Ikuerowo Stephen O, Ogunade Aderinsola A, Ogunlowo Taiwo O, Uzodimma Charles C, Esho Julius O
Urology Unit, Department of Surgery, Lagos State University College of Medicine and, Lagos State University Teaching Hospital Ikeja, Lagos, Nigeria.
BMC Urol. 2007 Sep 26;7:16. doi: 10.1186/1471-2490-7-16.
Acute urinary retention (AUR) is a common urological problem. We have observed a growing list of patients on indwelling bladder catheter awaiting surgery after AUR. This study was aimed at identifying the health, financial and quality of life (QoL) implications of prolonged use of indwelling catheter in these patients
We review the side-effects, QoL and cost of changing an indwelling catheter among patients who were on the waiting list for definitive surgery after AUR. All the 62 patients who presented to weekly catheter clinic for change of the indwelling catheter were recruited over a 3 - week period into the study.
The mean age of the patients was 57.5 years and the mean catheter use time was 23 months. The aetiology of AUR was BPH in 40 (64%) and urethral trauma in 16 (28.4%) of the patients. The common side effects of prolonged catheterization included urethral/suprapubic pain, bleeding per urethram, loss of dignity, loss of job or being out of school, lack of sexual intercourse, pericatheter leakage of urine and recurrent urinary tract infection. The cost of change of the indwelling catheter to the patient each time ranged from 460.00 - 2500.00 Naira (averaged 789.67 Naira). The total annual cost for the change of indwelling catheter after AUR in our catheter clinic was estimated to be 7,350,000.00 Naira (58,800 US dollars) with 1,890,000.00 Naira (15,120 US dollars) being the cost borne by the patients per annum and the rest being government subsidy. Fifty-three (85.5%) patients described that they were unhappy. There was a significant correlation between QoL and the presence of pain (p = 0.015) and bleeding (p = 0.042) associated with the presence of an indwelling catheter.
The need to have an indwelling catheter for a prolonged period after AUR is a painful experience and associated with several side-effects. This has a significant negative effect on the patients' QoL and constitutes a significant financial burden to the patients and the government. We suggest that measures should be put in place to reduce the waiting time for surgery and therefore the catheterization time among the patients with AUR.
急性尿潴留（AUR）是一种常见的泌尿系统问题。我们观察到越来越多因AUR而留置膀胱导管等待手术的患者。本研究旨在确定这些患者长期使用留置导管对健康、经济和生活质量（QoL）的影响。
我们回顾了AUR后等待确定性手术的患者更换留置导管的副作用、生活质量和成本。在3周内，所有到每周一次的导管诊所更换留置导管的62例患者被纳入研究。
患者的平均年龄为57.5岁，平均导管使用时间为23个月。AUR的病因在40例（64%）患者中为良性前列腺增生（BPH），16例（28.4%）为尿道创伤。长期导尿的常见副作用包括尿道/耻骨上疼痛、尿道出血、尊严丧失、失业或辍学、缺乏性生活、导管周围尿液渗漏和复发性尿路感染。每次更换留置导管给患者带来的费用在460.00 - 2500.00奈拉之间（平均789.67奈拉）。我们导管诊所AUR后每年更换留置导管的总费用估计为7350000.00奈拉（58800美元），其中患者每年承担1890000.00奈拉（15120美元），其余为政府补贴。53例（85.5%）患者表示不满意。生活质量与留置导管相关的疼痛（p = 0.015）和出血（p = 0.042）之间存在显著相关性。
AUR后长期留置导管是一种痛苦的经历，并伴有多种副作用。这对患者的生活质量有显著负面影响，给患者和政府带来了巨大的经济负担。我们建议应采取措施减少手术等待时间，从而减少AUR患者的导尿时间。
