Urethral cytology in spinal cord injury patients performing intermittent catheterisation

Vaidyanathan, S; Soni, B M; Dundas, Stephanie; Krishnan, K R

doi:10.1038/sc.1994.78

Cited by 64 publications

(41 citation statements)

References 9 publications

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“…The degree of urethral in¯ammation by urethral cytology proved to be less in patients using hydrophilic catheters compared to PVC catheters. 75 No extra strictures occured in patients on IC with hydrophilic catheters after a mean follow-up of 7 years in a study of Waller et al 76 Such data are suggestive that there is an advantage in using hydrophilic catheters to prevent stricture formation in the long-term but comparative studies have not been published. Urethral trauma with false passages can, in neurogenic patients on CIC, successfully be treated with 5 days antibiotics and 6 weeks indwelling catheter.…”

Section: Resultsmentioning

confidence: 96%

Complications of intermittent catheterization: their prevention and treatment

2002

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Study design: Literature review to evaluate the complications seen in patients on intermittent catheterization (IC) and intermittent self-catheterization (ISC). Objectives: To ®nd the prevalence of most complications seen in patients on IC. To study the prevention and the treatment of these complications. Setting: An international literature review. Methods: Most relevant articles on the subject are reviewed. Conclusion: Urinary tract infection is the most frequent complication in patients performing IC. Catheterization frequency and the avoidance of bladder over®lling are amongst the most important prevention measures. Asymptomatic bacteriuria does not need to be treated with antibiotics. Long-term antibacterial prevention does seem to bear a risk of development of bacterial resistance. Previous treatment with indwelling catheters is a risk factor for chronic infection and urinary sepsis. Prostatitis is more frequently present than often thought. Epididymitis and urethritis are rare. Trauma from catheterization occurs regularly, but lasting eects are more limited. However, the prevalence of urethral strictures and false passages increases with longer use of IC. The use of hydrophilic catheters might be able to lower the urethral complication rate but additional proof through comparative studies is needed. The most important prevention measures are good education of all involved in IC, good patient compliance, the use of a proper material and the application of a good catheterization technique.

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Section: Resultsmentioning

confidence: 96%

Complications of intermittent catheterization: their prevention and treatment

2002

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“…10,11 The time seems right for a comparative prospective clinical trial. 9 The hydrophilic catheter which has so far been tested (LoFric) seems to cause less short-term strains 12 and long-term trauma 10,11 and should logically reduce the risk of chronic prostatitis and epididymitis. 9,10 Positive results of self-catheterisaton have also been seen in stricture treatment following urethrotomy 13 including the low-friction variation.…”

Section: Introductionmentioning

confidence: 99%

The importance of osmolality in hydrophilic urethral catheters: a crossover study

1997

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The longterm use of clean intermittent self catheterisation as an option for bladder management in the care of spinal cord injury patients has shown the possible risk of urethral trauma and chronic infections being developed over time. The basic properties of the catheters being used need to be evaluated. In this crossover study of 14 male spinal cord injury patients, two commercial hydrophilic catheters were compared, as to the maximum friction force during the removal of the catheters after bladder emptying. The friction force, measured by a dynamometer twice daily, showed signi®cant lower values for LoFric (0.87/0.84 N) than for EsiCath/Conveen (1.38/1.27 N). Sticking to the urethral epithelium was reported three times (two patients) with the LoFric catheter, and 42 times (nine patients) with the EasiCath catheter. Osmolality of the outer layer of the catheters was measured using a freezing-point reduction technique. The greater than 10 times higher osmolality (*900 mOsm/kg) of the Lofric catheter may explain the results.Keywords: spinal cord injuries; urethral catheterisation; osmolality of catheters IntroductionIntermittent catheterisation (IC) and clean intermittent catheterisation (CIC) are the results of innovative ideas which have been most prevalent in the medical health and psycho-social life of spinal injury patients during the past 40 years. 1 ± 5 People's doubts surrounding new paradigms should be seen more as a result of tradition than a lack of technology for running conclusive, comparative studies. Nowadays, the technology exists but a decisive routine for starting randomised clinical trials is lacking in more or less the entire spinal injury area. Within the ®eld of neurology, detailed long-term follow-ups of the Lapides method have stated that urethral complications and chronic infections are dependent on the length of the regimen, 6 ± 9 while the hydrophilic CIC catheters could reduce these complications. 10,11 The time seems right for a comparative prospective clinical trial. 9 The hydrophilic catheter which has so far been tested (LoFric) seems to cause less short-term strains 12 and long-term trauma 10,11 and should logically reduce the risk of chronic prostatitis and epididymitis. 9,10 Positive results of self-catheterisaton have also been seen in stricture treatment following urethrotomy 13 including the low-friction variation. 14 Conclusive support for this requires prospective and su ciently large-scale studies over many years, where the optimal properties for the atraumatic performance of the catheters involved are tested and compared.This preparatory clinical study in a crossover design compares the friction during catheter removal between two commercial hydrophilic catheters as part of the spinal injury patient's usual bladder regimen during the post-injury phase.

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“…Unfortunately, CISC is not the ideal method to empty the bladder. The main problems are the patient's adherence, the potential impact on quality of life, pain during the procedure, urinary infection, costs, urethral injury and it depend on patient's ability and some degree of cognition (5,6).…”

Section: Introductionmentioning

confidence: 99%

Determining the variables associated to clean intermittent self-catheterization adherence rate: one-year follow-up study

et al. 2011

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Purpose: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC). Materials and Methods: Patients refereed to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD) and WHOQoL-bref questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80% of the initial recommendation. Results: Sixty patients (50.4 ± 19.9 years old) were trained to perform CISC (21 female and 39 male). Out of them, 30 (50%) had neurogenic and 30 (50%) had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7%, 58%, respectively. Patients < 40 years old had adherence rate of 86%. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively). In the WHOQoL-bref, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-bref scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. Conclusion: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-bref.

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Urethral cytology in spinal cord injury patients performing intermittent catheterisation

Cited by 64 publications

References 9 publications

Complications of intermittent catheterization: their prevention and treatment

Complications of intermittent catheterization: their prevention and treatment

The importance of osmolality in hydrophilic urethral catheters: a crossover study

Determining the variables associated to clean intermittent self-catheterization adherence rate: one-year follow-up study

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