Department of Urology, Guy's and St Thomas' Hospitals, London, UK.
BJU Int. 2020 Feb;125(2):299-303. doi: 10.1111/bju.14890. Epub 2019 Aug 26.
To evaluate the MIC-KEY button vesicostomy as an alternative to indwelling suprapubic catheters (SPCs) for bladder drainage in adults.
Phase II pilot study prospectively evaluating patients with indwelling SPCs that were converted to MIC-KEY buttons, or cystoscopic-guided de novo insertion, between November 2014 and February 2019. In all, 15 patients (14 female, one male) had indwelling SPCs that had conversion or attempted conversion to MIC-KEY button, and one (male) had a cystoscopic-guided de novo insertion with a history of previous suprapubic catheterisation. The mean (range) age was 44.2 (13-73) years. Catheter-related quality-of-life (C-IQoL) questionnaire data were collected at baseline and 3 months.
Two patients had attempted conversion but were abandoned perioperatively due to sizing issues and insertion difficulties, respectively. Three patients were subsequently converted back to a SPC; due to button sizing (18 days), leaking (3 months), and recurrent infection (13 months). The remaining 11 patients have remained well with continued drainage via the MIC-KEY button; mean (range) duration since conversion was 34.2 (5-105) months. The C-IQoL score improved 3 months after insertion, from 50.0 to 75.4. Changes were performed dependent on patient's personalised management, typically every 3 months, under local or general anaesthetic.
The MIC-KEY button is a safe alternative to SPC drainage in adults in the short- to medium-term, in a selected cohort.
评估 MIC-KEY 按钮式膀胱造瘘术作为成人膀胱引流的替代方法，以替代留置导尿管（SPC）。
这是一项前瞻性的 II 期试点研究，评估了 2014 年 11 月至 2019 年 2 月期间，将留置 SPC 转换为 MIC-KEY 按钮或膀胱镜引导下初次插入的患者。共有 15 名患者（14 名女性，1 名男性）留置 SPC，其中 15 名患者进行了转换或尝试转换为 MIC-KEY 按钮，1 名（男性）曾有过留置 SPC 病史，行膀胱镜引导下初次插入。患者的平均（范围）年龄为 44.2（13-73）岁。在基线和 3 个月时收集了与导管相关的生活质量（C-IQoL）问卷数据。
有 2 名患者在围手术期因尺寸问题和插入困难分别尝试了转换，但均失败。随后，又有 3 名患者因按钮尺寸（18 天）、渗漏（3 个月）和反复感染（13 个月）而转回 SPC。其余 11 名患者继续通过 MIC-KEY 按钮保持良好的引流，自转换以来的平均（范围）时间为 34.2（5-105）个月。插入后 3 个月，C-IQoL 评分从 50.0 提高到 75.4。这些变化是根据患者的个性化管理进行的，通常每 3 个月进行一次，在局部或全身麻醉下进行。
在选定的患者群体中，MIC-KEY 按钮在短期至中期内是 SPC 引流的安全替代方法。
