Johnson D E, O'Reilly J L, Warren J W
Infectious Diseases Laboratory, Veterans Administration Medical Center, Baltimore, Maryland 21218.
J Urol. 1989 Mar;141(3):535-7. doi: 10.1016/s0022-5347(17)40884-6.
Chronic urinary incontinence is a frequent complication of a variety of neurological diseases and is a major clinical problem among the aged. Urinary incontinence may be the pivotal factor that determines whether a patient requires long-term institutional care. For management of urinary incontinence in aged, nonambulatory women use of absorbent products may not prevent decubitus ulcers, while chronic use of indwelling urethral catheters results in bacteriuria and its complications. An effective external urine collection device for women, analogous in function to the condom catheter for men, may improve care by reducing complications, averting admissions to chronic care facilities and lowering medical costs. During 125 patient-days we evaluated 63 applications of an external urine collection device on 7 incontinent women in a nursing home. Each device was allowed to remain in situ for a maximum of 48 hours. Only 14 per cent of the devices required premature replacement due to unacceptable urine leakage. The median device wear time was 48 hours. The only adverse reactions observed were minimal erythema at 2 of 63 device removals and transient periurethral edema in 1 patient, which disappeared with continued use of the device. Thus, this device, exploiting an adhesive developed for ostomy appliances, was effective in maintaining patient dryness and was not associated with severe local reactions. These results appear to warrant clinical trials for extended periods in incontinent women.
慢性尿失禁是多种神经系统疾病常见的并发症，也是老年人中的一个主要临床问题。尿失禁可能是决定患者是否需要长期机构护理的关键因素。对于老年、非卧床女性的尿失禁管理，使用吸收性产品可能无法预防褥疮，而长期使用留置导尿管会导致菌尿及其并发症。一种对女性有效的外部尿液收集装置，其功能类似于男性的避孕套导尿管，通过减少并发症、避免入住长期护理机构和降低医疗成本，可能会改善护理。在125个患者日期间，我们在一家养老院对7名尿失禁女性使用外部尿液收集装置进行了63次应用评估。每个装置最多允许原位放置48小时。由于不可接受的尿液泄漏，只有14%的装置需要提前更换。装置的中位佩戴时间为48小时。观察到的唯一不良反应是在63次装置移除中有2次出现轻微红斑，1名患者出现短暂的尿道周围水肿，随着装置的持续使用而消失。因此，这种利用为造口器具开发的粘合剂的装置有效地保持了患者的干爽，且未出现严重的局部反应。这些结果似乎值得对尿失禁女性进行长期的临床试验。
