Quality of life and urological morbidity in tetraplegics with artificial ventilation managed with suprapubic or intermittent catheterisation

Böthig, Ralf; Hirschfeld, Sven; Thietje, Roland

doi:10.1038/sc.2011.94

Cited by 22 publications

(11 citation statements)

References 19 publications

(21 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Thus, SPC is commonly (that is, 18% in present investigation) chosen as an alternative evacuation method. [2][3][4] In AIS A-C tetraplegics, the odds of bladder evacuation by indwelling catheterization were increased up to eightfold. Evacuation by self-IC is possible in tetraplegics with a motor lesion level below C5 and sufficient wrist extensor muscle strength.…”

Section: Discussionmentioning

confidence: 99%

“…In selected aging or multi-morbid individuals, SPC represents an appropriate alternative evacuation method, provided that close urological monitoring is maintained. 2,3 Urinary diversion is a good alternative in otherwise healthy individuals who are not able to perform IC. However, in the patient group mentioned above, the general health condition usually precludes such surgical techniques.…”

Section: Discussionmentioning

confidence: 99%

“…1 If insufficient manual dexterity or other reasons preclude IC, triggered reflex voiding (RV) in men or suprapubic catheterization (SPC) in women may represent alternative evacuation methods. [2][3][4] IC by a caregiver is only rarely accepted by individuals with NLUTD because of the loss of independence. 5 Bladder evacuation by IC may be the most prevalent evacuation method at discharge from rehabilitation; 2,6,7 however, some individuals seem to change their evacuation method over time.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bladder management in individuals with chronic neurogenic lower urinary tract dysfunction

2015

View full text Add to dashboard Cite

Study Design: Retrospective investigation. Objectives: To investigate the association of patient and injury characteristics with bladder evacuation by indwelling catheterization in patients with chronic neurogenic lower urinary tract dysfunction (NLUTD). Setting: Tertiary urologic referral center. Methods: The patient database was screened for patients with chronic (412 months) NLUTD. Patient characteristics and bladder management details were collected. Binary logistic regression analysis was used to investigate the effects of the investigated factors on bladder evacuation by indwelling catheterization. Results: The data of 1263 patients with a median age of 47 years (range 11-89 years) and a median NLTUD duration of 15.2 years (range 1.0-63.4 years) were investigated. The most common bladder evacuation method was intermittent catheterization (IC; 41.3%) followed by triggered reflex voiding (25.7%), suprapubic catheterization (11.8%), sacral anterior root stimulation (7.3%), spontaneous voiding (7.0%), abdominal straining (5.7%) and transurethral catheterization (1.3%). Female gender, tetraplegia, an age older than 45 years and injury duration were significant (o0.001) predictors of indwelling catheterization. The odds of bladder evacuation by indwelling catheterization were increased~2.5, 3 and 4 times in women, patients older than 45 years and tetraplegics, respectively. Conclusions: IC is the most common bladder evacuation method. However, the majority of individuals with NLUTD are using other evacuation methods, because factors such as functional deficiencies, mental impairment or the social situation are relevant for choosing a bladder evacuation method. Individuals at risk of indwelling catheterization can be identified based on female gender, age, injury severity and injury duration.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Bladder management in individuals with chronic neurogenic lower urinary tract dysfunction

2015

View full text Add to dashboard Cite

show abstract

“…1) papers were initially identified after removal of duplicates. After independent review of titles and abstracts by two authors (KM, KH), 26 potentially relevant articles were selected: 6 RCTs; 11–16 1 prospective non‐randomized study with comparator;17 8 retrospective studies with a comparator;6, 18–24 6 retrospective studies with no comparator;25–30 1 prospective case series with comparator;31 and 4 descriptive or qualitative studies 32–35. Reference lists of all 26 potentially relevant papers were hand searched for any additional relevant papers but none were identified.…”

Section: Resultsmentioning

confidence: 99%

Long‐term bladder drainage: Suprapubic catheter versus other methods: A scoping review

Hunter

Bharmal

Moore

2012

Neurourology and Urodynamics

View full text Add to dashboard Cite

show abstract

“…Indwelling catheters can be effective in treating urinary incontinence and especially suprapubic catheters might be an option for highly selected populations, such as tetraplegic patients [19]. However, indwelling catheters are not recommended for routine long-term treatment because of the associated complications such as acute and chronic UTI, stone formation, urinary leakage/incontinence, erosion of meatus and urethra, fistula formation, reduction in bladder capacity, and compliance (with continuous drainage) [20,21,22 && ].…”

Section: Cathetersmentioning

confidence: 99%

The management of urinary incontinence in the male neurological patient

Mehnert

Kessler

2014

Current Opinion in Urology

View full text Add to dashboard Cite

PURPOSE OF REVIEW: Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. RECENT FINDINGS: Intermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SUMMARY: Standard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in male neurological patients, well-designed, multicenter studies are warranted. Purpose of review Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. Recent findingsIntermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SummaryStandard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in mal...

show abstract

Quality of life and urological morbidity in tetraplegics with artificial ventilation managed with suprapubic or intermittent catheterisation

Cited by 22 publications

References 19 publications

Bladder management in individuals with chronic neurogenic lower urinary tract dysfunction

Bladder management in individuals with chronic neurogenic lower urinary tract dysfunction

Long‐term bladder drainage: Suprapubic catheter versus other methods: A scoping review

The management of urinary incontinence in the male neurological patient

Contact Info

Product

Resources

About