchitis, urethral stenosis, and urethral bleeding, were reported by less than 5% (n = 2) of participants. CONCLUSIONS: Participants managed by CIC for chronic urinary retention of any cause reported acceptable levels of satisfaction with the procedure. The reported incidence of complications was low, except for UTIs.


Assuntos
Cateterismo Uretral Intermitente , Bexiga Urinaria Neurogênica , Retenção Urinária , Infecções Urinárias , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Cateterismo Uretral Intermitente/efeitos adversos , Cateterismo Uretral Intermitente/métodos , Retenção Urinária/terapia , Retenção Urinária/complicações , Qualidade de Vida , Autorrelato , Estudos Transversais , Infecções Urinárias/etiologia , Infecções Urinárias/complicações , Cateterismo Urinário/efeitos adversos , Cateterismo Urinário/métodos
20.
Neurourol Urodyn ; 42(8): 1702-1711, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37638404

RESUMO

INTRODUCTION: Clean intermittent catheterization (CIC) is often used for bladder emptying in children with lower urinary tract dysfunction. Until recently, the emphasis in assessing the effects of CIC has been on preserving kidney function, reducing urinary tract infection, and achieving urinary continence. Few studies have investigated the impact of CIC on students and families in a school setting. This study sought to examine what students and caregivers experienced when CIC was required during the school day and how schools adjusted to a student needing to perform it. MATERIALS AND METHODS: A phenomenological approach utilizing semistructured interviews was performed to understand the impact of CIC on students. Purposeful sampling identified eligible families. A guide was developed from expert opinion validated by a pilot sample with feedback collated into a family/provider codesigned questionnaire. Interviews emphasized the impact and challenges students faced at school. Transcripts were coded using Dedoose software with emerging themes identified and a code book was created for closed coding that led to thematic analysis. RESULTS: A total of 40 families (52 caregivers and children > 12 years) were interviewed. Emergent themes included: Caregivers and students felt (1) school personnel were not always aware of nor prepared regarding the implications of CIC; (2) school bathrooms were often less than ideal (e.g., location, size, cleanliness, privacy, and availability); and (3) student participation in extracurricular activities was challenging. CONCLUSIONS: This study identifies potential areas of intervention in meeting the needs of students who require CIC and the importance of having collaborative efforts of caregivers, health care providers, and school personnel in addressing and meeting CIC needs. Care coordination that involves consistent communication and careful planning between health care teams, school personnel, students, and caregivers can optimize a student's educational experience.


Assuntos
Cateterismo Uretral Intermitente , Infecções Urinárias , Criança , Humanos , Bexiga Urinária , Inquéritos e Questionários , Estudantes , Cateterismo Urinário
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