Impact of the route of clean intermittent catheterization on quality of life in children with lower urinary tract dysfunction.

AIMS: To compare the impact of the different routes for clean intermittent catheterization on the quality of life of children with lower urinary tract dysfunction. METHODS: In this cross-sectional study, all children and adolescents under treatment in our clinic from August 2011 to May 2012 who were on CIC for bladder dysfunction were included. To evaluate the technical difficulty and the discomfort associated with the procedure we used a standard visual analog scale. Quality of life was measured using the Pediatric Quality of Life Inventory Version 4.0. RESULTS: A total of 70 children including 38 (54.3%) boys and 32 (45.7%) girls with a mean age of 11.8 ± 3.6 years (range 5 to 18 years) were evaluated. The mean daily number of catheterizations was 4.2 ± 1.1. CIC was performed through the urethra in 51 (72.9%) subjects and a stoma in 19 (27.1%). A 45 (64.3%) were assisted by a caregiver to perform a catheterization. No differences in both difficulty and discomfort for performing CIC were observed between groups. Children who performed CIC through a stoma had a better quality of life scores for the physical (P = 0.015) and social functioning domains (P = 0.011). CONCLUSION: The quality of life of children and adolescents performing CIC appears to be affected by the route of catheterization, with a worse performance for those using urethral catheterization.

Desmopressin versus behavioral modifications as initial treatment of primary nocturnal enuresis.

The purpose of this study was to compare the effectiveness of desmopressin to behavioral modifications as the initial treatment of primary monosymptomatic nocturnal enuresis (PMNE). Study results determined that either intervention led to a significant reduction in PMNE episodes. These results suggest that either method is equally effective for treatment of PMNE.

Behavioral interventions in primary enuresis: experience report in Brazil.

Nurses, parents, and children play an equally important role in successful behavioral management of childhood enuresis. This pilot study describes results of a multifaceted program in Brazil in which all children showed improvement in bedwetting over a 4-month treatment period. Methods used by these nurses may help in designing and implementing similar programs.

Lubricated urethral catheters with lidocaine versus gentamycin for clean intermittent catheterization / Cateteres uretrais lubrificados com lidocaína versus gentamicina na realizaçäo do cateterismo vesical intermitente técnica limpa

Introduçäo: Diferentes métodos de profilaxia de infecçöes do trato urinário têm sido propostos para pacientes em uso de cateterismo vesical intermitente, entre estes a lubrificaçäo de cateteres uretrais com gentamicina creme 0.1 por cento. Este estudo comparou a lubrificaçäo dos cateteres uretrais com gentamicina creme 0.1 por cento e lidocaína geléia 2 por cento quanto aos resultados quantitativos das urinoculturas e incidências de infecçäo sintomática do trato urinário e bacteriúria assintomática em pacientes em uso de cateterismo vesical intermitente com técnica limpa. Material e métodos: Este estudo, randomizado e prospectivo, foi realizado em um hospital geral de ensino, no período de 05/99 à 08/00. Foram estudados 20 pacientes, divididos por sorteio em grupos A e B. Os pacientes do grupo A foram orientados a lubrificar o cateter uretral com gentamicina creme 0.1 por cento, e os do grupo B com lidocaína geléia 2 por cento. Todos foram orientados a desprezar o cateter após o uso. Foram realizados exames de urinocultura e urina I dos pacientes a cada três semanas, por aproximadamente quatro meses, no total de cinco coletas, e verificado presença ou ausência de bactérias ou fungos, número de colônias e tipo isolados, e contagem de leucócitos. Resultados: Näo foram encontradas diferenças significantes entre os dois grupos quanto à presença de bacteriúria significativa, infecçäo sintomática do trato urinário e bacteriúria assintomática. Entre as bactérias identificadas houve predomínio de Escherichia coli em ambos os grupos, e näo houve crescimento de fungos. Conclusäo: Os resultados deste estudo indicaram que a lubrificaçäo dos cateteres uretrais com gentamicina creme 0.1 por cento näo é uma alternativa eficaz para a diminuiçäo de bacteriúria significativa e prevençäo de infecçäo urinária em pacientes que realizam cateterismo vesical intermitente.