Grigoleit U, Pannek J, Stöhrer M
Schwerpunkt Neuro-Urologie, Urologische Klinik, Ruhr-Universität Bochum, Marienhospital, Herne.
Urologe A. 2006 Feb;45(2):175-82. doi: 10.1007/s00120-006-1007-9.
In patients with bladder dysfunctions, intermittent catheterisation is a bladder evacuation technique with a low complication rate. Therefore, it is regarded as the method of choice in the treatment of chronic residual urine, mostly due to a hypo- or acontractile detrusor. Regarding the incidence of urinary tract infections and urethral strictures, aseptic catheterisation seems to be superior to the clean technique. There are, however, no independent, prospective, controlled, randomised, double-blinded studies comparing the different catheter types. Thus, the question of which catheter is the ideal one cannot be answered yet. Predominantly in patients who have to perform intermittent catheterisation for good, the prevention of long-term complications, especially of the upper urinary tract, is of the utmost importance. In the long run, using an inadequate technique and catheters not optimally designed will clearly lead to a higher complication rate. Despite the lower prices of certain catheters, treatment of these complications will lead to higher instead of lower costs. The data available today clearly demonstrate that aseptic intermittent catheterisation is the technique of choice today. Important details of this treatment modality, however, have to be elucidated by prospective studies in the future.
在膀胱功能障碍患者中,间歇性导尿是一种并发症发生率较低的膀胱排空技术。因此,它被视为治疗慢性残余尿的首选方法,主要是由于逼尿肌收缩功能减退或收缩无力。就尿路感染和尿道狭窄的发生率而言,无菌导尿似乎优于清洁导尿技术。然而,目前尚无比较不同类型导尿管的独立、前瞻性、对照、随机、双盲研究。因此,哪种导尿管是理想选择的问题尚未得到解答。对于那些必须长期进行间歇性导尿的患者来说,预防长期并发症,尤其是上尿路并发症,至关重要。从长远来看,使用不当的技术和设计并非最佳的导尿管显然会导致更高的并发症发生率。尽管某些导尿管价格较低,但治疗这些并发症反而会导致成本增加而非降低。目前可得的数据清楚地表明,无菌间歇性导尿是当今的首选技术。然而,这种治疗方式的重要细节仍有待未来的前瞻性研究予以阐明。