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ObjectiveTo investigate the status of self-management in patients with spinal cord injury and the related factors. MethodsFrom May, 2020 to February, 2021, 255 patients from a spinal cord injury club were enrolled, and investigated with the general information questionnaire, self-management ability scale, Chronic Disease Self-efficacy Scale through internet. Multiple linear stepwise regression was used to explore the related factors. ResultsThe scores of disease symptom management, daily life management, intermittent catheterization behavior management, emotional management and social return were (40.458±9.122), (33.945±6.800), (36.709±8.736) and (25.011±4.932), respectively. The average score for the single question of daily life management was the highest (3.772±0.755), while emotional management and social return was the lowest (3.573±0.705). Duration of intermittent catheterization, family members' attitude, self-efficacy and occupation were the related factors of symptom management (R2 = 0.135, F = 7.744, P < 0.001). Self-efficacy, duration of intermittent catheterization, use of hydrophilic coated catheters and complications were the related factors of daily life management (R2 = 0.173, F = 13.042, P < 0.001). Self-efficacy, duration of intermittent catheterization, use of hydrophilic coated catheters and medical insurance were the related factors of intermittent catheterization behavior management (R2 = 0.141, F = 10.259, P < 0.001). Self-efficacy, duration of intermittent catheterization, complications and frequency of intermittent catheter in the last week were the related factors of emotional management and social regression dimensions (R2 = 0.282, F = 19.590, P < 0.001). ConclusionThe self-management of patients with spinal cord injury by clean intermittent catheterization is at medium level. Moreover, it may be affected by many factors. Some of them can be targets of intervention.
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ABSTRACT Objective to analyze diverse scientific evidence about educational materials related to intermittent urethral catheterization in children. Method a scoping review based on the method proposed by the Joana Briggs Institute and conducted in nine stages from July to December 2021, with the following guiding question: "Which is the available evidence about educational materials on intermittent urethral catheterization in children?". Articles from the following databases were analyzed: National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Scientific Electronic Library Online and SciVerse Scopus. Results six of the 3,323 articles retrieved were kept after applying the eligibility criteria and excluding the duplicates. The publication dates varied from 2009 to 2019; five were published in Brazil and one in the United States. Regarding the design, one was a cross-sectional study and there were two descriptive studies, two methodological studies and one case study. The data were presented considering the following variables: type of material, means of dissemination, target audience, and theoretical framework of the educational materials. Conclusion the studies analyzed in this review presented several educational materials, such as elaboration of educational software, a Telenursing manual, an educational video to guide parents and an online forum. Therefore, these materials are useful as teaching and learning strategies for caregivers of children undergoing intermittent urethral catheterization.
RESUMEN Objetivo analizar diversas evidencias científicas sobre materiales educativos relacionados con cateterismo uretral intermitente en niños. Metodo revisão de alcance basada en el método propuesto por el Joana Briggs Institute y realizada en nueve etapas entre julio y diciembre de 2021, con la siguiente pregunta guía: "¿De qué evidencias se dispone acerca de materiales educativos sobre cateterismo uretral intermitente en niños?". Se analizaron artículos de las siguientes bases de datos: National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, Scientific Electronic Library Online y SciVerse Scopus. Resultados seis de los 3.323 artículos recuperados se mantuvieron después de aplicar los criterios de elegibilidad y de excluir los duplicados. Las fechas de publicación variaron entre los años 2009 y 2019; cinco se publicaron en Brasil y uno en Estados Unidos. En relación co el diseño, uno era un estudio transversal y había dos estudios descriptivos, dos estudios metodológicos y un estudio de caso. Los datos se presentaron sobre la base de las siguientes variables: tipo de material, vehiculo de diseminación, público objetivo y referencial teórico de los materiais educativos. Conclusión los estudios que se analizaron en esta revisión presentaron diversos materiales educativos, como ser la elaboración de un programa de software educativo, un manual de Tele-Enfermería, un video educativo para orientar a los padres y foro virtual. EN consecuencia, estos materiales sirven com estrategias de enseñanza y aprendizaje para cuidadores de niños sometidos a cateterismo uretral intermitente.
RESUMO Objetivo Analisar evidências científicas sobre materiais educativos relativos ao cateterismo uretral intermitente em crianças. Metodo Revisão de escopo, baseada no método proposto pelo Joana Briggs Institute, realizada em nove etapas, no período de julho a dezembro de 2021, com a pergunta norteadora: "Quais as evidências disponíveis acerca de materiais educativos sobre cateterismo uretral intermitente em crianças?". Analisaram-se artigos das bases de dados: National Library of Medicine's,Cumulative Index to Nursing and Allied Health Literature, Scientific Electronic Library Online e SciVerse Scopus. Resultados Dos 3.323 artigos recuperados, foram mantidos seis artigos após aplicação dos critérios de elegibilidade e exclusão dos duplicados. As datas de publicação variaram de 2009 a 2019; cinco foram publicados no Brasil e um nos Estados Unidos. Quanto ao desenho, um era estudo transversal, dois estudos descritivos, dois estudos metodológicos e um estudo de caso. Os dados foram apresentados com base nas variáveis: tipo de material, meio de disponibilização, público-alvo e referencial teórico dos materiais educativos. Conclusão Os estudos analisados nesta revisão apresentaram diversos materiais educativos, como a construção de software educativo, manual de tele-enfermagem, vídeo educativo para orientação de pais e fórum virtual. Estes materiais são, portanto, úteis como estratégias de ensino e aprendizagem para cuidadores de crianças em cateterismo uretral intermitente.
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Objective:To evaluate the effect of safety bladder capacity catheterization on lower urinary tract function in patients with supracacral spinal cord injury. Methods:A total of 60 patients with lower urinary tract dysfunction after suprasacral spinal cord injury in our hospital from January to December, 2019 were divided into control group (n = 30) and observation group (n = 30) randomly. Both groups were given intermittent catheterization, the frequency of catheterization was determined according to postvoid residual volume in the control group, while it was according to safety bladder capacity in the observation group. Their maximum destrusor pressure, postvoid residual volume, safety bladder capacity, urinary tract infection and detrusor wall thickness were compared. Results:Eight weeks after intervention, the maximum destrusor pressure and postvoid residual volume decreased, and the safety bladder capacity increased in the observation group (t > 5.623, P < 0.05), and were better than that of the control group (t > 2.242, P < 0.05); the detrusor wall thickness significantly decreased in the observation group (t = 7.871, P < 0.05), and was lower than that of the control group (t = 3.049, P < 0.01). The number of urinary tract infection patients was less in the observation group than in the control group (χ2 = 4.320, P = 0.038). Conclusion:Intermittent catheterization based on safety bladder capacity can improve lower urinary tract function in patients with suprasacral spinal cord injury.
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Objective:To investigate the knowledgement and clinical application of neurogenic bladder and intermittent catheterization among nurses in Guangdong. Methods:From December, 2020 to January, 2021, 241 nurses in Guangdong were investigated with a questionnaire designed by ourselves. Results:The score was low in understanding the neurogenic bladder rehabilitation nursing management and intermittent catheterization through self-assessment. The awareness was deficient in the complication and risk management of neurogenic bladder. Although there were a lot of patients with dysuria in clinical practice, 67.2% of nurses still used indwelling catheter, and only 24.1% used intermittent catheterization. Only 9.9% nurses thought that patients with dysuria were treated positively by doctors. Most of nurses would like to participate in the training and nursing alliance in neurogenic bladder rehabilitation nursing management and intermittent catheterization, and manage patients with neurogenic bladder after discharge. Conclusion:The knowledge of guidelines related with neurogenic bladder and intermittent catheterization among nurses is insufficient, and is not applied in clinical practice. More work should be done to improve the knowledge and standardization of management of neurogenic bladder.
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Background: Catheter associated complications are very common in the emergency departments of medicine, general surgery, orthopaedics and in community. They mostly occur in patients with neurological afflictions because of inexperience of the first handlers as they lack the insight of altered physiology and anatomy in the lower urinary tract because of neurological lesions and also because of an inadequate advice at the time of discharge regarding the catheter care. Objectives of this study were to find the prevalence of per-urethral catheter associated injuries in patients with neurological lesions in a tertiary care centre of south-eastern Punjab and their prevention in completely recoverable neurological afflictions.Methods: This is a cross-sectional observational study conducted in urology department from 1st August 2017-31st August 2018. The data was taken from medicine, general surgery and orthopedic emergency departments. A total of 82 patients were taken from 19-78 years and 49 patients had per-urethral catheter placement. Analysis was done using Statistical Program of Special Sciences, version 20.Results: It was observed that overall neurological lesions are more common in males (80.48%) as compared to females (19.51%) and distributed over an age range of 19-84 years in both sexes. Out of total patients, 59.75% required per urethral catheterization. The prevalence of per-urethral catheter associated complications was 20.40%.Conclusions: Insertion of per-urethral catheter is a simple procedure but an error of omission on the part of health professionals’ results in a serious complication in a neurological patient. Proper insertion technique and catheter care are to be followed to prevent avoidable complications in this subset of patients.
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@#secondary medical impairment following spinal cord injury(SCI). Ultrasound (US) of the kidneys, ureters and bladder(KUB) has been recommended as a useful, non-invasivesurveillance method with good diagnostic sensitivity. Thisstudy aims to understand US diagnosed NB complicationsand identify its associated factors.Methods: We enrolled all patients referred for SCIrehabilitation from 2012 to 2015 that fulfilled our studycriteria. Data that were retrospectively reviewed includeddemographic and clinical characteristic data; and US KUBsurveillance studies.Results: Out of 136 electronic medical records reviewed, 110fulfilled the study criteria. The prevalence of NB in our studypopulation was 80.9%. We found 22(20%) of the patientsshowed evidence of US diagnosed NB complications withthe mean detection of 9.61±7.91 months following initial SCI.The reported NB complications were specific morphologicalchanges in the bladder wall 8(36.4%); followed byunilateral/bilateral hydronephrosis 7(31.8%); bladder and/orrenal calculi 5(22.7%); and mixed complication 2(9.1%)respectively. Half of the patients with NB complications hadurodynamic diagnosis of neurogenic detrusor overactivitywith/without evidence of detrusor sphincter dyssynergia.We found co-existing neurogenic bowel, presence ofspasticity and mode of bladder management weresignificantly associated factors with US diagnosed NBcomplications (p<0.05), while spasticity was its predictorwith adjusted Odds Ratio value of 3.93 (1.14, 13.56).Conclusion: NB is a common secondary medical impairmentin our SCI population. A proportion of them had USdiagnosed NB complications. Co-existing neurogenic bowel,presence of spasticity and mode of bladder managementwere its associated factors; while spasticity was itspredictor.
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Clean intermittent catheterization (CIC) is one of the core elements of neurogenic bladder management in the patients with spinal cord injury and is effective and safe to maintain low intra-bladder pressure and achieve urinary continence. Until now, the most notable development in urinary catheter products for CIC is the introduction of hydrophilic coating. Fortunately, in Korea, the national medical insurance has recently covered the cost for urinary catheters in this patient group. The purpose of this review is to summarize the history of CIC and the recent development of urinary catheter products. From our review, we would like to suggest a way of thinking that is the way forward for the future to improve the implementation of CIC with minimal morbidity.
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Humans , Insurance , Intermittent Urethral Catheterization , Korea , Spinal Cord Injuries , Spinal Cord , Thinking , Urinary Bladder, Neurogenic , Urinary CathetersABSTRACT
Objective:To summarize the nursing care of a patient with clean intermittent catheterization after sigmoid augmentation cystoplasty and abdominal sigmoidostomy for the treatment of neurogenic bladder. Methods:On October 16, 2017, one patient with neurogenic bladder was admitted to Beijing Bo'ai Hospital. Psychological instructions were given to the patient after surgery. Catheter of appropriate type and material was selected, and then the patient was instructed to implement correct and regular clean intermittent catheterization procedures. At the same time, nursing care of abdominal sigmoidostomy was carried out. In order to prevent tube blocking, bladder irrigation was implemented at regular intervals. Follow-up visit was scheduled. Results:After four-month follow-up, the patient completed the whole procedures successfully, and its renal function was protected without severe urinary tract infection, also the patient was with good social adaptation. Conclusion:Comprehensive nursing care is needed in patients after sigmoid augmentation cystoplasty and abdominal sigmoidostomy. Correct and regular clean intermittent catheterization is critical. Psychological nursing, care of abdominal sigmoidostomy and tube blocking prevention should not be neglected, also long-term follow-up is of great significance for the outcome.
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Purpose：This study examined functional outcomes and discharge disposition in patients with and without indwelling urethral catheters, who were admitted to a convalescent (Kaifukuki) rehabilitation ward (KRW) following an acute care hospital stay.Subjects and Methods：We retrospectively reviewed the medical records of 113 patients with cerebrovascular disease and traumatic brain injury who had indwelling urethral catheters at the time of admission to the KRW of our hospital between April 1, 2012 and March 31, 2015. We studied the motor score of the Functional Independence Measure (FIM-M) and discharge disposition from our KRW in patients without indwelling urethral catheters.Results：The ratio of patients without indwelling urethral catheters was 75.2％ (85 cases：catheter-free group). The catheter-free group had higher FIM-M scores and a higher rate of living at home, compared to the 28 patients with indwelling urethral catheters. The average duration until urination independence after catheter removal was 17.3 (standard deviation：21.1) days. Urination independence recovered in 80.9％ of the catheter-free group within 4 weeks after catheter removal.Conclusion：Indwelling urethral catheter should be removed to enable discharge to home.
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Objective To identify the risk factors associated with recurrent urinary tract infection (RUTI) in children with neurogenic bladders (NB) who received clean intermittent catheterization (CIC) in order to provide recommendations for reducing the risk of RUTI.Methods Records of 184 children with NB managed by CIC at the Department of Urology Surgery,the First Affiliated Hospital of Zhengzhou University from July 2011 to September 2015 were reviewed and analyzed.According to UTI incidence,they were divided into 2 groups as occasional UTI group (0-1 time/year,OUTI group) and RUTI group (＞ 1 time/year).The clinical and urodynamic data were compared between 2 groups,and the risk factors were identified by regression analysis.Results Of the total patients,147 patients (79.9％) were diagnosed as OUTI and 37 cases (20.1％) as RUTI.Median follow-up lasted for average 27 months (12-39 months).The characteristics of RUTI group was indicated significantly in the study,which included increasing age(7.4 years old vs.5.9 years old),a higher level of spinal lesions,and more vesicoureteral reflux(VUR),and there were significant differences in bladder wall thickness(4.7 cm vs.3.6 cm) and lower bladder compliance compared with RUTI group (all P ＜ 0.05).But there was no statistical significance in gender,antibiotics,hydronephrosis,incontinence,bladder capacity,detrusor overactivity,detrusor sphincter dyssynergia and detrusor leakage point pressure between 2 groups (all P ＞ 0.05).Increasing age,increased bladder wall thickness,lower bladder com-pliance and the presence of VUR were independent risk factors associated with RUTI group (all P ＜ 0.05).Conclusions Increasing age,increasing bladder wall thickness,lower bladder compliance and VUR are the risk factors for RUTI in NB children managed with CIC.It is necessary to follow up video-urodynamic and ultrasound findings in order to identify the high-risk patients and provide the evidence for preventing RUTI.
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Objective To evaluate the clinical outcome and the problems of patients who have performed the clean intermittent self-catheterization(CISC)through detailed telephone interviews and then develop corresponding measures to solve.Methods In this study,telephone interviews were carried out in 27 patients who were diagnosed as detrusor underactivity from January 2011 to September 2015,and received CISC as treatment.They were asked to finish the micturition diary and answer questions from 4 questionnaires of which the first one was IPSS and the other 3 parts were ICDQ,InCaSaQ,and SF-36. Results 27 patients completed the follow-up interview,and the median time of CISC is 1 8 months.The average frequency of voiding by catheterization was 3.7 times a day.After the intervention of CISC,the symptoms of voiding difficulty and chronic urinary retention in all the 27 patients were relieved.11.1% of the 27 patients experienced urinary tract infection.The average ICDQ score was 0.4 and 88.9% of them were satisfied with the current states and what they experienced after performing CISC.The average InCaSaQ score was 2.15.The average physical and mental score from SF-36 questionnaire was 76.9 and 79.2 respectively.Conclusions CISC is an easy-to-do operation that relieves retention effectively and protects upper urinary tract function.The incidence of complications is quite low and the influence on quality of life is moderate,making it easy to persist in the long term of bladder management.
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Objective To summarize the nursing for acute epididymitis within intermittent catheterization. Methods From August, 2013 to February, 2016, twelve patients suffering acute epididymitis within intermittent catheterization after spinal cord injury were reviewed. Re-sults Epididymitis was cured in all the patients after retention catheterization, psychological nuring, diet and drinking guide, reasonable drug use, etc. Conclusion Acute epididymitis within intermittent catheterization can be controlled by appropriate medication and nursing.
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Objective To investigate the effect of early application of clean intermittent catheterization(CIC) in infants with neurogenic bladder(NB).Methods Eighty-seven children with NB diagnosed in our urodynamic center were less than 1 year old when they first came to hospital from January 2007 to January 2010, and CIC was carried out at different age.Sixty-four patients were followed up for a long time and divided into early CIC group(less than 1 year old children) and late CIC group(more than 3 years old children) according to the treatment time.Early CIC group included 29 patients [19 boys and 10 girls with the mean age of (7.5 ±2.8) months].And 4 cases were suffering from postoperative spina bifida manifesta;22 cases with spina bifida occulta;2 cases with sacral dysplasia;1 case with meningitis.Late CIC group included 35 patients [20 boys and 15 girls with the mean age of (8.0 ±2.9) months].2 cases were suffering from postoperative spina bifida manifesta;28 cases with spina bifida occulta;4 cases with sacral dysplasia;1 case with postoperative pelvic surgery.Before the treatment, there were no significant differences of the bladder compliance (BC), the maximum cystometric capacity (MCC) and the safety bladder capacity (SBC) between two groups.Urodynamic parameters and complications of 64 patients who were successfully followed up for 6 years were compared.Results After 3 years follow up, BC, SBC and MCC in early CIC group [(8.5 ± 1.9) ml/cmH2O, (140 ±25) ml, (142 ±29) ml]were significantly higher than those of late CIC group [(7.0 ± 2.2) ml/cmH2O, (110 ± 31) ml, (120 ± 28) ml;all P ＜ 0.05].After 6 years follow up, BC, SBC and MCC in early CIC group [(12.0 ±2.5) ml/cmH2O, (210 ±26) ml, (230 ±30) ml] were significantly higher than those of late CIC group [(9.3 ± 2.3) ml/cmH2O, (192 ± 31) ml, (205 ± 35) ml;all P ＜ 0.05], and the vesicoureteral reflux rate [24.1％ (7/29)] in early treatment group was significantly less than that in late treatment group [54.3％ (19/35), P ＜ 0.05].Increases in BUN and serum creatinine were found in 6 cases (20.7％) in early CIC group and 17 cases (48.6％) in late CIC group, the difference was significant (P ＜ 0.05).Conclusion For NB patients, the effect of early CIC is better than that of late CIC.
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Objective To investigate the video-urodynamics indication of upper urinary tract dilation secondary to neurogenic bladder that may be resolved only by intermittent catheterization. Methods From January, 2008 to August, 2016, twelve cases of upper urinary dila-tion secondary to neurogenic bladder were treated by intermittent catheterization only. Their clinical data was reviewed. Results The mor-phology and function index of upper urinary tract were improved gradually during the regular follow-ups. The common video-urodynamics characteristics include no detrusor overactivity, no vesicoureteral reflux, cysctometry volume larger than 300 ml and detrusor presser at the capacity lower than 40 cmH2O, poor voiding efficiency with residual volume larger than 150 ml. Conclusion For upper urinary tract dilation secondary to neurogenic bladder characterized as passable storage and poor voiding, intermittent catheterization may be enough to resolve the dilation.
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Objective To explore the effect of continuing care on the intermittent catheterization compliance of patients with neurogenic bladder. Methods From January to December, 2015, 60 patients with neurogenic bladder after spinal cord injury receiving intermittent cathe-terization were randomly assigned to control group (n=30) and intervention group (n=30). The control group received routine discharge in-struction, while the intervention group received continuing care in addition. The intermittent catheterization compliance, residual urine vol-ume, urinary tract infection and quality of life were assessed at discharge and three months after intervention. Results After intervention, the intermittent catheterization compliance was better in the intervention group than in the control group (χ2=7.500, P=0.006). The residual urine volume significantly decreased in both groups (t>12.040, P4.572, P5.505, P<0.001). Con-clusion Continuing care could improve the intermittent catheterization compliance, reduce the residual urine volume and the urinary tract in-fection rate, and improve the quality of life in patients with neurogenic bladder after discharge.
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As crianças portadoras de disfunções miccionais, sendo de ordem neurológica (bexiga neurogênica) ou funcionais, necessitam de cuidados especiais para evitar a deterioração do sistema urinário inferior e insuficiência renal. Na maioria dos casos de bexiga neurogênica, indica-se, o cateterismo intermitente limpo. Também indicado para as disfunções não neurogênicas quando não se consegue bons resultados com outros tratamentos. São crianças com necessidades especiais de saúde (CRIANES), com mudanças na sua vida cotidiana e necessidade de cuidados especiais. O enfermeiro necessita interagir com as mesmas, de forma que, na fase escolar, possam juntos, planejar e administrar o autocuidado, necessários para facilitar o processo de viver saudável. Objeto de estudo: o autocateterismo intermitente limpo realizado pelo escolar portador de disfunção miccional. Objetivos: descrever as práticas de cuidados concernentes ao autocateterismo intermitente limpo realizado pelo escolar portador de disfunção miccional e analisar os desafios para a realização dessa prática de cuidado por esse escolar nos diversos espaços de socialização. Metodologia: estudo de natureza qualitativa, desenvolvido sob o método criativo sensível, através das dinâmicas de criatividade e sensibilidade Corpo Saber e Mapa Falante. Os participantes da pesquisa foram sete crianças portadoras de disfunção miccional, com idade entre 9-11 anos. O cenário de estudo foi um ambulatório de pediatria, situado em um hospital de ensino e pesquisa no estado do Rio de Janeiro. Os dados foram coletados no período entre fevereiro e março de 2015, e foram analisados a partir da análise de discurso em sua corrente francesa, sendo interpretados à luz do autocuidado de acordo com o conceito de Orem, a Teoria do Desenvolvimento Psicossocial de Erik Erikson e da educação em saúde com as concepções freirianas para a educação. Resultados:através da análise da prática de cuidados desses escolares, evidenciamos a preocupação com a higienização das mãos, da região íntima e do óstio de Mitrofanoff e, cuidados com o esvaziamento completo da bexiga. Quanto aos desafios, foram evidenciados a necessidade do uso de dispositivos para a visualização do meato urinário, dificuldades para a visualização do meato uretral feminino no período matutino, no posicionamento para a realização do autocateterismo, a presença de desconfortos com a sondagem uretral, a irregularidade na frequência do autocateterismo, as dificuldades para brincar em função da realização do autocateterismo, a (in) dependência no autocateterismo e o (des)velamento do autocateterismo nos diversos espaços de socialização. Conclusão: Revelou-se uma consciência ingênua na prática de cuidados, assim como fatores ambientais interferindo no autocuidado e riscos de infecção do trato urinário. Os diversos desafios enfrentados pelos escolares, na realização do autocateterismo, apontam para a necessidade de aproximação com estes de forma dinâmica e criativa, facilitando a exposição de suas dúvidas, medos e anseios, e para a promoção da conscientização crítica e a socialização dos saberes, capacitando-os para o autocuidado. Também na divulgação junto aos órgãos competentes, para a adequação social, com vistas à inclusão destas CRIANES nos diversos espaços de socialização.
Children suffering from voiding dysfunction, which stems from a neurological (neurogenic bladder) or a functional disorder, need special care to prevent deterioration of the lower urinary tract and kidney failure. In most cases of neurogenic bladder it is indicated clean intermittent catheterization. Also suitable for non-neurogenic dysfunction when you don`t get good results with other treatments. These are children with special health care needs(CSHCN), with changes in their daily lives. The nurse needs to interact with them, so that, at school age, they can together plan and manage the self-care necessary to facilitate the process of healthy living. Subject: clean intermittent catheterization performed by the children that suffers from voiding dysfunction. Objectives: To describe the practices from care concerning the clean intermittent catheterization performed by the children that suffers from voiding dysfunction and analyze the challenges for the realization of this practice by that children in the various spaces of socialization. Methodology: qualitative study developed under the sensitive creative method, through the dynamics of creativity and sensitivity "Corpo Saber e Mapa Falante". The survey participants were seven children with voiding dysfunction, aged 9-11 years.The study setting was an outpatient pediatric clinic located in a teaching hospital in the state of Rio de Janeiro. Data were collected between February and March 2015 and were analyzed from the speech analysis in its French stream being interpreted in the lightof the self-care according to the Orem concept, the Psychosocial Development Theory of Erik Erikson and of health education with Freirian concepts for education. Results: by analyzing the practice of these children we noted the concern on hands, genitals and the Mitrofanoff ostium hygienization, and, the complete evacuation of the bladder.Regarding the challenges, were highlighted the necessity of devices for visualizing the urinary meatus, difficulties in the visualization of the feminine urethral meatus in the morning, the position to perform the catheterization, the discomfort with the urethral probe, the irregularity in the frequency of catheterization, the difficulties to play due the realization of catheterization, the (in)dependence on autocatheterism and the (un)veiling of autocatheterism in various spaces of socialization. Conclusion: It was revealed an ingenuous consciousness in the practice of cares, as well as environmental factors interfering in the self-care and risk of urinary tract infection.The various challenges faced by the children in performing the catheterization point to the necessity of closer ties in a dynamic and creative way, facilitating the exposure of their doubts, fears and desires, to promote critical awareness and the socialization of knowledge, enabling them for self-care. Also, in the disclosure with the competent organs, to social adaptation, aiming to incorporate such CSHCN in various spaces of socialization.
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Humans , Male , Female , Child, Preschool , Child , Child , Intermittent Urethral Catheterization/nursing , Pediatric Nursing/methods , Self Care , Urination Disorders/nursing , Stents/statistics & numerical dataABSTRACT
@#Objective To explore the clinical effect of innovative bladder irrigation on prevention of urinary tract infection in neurogenic bladder patients with clean intermittent catheterization after spinal cord injury (SCI). Methods 40 neurogenic bladder patients with clean intermittent catheterization after SCI were divided into observation group (n=20) and control group (n=20). The observation group received innovative bladder irrigation with normal saline 500 ml every other day, and the control group received normal bladder irrigation with normal saline 500 ml every day. Results 4 weeks and 6 weeks after treatment, the incidence of urinary tract infection was lower in the observation group than in the control group (P<0.05). Conclusion The innovative bladder irrigation method can decrease the rate of urinary tract infection in neurogenic bladder patients with clean intermittent catheterization after SCI.
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Objective To explore the clinical effect of innovative bladder irrigation on prevention of urinary tract infection in neurogenic bladder patients with clean intermittent catheterization after spinal cord injury (SCI). Methods 40 neurogenic bladder patients with clean in-termittent catheterization after SCI were divided into observation group (n=20) and control group (n=20). The observation group received in-novative bladder irrigation with normal saline 500 ml every other day, and the control group received normal bladder irrigation with normal saline 500 ml every day. Results 4 weeks and 6 weeks after treatment, the incidence of urinary tract infection was lower in the observation group than in the control group (P<0.05). Conclusion The innovative bladder irrigation method can decrease the rate of urinary tract infec-tion in neurogenic bladder patients with clean intermittent catheterization after SCI.
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Neurogenic bladder (NB) is a lower urinary tract dysfunction (LUTD) caused by underlying neural diseases that affect the central nervous system and peripheral nerves. LUTD includes urine storage dysfunction and voiding dysfunction. LUTD causes various lower urinary tract symptoms (LUTS) and has a negative impact on patients' quality of life. In addition, urinary tract infection and upper urinary problems can be associated with LUTD, especially with NB. Thus, the diagnosis and management of NB in patients with underlying neural diseases are very important in patient care. LUTD can be screened by a careful history taking of LUTS and simple, non-invasive measures such as postvoid residual urine measurement and uroflowmetry. A urodynamic study is required for precise evaluation of urine storage function and voiding function. Urine storage dysfunction is predominantly caused by detrusor overactivity (involuntary detrusor contractions during bladder filling) and occasionally caused by sphincter deficiency, while voiding dysfunction is caused by detrusor-sphincter dyssynergia (DSD) and/or impaired detrusor contraction. Urodynamic evaluation is mandatory for proper management of NB. Management of detrusor overactivity includes pharmacotherapy using anticholinergics and selective β3-receptor agonist, and neuromodulation. For refractory cases, surgery such as bladder augmentation can be a treatment option. Pharmacotherapy for voiding dysfunction includes α-blockers for DSD and cholinergic agents for impaired detrusor contraction. However, their efficacy has been limited, and not a few patients with NB need urinary management by clean intermittent catheterization (CIC). The goals of urinary management in patients with NB are to render patients free from significant urinary problems, maintain continence, and provide better quality of life. For this purpose, close collaboration between physicians involved in rehabilitation medicine and urology is very important and should be promoted.
ABSTRACT
Introducción: Existen situaciones en la práctica urológica, en que el daño al aparato esfinteriano, uretra o vejiga obliga a recurrir a algún mecanismo que permita derivar un reservorio o vejiga ampliada hacia la pared abdominal. Para ello, es posible realizar ostomías continentes, con distintos segmentos intestinales, para autocateterismo intermitente limpio. La técnica de Yang-Monti presenta ventajas con respecto a otras ostomías, como el uso de un segmento intestinal pequeño, la mayor facilidad en ubicar y fijar la ostomía. Objetivo: Describir la experiencia de la técnica de Yang-Monti para cateterismo intermitente limpio, su evolución a través del tiempo y sus principales complicaciones según la casuística de nuestro centro. Materiales y Método: Estudio observacional retrospetivo. Revisión de 31 casos de ostomías continentes para cateterismo intermitente con la técnica de Yang-Monti desde enero de 1996 a septiembre del 2011. Se evalúa el diagnóstico etiológico, segmento intestinal del reservorio, ubicación del extremo distal de la ostomía y sus respectivas complicaciones precoces, tardías y estado al final del seguimiento. Resultado: En relación al segmento intestinal utilizado para reservorio, en 14 casos (45 por ciento) se utilizó colon sigmoides, en 9 (29 por ciento) íleon y en 8 transverso (26 por ciento). Con respecto al lugar en que fue exteriorizado el conducto de Yang-monti, en 19 casos (61por ciento) fue al ombligo y en 12 (39 por ciento) a fosa iliaca. Hubo complicaciones precoces (antes de 3 meses) en 8 pacientes (25 por ciento), de los cuales 4 (12,9 por ciento) requirieron reintervención, 3 de estos fallecen precozmente a consecuencia de la cirugía, presentando los diagnósticos de evisceración, obstrucción intestinal e infección de herida operatoria...
Introduction: There are situations in urological practice, in that the damage to the sphincter apparatus, urethra or bladder makes it necessary to use some mechanism to derive an enlarged reservoir or bladder to the abdominal wall. It is therefore possible to use different intestinal segments as continente ostomies for intermittent self cathetherisation. Yang Monti technique presents advantages over other ostomies: use of a small intestinal segment, easier placement and fixation. Objective: To describe the experience of the Yang-‐Monti technique for clean intermittent catheterization, its evolution over time and its major complications in our center. Materials and Methods: Observational retrospective study. Review of 31 cases of Yang‐Monti intermittent catheterization continente ostomies from January 1996 to September 2011. Etiologic diagnosis, intestinal segment of the reservoir, location of the distal end of the ostomy and their early and late complications, and follow-‐up status are evaluated. Results: Regarding the intestinal segment used for reservoir: in 14 cases (45 percent) was used sigmoid colon, in 9 ileum (29 percent) and in 8 transverse colon (26 percent). The Yang‐Monti was externalized in the navel in 19 cases (61 percent) and in iliac fossa 12 (39 percent)...