Many treatment options for stress urinary incontinence are difficult to apply to neurological patients. Urolastic is a new agent that is primarily indicated for women with mild stress urinary incontinence or men after prostate surgery. In this report, we present a series of 5 cases describing the first use of Urolastic to treat neurological patients. All patients were evaluated with a voiding diary and the use of auxiliary devices as the main indicators of continence. The median operative time was 30.8 minutes, and no complications were observed. Of the 5 patients, 4 reported improved incontinence: 2 switched from diapers to small pads, while the other 2 patients were able to discontinue urinary condom use. The only instance of treatment failure occurred in a patient with a low-compliance bladder. The advantages of this procedure appear to include a soft-cuff effect, reversibility, and minimal invasiveness. However, a future randomized study would be necessary to validate this treatment option.
Intermittent catheterisation (IC) is considered the gold standard for bladder dysfunction‐related voiding problems following spinal cord injury (SCI). Despite this, up to 50% of individuals were no longer using IC 5 years after discharge from the rehabilitation centre. Hence, we initiated the IC Education Programme to offer standardized IC training and improve adherence. The programme was a European initiative undertaken by eight rehabilitation centres in Norway, France and Italy. The aim of this study is to evaluate the effectiveness of the IC Education Programme. The control group comprised individuals with SCI discharged from one of the participating rehabilitation centres using IC up to 1 year before the Education Programme was initiated. A questionnaire was sent by post to this group before the IC Education Programme started. The second group comprised individuals who had participated in and been discharged using the IC Education Programme; they received the questionnaire up to 1 year after programme initiation. Anonymous responses from the two groups were compared to assess outcomes such as ongoing use of IC, satisfaction with training and attitude towards bladder issues. Three hundred sixteen responses (from 500 questionnaires sent) were received from the control group (63%) and 84 (of 142) from the IC Education Programme group (59%). The IC Education Programme significantly increased the percentage of individuals still using IC during the first year at home (99 vs. 83% for the Education Programme and control groups, respectively; p < 0·05) and improved satisfaction with training in IC. Individuals who had participated in the IC Education Programme were also significantly less bothered by bladder issues than the control group (overall SF‐Qualiveen index 1·58 vs. 1·76, respectively; p = 0·032). The IC Education Programme improved the standard of care following SCI as it enabled more individuals to continue with IC up to 1 year after discharge, and improved training satisfaction.
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