ABSTRACT
OBJECTIVE: To compare empiric single-dose gentamicin versus culture-specific oral antibiotics as prophylaxis before cystometrogram and/or cystogram. Comparisons with regards to infection, patient preference, and cost were made. DESIGN: Prospective randomized control trial. SETTING: Inpatient and outpatient rehabilitation hospital. PATIENTS: Seventy received oral antibiotics and 72 received intramuscular gentamicin. INTERVENTION: Cystometrograms and/or cystograms were performed. MAIN OUTCOME MEASURE: Patient interviewed and chart reviewed for infection. Convenience and comfort were rated by patient. RESULTS: Oral antibiotics and gentamicin have similar efficacy. Patients rated the gentamicin more convenient (p < .001) and comfortable (p < .01) than oral antibiotics. Gentamicin is less expensive. CONCLUSION: Gentamicin should be used as the method of choice for cystometrogram/cystogram prophylaxis.
Subject(s)
Antibiotic Prophylaxis , Bacterial Infections/prevention & control , Gentamicins/administration & dosage , Urography/methods , Administration, Oral , Adult , Aged , Aged, 80 and over , Antibiotic Prophylaxis/adverse effects , Antibiotic Prophylaxis/economics , Bacterial Infections/etiology , Chi-Square Distribution , Consumer Behavior , Cost-Benefit Analysis , Female , Gentamicins/adverse effects , Gentamicins/economics , Humans , Injections, Intramuscular , Male , Middle Aged , Prospective Studies , Urography/adverse effectsABSTRACT
Although the literature has indicated that incontinence can be successfully treated with nonsurgical methods in the able-bodied population, there has been little research performed in the disabled population. Fifty-four patients with various disabilities were treated with pelvic muscle exercises, using biofeedback in conjunction with adjustments in their bowel program, caffeine intake, fluid intake, toileting schedules, transfer training, and medications. The average number of incontinent episodes before intervention was 3.6 per day, which was reduced to 0.8 per day after interventions (p < .001). The characteristics associated with treatment success and failure were evaluated and are discussed in this article, In addition, the change in amplitude and duration of the pelvic muscle surface electromyograph were analyzed. A statistical trend (p = .07) was discovered between an increase in amplitude and a positive outcome. There was a statistical association between increased pelvic floor contraction duration and a good or excellent outcome (p < .05). In conclusion, a behavioral approach to treatment of urinary incontinence is efficacious in the disabled population who can volitionally void and can voluntarily contract their pelvic muscles.
