Bickhaus Jennifer A, Drobnis Erma Z, Critchlow William A, Occhino John A, Foster Raymond T
From the *Department of Obstetrics, Gynecology, and Women's Health, University of Missouri School of Medicine, Columbia, MO; and †Division of Gynecologic Surgery, Department of Urogynecology, Mayo Clinic, Rochester, MN.
Female Pelvic Med Reconstr Surg. 2015 Jul-Aug;21(4):220-4. doi: 10.1097/SPV.0000000000000155.
The aim of this study was to evaluate the feasibility of teaching clean intermittent self-catheterization (CISC) in an outpatient setting to women planning surgery for pelvic organ prolapse (POP) and/or urinary incontinence (UI).
This was a prospective observational study of 55 women who planned surgical correction of POP and/or UI. All women were taught CISC as part of their preoperative education. The ability to learn CISC and the amount of time needed to teach CISC were recorded. Multivariate modeling, χ2 test, Fisher exact test, and Kruskal-Wallis analysis of variance were used for statistical analysis.
Of the 55 subjects consecutively enrolled, 51 subjects (93%) were able to learn CISC and demonstrate competency (P < 0.00001). Four subjects (7%) were unable to learn CISC. The median time to teach CISC with demonstrated proficiency was 3.7 minutes (range, 1.8-7.4 minutes). Of the subjects who learned CISC and had surgery, the mean (SD) time in days from preoperative teaching to the postoperative voiding trial was 16 (11) days (range, 2-39 days). Of the 41 subjects who completed the postoperative voiding trial and had data recorded, 33 (80%) were able to self-catheterize without nurse assistance or with minimal verbal coaching, whereas 8 (20%) subjects required hands-on nursing assistance or were unable to perform CISC (P < 0.001).
Clean intermittent self-catheterization can be taught to most patients undergoing POP/UI surgery in a short time (median, 3.7 minutes). The overwhelming majority of patients are able to retain the CISC skill weeks after being taught in the clinic.
本研究旨在评估在门诊环境中，对计划接受盆腔器官脱垂（POP）和/或尿失禁（UI）手术的女性进行清洁间歇性自我导尿（CISC）教学的可行性。
这是一项对55名计划接受POP和/或UI手术矫正的女性进行的前瞻性观察研究。所有女性都接受了CISC教学，作为她们术前教育的一部分。记录学习CISC的能力以及教授CISC所需的时间。采用多变量建模、χ²检验、Fisher精确检验和Kruskal-Wallis方差分析进行统计分析。
在连续纳入的55名受试者中，51名受试者（93%）能够学会CISC并展示出能力（P < 0.00001）。4名受试者（7%）无法学会CISC。教授CISC达到熟练水平的中位时间为3.7分钟（范围为1.8 - 7.4分钟）。在学会CISC并接受手术的受试者中，从术前教学到术后排尿试验的平均（标准差）天数为16（11）天（范围为2 - 39天）。在41名完成术后排尿试验并记录了数据的受试者中，33名（80%）能够在无需护士协助或只需极少口头指导的情况下自行导尿，而8名（20%）受试者需要实际的护理协助或无法进行CISC（P < 0.001）。
对于大多数接受POP/UI手术的患者，可以在短时间内（中位时间为3.7分钟）教会他们清洁间歇性自我导尿。绝大多数患者在门诊接受教学数周后仍能保留CISC技能。
