Department of Paediatric Surgery and Urology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
Department of Paediatric Surgery and Urology, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
J Pediatr Urol. 2019 May;15(3):252.e1-252.e4. doi: 10.1016/j.jpurol.2019.03.018. Epub 2019 Mar 29.
Many urological operations require placement of a urethral Foley catheter. The catheter often needs to remain in situ for a period of time after discharge; and patients subsequently require either a further hospital admission or community nurse review for catheter removal. Parents can easily remove the catheter at home by cutting the balloon port. This disrupts the valve and hence deflates the retaining balloon, thereby facilitating spontaneous passage of the catheter. The authors introduced this practice to their institution.
The aim was to assess safety and success of parental home catheter removal.
A prospective data study was performed in a large pediatric urology center over a 12-month time period. Patients <16 years after single-stage hypospadias repair or other penile surgery were included on a voluntary basis. Parents of eligible patients were instructed verbally and with an information leaflet, including date for removal. Telephone follow-up after removal was undertaken to assess the outcome.
Thirty-eight patients were included over a 12-month time period. Patient age ranged from 9 months to 12 years (median age 2.5 years). The majority (82%) of patients had required a catheter after hypospadias repair. Home catheter removal was successful in 92% cases. Three children required professional support for catheter removal. Median time until catheter passage was 3 h (range 0-24 h). Considering that cost for day case admission for catheter removal averages at 130£ per patient, home catheter removal saved the NHS 4550£ in the time period.
This is the first study to report the safety and feasibility of parental home catheter removal by cutting the balloon port valve in the pediatric population. It offers a number of distinct advantages compared with traditional methods for removal. These include, namely, (i) positive patient experience: catheter removal in a familiar environment by a relative minimizes stressful experiences for the family; (ii) minimal trauma to healing tissues through spontaneous catheter passage; and (iii) health care-related cost savings. This was an initial benchmarking study, so patient numbers were relatively small. Nevertheless, it shows that the method is safe and received positive parental feedback.
Parental home removal of a urethral catheter is a feasible and safe alternative to catheter removal by a health-care professional. It minimizes parental anxiety and inconvenience related to the catheter removal appointment and allows for significant cost savings.
许多泌尿科手术需要放置尿道 Foley 导管。导管通常在出院后需要在原位保留一段时间；随后，患者需要再次住院或社区护士进行导管移除的复查。父母可以通过切割球囊端口轻松地在家中移除导管。这会破坏阀门并使保留的球囊泄气，从而促进导管的自然排出。作者将这种做法引入了他们的机构。
评估父母在家中自行移除导管的安全性和成功率。
在一家大型儿科泌尿科中心进行了为期 12 个月的前瞻性数据研究。对接受一期阴茎下裂修复术或其他阴茎手术的<16 岁患者进行了自愿性研究。向符合条件的患者的父母进行了口头和信息传单指导，包括移除日期。移除后进行电话随访以评估结果。
在 12 个月的时间内纳入了 38 名患者。患者年龄从 9 个月至 12 岁（中位数年龄 2.5 岁）。大多数（82%）患者在阴茎下裂修复术后需要导管。92%的病例在家中成功移除了导管。有 3 名儿童需要专业支持来移除导管。中位导管排出时间为 3 小时（范围 0-24 小时）。考虑到日间手术入院以移除导管的费用平均为每位患者 130 英镑，在该时间段内，家庭导管移除为 NHS 节省了 4550 英镑。
这是第一项报告在儿科人群中通过切割球囊端口阀进行父母在家中导管移除的安全性和可行性的研究。与传统的移除方法相比，它具有许多明显的优势。这些优势包括：（i）积极的患者体验：在熟悉的环境中由亲属移除导管，最大限度地减少了家庭的紧张体验；（ii）导管自然排出对愈合组织的最小创伤；和（iii）与医疗保健相关的成本节约。这是一项初步的基准研究，因此患者数量相对较少。然而，它表明该方法是安全的，并得到了家长的积极反馈。
父母在家中自行移除尿道导管是一种可行且安全的替代方法，可替代医疗保健专业人员进行的导管移除。它最大限度地减少了与导管移除预约相关的父母焦虑和不便，并可显著节省成本。
