Self-perception, quality of life and ease of catheterization in patients with continent urinary diversion with the mitrofanoff principle

ABSTRACT Purpose: Continent urinary diversion (CUD) with the Mitrofanoff principle stands as an alternative to urethral catheterization by a route other than the urethra. The aim of the study was to determine self-perception of health-related quality of life (HRQoL), ease of catheterization and global and cosmetic outcomes in patient's dependent on Mitrofanoff catheterization. Materials and methods: Records of all patients who underwent CUD with the Mitrofanoff principle between 2012 to 2018 were reviewed. Data were collected and analysed retrospectively from medical charts. We assessed HRQoL with the EuroQol EQ-5D-3L questionnaire, cosmetic and global satisfaction with a questionnaire designed by the reconstructive urology board and ease of catheterization with a Likert questionnaire adapted from the Intermittent Catheterization Difficulty Questionnaire (ICDQ) validated in patients reliant on retrograde CIC. Results: A total of 25 patients requiring CUD with the Mitrofanoff principle between 2012 and 2018 were assessed, the group was composed mainly of: appendiceal conduits 18 patients (72%) and 7 ileal conduits (Yang-Monti) and three of those requiring Casale (Monti Spiral) and 1 a double Monti technique. Median follow-up was 57 months, median age was 30 years. Visual Analogue Scale (VAS) of the EQ-5D-3L reported a Global health score of 86.5%. Fifty nine percent of the patients had no pain or bleeding with catheterizations. Regarding global satisfaction and cosmetic perception 91% were satisfied with their CUD. Conclusions: CUD is associated with good HRQoL, global satisfaction, ease and painless catheterization, adequate self-perception of cosmetic outcomes and a low complication rate, remaining a safe and viable option.

Intoxicación aguda por escopolamina / Acute intoxication for escopilamine

Se estudiaron 245 pacientes que asistieron al servicio de urgencias de la Clínica de Toxicología Limitada, por intoxicación aguda de cualquier etiología, para revisar los casos correspondientes a intoxicación por escopolamina y así poder identificar los factoresde riesgo asociados, encontrar la incidencia total y con esto sugerir parámetros para un porgrama preventivo. El estudio mostró que los factores de riesgo asociados con sexo masculino, ingestión de bebidas embriagantes, niveles elevados de escolaridad y asistencia a lugar de diversión nocturna. El objetivo principal que se busca al administrar el tóxico es robar a la víctima. Estos datos se compararon con un estudio publicado por el Dr. Camilo Uribe Gonzalez en 1982, donde se encontraron los mismos factores de riesgo y la inicidencia total no varió considerablemente. Según el estudio el mejor método para llegar a la gente es la prensa, por lo que hay que explotarla para aumentar el cubrimiento en la población sin llegar a desestimar los demás medios para los programas de prevención