Batista-Miranda José Emilio, Martínez Pablo, Bassas-Parga Anaïs
Unidad de Urodinamia. URD/Hospital Quirón Teknon. Barcelona. España.
Arch Esp Urol. 2014 Dec;67(10):831-8.
To evaluate usefulness and morbidity of clean intermittent catheterization (CIC) using a decreasing pattern in patients with bladder voiding dysfunction (BVD) of varied etiology.
We performed a retrospective study of patients with BVD in whom CIC was indicated. We evaluated the clinical presentation, post-void residual urine (PVR), results of the urodynamic studies (UDS), and response to CIC in a decreasing pattern, complications espeand patient adherence. The primary endpoint was a favorable response to CIC in a decreasing frequency pattern. Secondary endpoints were complications and patient perception of it.
We evaluated a total of 27 patients with BVD. Of these, 15 (56%) were women and 12(44%) were men. Mean age was 54.33 years (32-82) and mean follow-up time was 23.5 months (2-66). The mean catheterized volume and the number of catheterizations decreased in all groups of patients. 40.7% of all patients did not need to perform catheterization after an average time of 7.38 months. The average time to reach a stable PVR or the lack of it was 9.76 months (0.75 to 63). The only complication recorded were urinary tract infection (UTI) presenting as mild cystitis in 7 patients and orchitis in 2 patients. 70.4% (19/27) responded to the telephone survey. 79% (15/19) said they have had no major difficulty in learning CIC, 52.7% (10/19) said to be continuing CIC, and the mean personal rating was 6/10.
CIC in a decreasing pattern allows almost half of the patients to be totally free from catheterization. The other half reduces significantly the number of catheterizations, with little interference in their daily lives. It is an effective technique, well accepted and well learned by most patients with BVD in a wide range of indications, beyond neurogenic dysfunction.
评估在不同病因的膀胱排尿功能障碍(BVD)患者中采用递减模式进行清洁间歇性导尿(CIC)的有效性和发病率。
我们对有CIC指征的BVD患者进行了一项回顾性研究。我们评估了临床表现、排尿后残余尿量(PVR)、尿动力学研究(UDS)结果以及对递减模式CIC的反应、并发症尤其是患者的依从性。主要终点是对递减频率模式的CIC有良好反应。次要终点是并发症和患者对其的认知。
我们共评估了27例BVD患者。其中,15例(56%)为女性,12例(44%)为男性。平均年龄为54.33岁(32 - 82岁),平均随访时间为23.5个月(2 - 66个月)。所有患者组的平均导尿量和导尿次数均减少。40.7%的患者在平均7.38个月后无需进行导尿。达到稳定PVR或未达到稳定PVR的平均时间为9.76个月(0.75至63个月)。记录的唯一并发症是7例患者出现轻度膀胱炎的尿路感染(UTI)和2例患者出现睾丸炎。70.4%(19/27)的患者回复了电话调查。79%(15/19)的患者表示学习CIC没有太大困难,52.7%(10/19)的患者表示继续进行CIC,平均个人评分是6/10。
递减模式的CIC可使近一半患者完全摆脱导尿。另一半患者显著减少了导尿次数,对其日常生活干扰很小。这是一种有效的技术,在广泛的适应症范围内,除神经源性功能障碍外,大多数BVD患者都能很好地接受并掌握。