Effects of clean intermittent self-catheterization on late bladder dysfunction after radical hysterectomy in cervical cancer

Abstract

Objective To identify the benefits of clean intermittent self-catheterization in women who have late bladder dysfunction caused by radical hysterectomy in cervical cancer. Methods Thirty women who underwent radical hysterectomy with late bladder dysfunction were recruited. A nursing intervention program focusing on clean intermittent self-catheterization and a drinking plan was implemented. We recorded urinary times during the day and night, post-voiding residual urine volume, positive catheter specimen of urine rate, and quality of life instruments for patients with cervical cancer . Results All patients were able to satisfactorily manage clean intermittent self-catheterization following video-based operational training. Bladder function was significantly increased after 3-month intervention compared with before the intervention. Urinary times during the day and night, and post-voiding residual urine volume were greatly decreased post-intervention compared with pre-intervention. The rate of a positive catheter specimen of urine test significantly decreased over time. There was significant improvement in quality of life in five dimensions between weeks 1 and 12 following the intervention. Conclusions Patients are able to learn the technique of clean intermittent self-catheterization without any difficulty. This technique is effective together with a drinking plan to decrease late bladder dysfunction caused by radical hysterectomy in cervical cancer.

Intermittent Catheterization Continuity Care on Bladder Function Recovery and Quality of Life in Patients After Radical Hysterectomy for Cervical Cancer: A Quasi-Experimental Study

“… 7 Previous studies showed that clean self-IC combined with a drinking plan is effective in decreasing late bladder dysfunction after radical hysterectomy for cervical cancer. 14–16 , 19 The standard self-IC care usually includes 1) operation training, 2) catheter care, 3) pelvic floor rehabilitation exercises, instructing patients on pelvic floor exercises, abdominal muscle training, and leg lifting exercises, 4) hydration guidance and urine observation, and 5) follow-up guidance. Compared with standard self-IC, the key features of continuity of care nursing for self-IC include the personal nursing scheme drafted based on the careful discharge assessment, the proper teaching of the technique, and the personal follow-up that ensures the patient continues to practice the technique properly.…”

“…[14][15][16] IC can be self-performed by the patient, alleviating the requirements on the healthcare system and giving the patient more freedom. [17][18][19] Continuity of care, also known as continuous care or continuous rehabilitation, refers to a set of nursing activities that enable patients to receive continuous and coordinated care services when transferring to different healthcare facilities or levels of healthcare institutions. 20,21 It is a recent nursing model developed in the past 20 years and aims at extending nursing from hospitals to families, compensating for the difficulties in obtaining information and meeting the healthcare needs of the patients after discharge, providing a basis for improving patients' self-care behavior and abilities, and promoting recovery.…”

Summary of evidence on prevention and management of bladder dysfunction in patients after radical hysterectomy

“…RH with pelvic lymphadenectomy is considered a standard surgical treatment by the Federation of Obstetrics and Gynaecology stages IB1‐IIACC (Shen et al., 2020 ). As the surgical site is inside the pelvic cavity, the ureter and bladder can get easily damaged during the surgery, possibly leading to bladder complications such as urinary retention and urinary tract infection (Yu et al., 2022 ).…”

“…In recent years, scholars have attempted to prevent and manage bladder dysfunction after RH, which includes pharmacological interventions, early postoperative bladder training, low‐frequency electrical stimulation, intermittent catheterization, acupuncture therapy and indwelling catheterization. Most of these methods have been proven to be effective and can promote the bladder function rehabilitation of patients to a certain extent (Jackson et al., 2019 ; Li et al., 2021 ; Shen et al., 2020 ). Furthermore, intermittent catheterization has become the management method of choice for bladder dysfunction, as also recognized by the International Association for Urinary Control (Engberg et al., 2020 ).…”