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Long-term Urinary Catheter (long-term + urinary_catheter)
Selected AbstractsPotentially inappropriate urinary catheter indwelling among long-term care facilities residentsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2009Yi-Tsun Chen MD Abstract Purpose, To evaluate the prevalence of long-term urinary catheter (UC) indwelling and potentially inappropriate urinary catheterization among residents of long-term care facilities (LTCFs) in Taiwan. Method, From January to March of 2007, residents with long-term urethral UC indwelling of LTCFs in northern Taipei were invited for study and were enrolled when the informed consent was obtained. For every subject, UC was removed by home care nurses, and self-voiding (SV) status was determined after a 4-hour observation period. Residual volume (RV) was measured when the UC was re-indwelled. Potentially inappropriate UC indwelling was defined by the concomitant presence of SV and the RV less than 150 mL. Results, In total, 252 residents from eight LTCFs were screened and 45 out of 62 residents with long-term UC indwelling were enrolled (mean age = 80.4 ± 8.9 years, 40% were males, 95.6% were severely disabled). SV was noted in 86.7% (39/45) of study subjects, and 71.8% (28/39) self-voided subjects had their RV less than 150 mL. By definition, the prevalence of potentially inappropriate UC indwelling in this study was 62.2%. The mean RV was significantly lower in subjects with SV (101.3 ± 66.1 vs. 221.7 ± 154.1 mL, P = 0.002) and subjects with SV were more prone to have the RV less than 150 mL (P = 0.018). Conclusion, The prevalence of long-term UC indwelling among Taiwanese LTCF residents was high and a high proportion of their UC may be removable. A national audit and introducing a practice guideline for continence care in LTCFs may help to promote quality of care for institutionalized older people in Taiwan. [source] Urine flowing: A phenomenological study of living with a urinary catheter,RESEARCH IN NURSING & HEALTH, Issue 1 2002Mary H. Wilde Abstract The experience of living with a long-term urinary catheter was investigated with a community-dwelling sample of 14 adults ranging in age from 35 to 95 who had worn a catheter for 6 months to 18 years. Data were obtained by audiotaped face-to-face interviews. Merleau-Ponty's phenomenology and van Manen's methodology guided the study. Living with a urinary catheter was found to be like living with the forces of flowing water. People were keenly aware of the flow of urine through their catheters, and they noticed when their bags needed emptying or when urine drainage seemed sluggish or obstructed. The metaphor of urine flowing like water may provide a teaching heuristic for assisting clients in adjusting to living with a catheter. Implications for further research focus on understanding the relationship between sensitivity to the dynamics of urine flow and urinary tract infection. © 2002 John Wiley & Sons, Res Nurs Health 25:14,24, 2002. [source] Increased postvoid residual volume after measuring the isovolumetric bladder pressure using the noninvasive condom catheter methodBJU INTERNATIONAL, Issue 6 2007Sandra De Zeeuw The papers in this section cover a variety of topics, from urodynamics using a noninvasive method, the morbidity associated with long-term urinary catheters and attempts being made to lower this, the use of botulinum toxin in refractory idiopathic detrusor overactivity, and finally, a study into the effect of chronic prostatitis-like symptoms on the quality of life in a relatively large patient sample. OBJECTIVE To test, in an ongoing noninvasive longitudinal study in healthy men, whether the condom catheter method (a noninvasive urodynamic test to assess bladder function and bladder outlet obstruction) inhibits bladder function and whether this affects the reliability of the measured isovolumetric bladder pressure (Pves.iso). SUBJECTS AND METHODS Subjects (754, aged 40,79 years) voided three times, i.e. one free void and two condom measurements. The postvoid residual volume (PVR) was measured after each void using transabdominal ultrasonography. The statistical significance of differences was tested using Wilcoxon rank test and the Mann,Whitney U -test. RESULTS After free voiding the median (interquartile range) PVR was 18 (37) mL, and independent of the amount of fluid intake. In a subgroup of volunteers, when the free void was done last, the PVR was no different (P = 0.25), suggesting that the bladder did not become exhausted during the protocol. The PVR after two subsequent condom measurements was significantly higher than after free voiding, at 45 (78) and 57 (88) (both P < 0.05), independent of the number of interruptions in voiding. After supplementary fluid intake before the condom measurements, the PVR was double that with a normal fluid intake (P = 0.03). The median Pves.iso was 3 cmH2O higher in the second condom measurement than in the first (P < 0.05), although this small difference was not clinically relevant. CONCLUSIONS The condom measurement is associated with a significantly higher PVR, partly caused by supplementary fluid intake. This effect was only temporary and did not affect the measured Pves.iso. [source] Developing a strategy to reduce the high morbidity of patients with long-term urinary catheters: the BioMed catheter research clinicBJU INTERNATIONAL, Issue 6 2007Azhar A. Khan OBJECTIVE To assess the idea of managing patients having problems with long-term catheterization (LTC, normally used when all other methods of bladder management have failed or are unsuitable) in a dedicated clinic, to present a prospective analysis of consecutive new patients attending between February 2002 and October 2006, and to establish the incidence of bladder stones in patients who have recurrent catheter encrustation and blockage. PATIENTS AND METHODS Patients treated with LTC are a large heterogeneous group, mainly consisting of elderly people who have chronic disabilities, and catheter-associated complications occur in > 70% of them. In all, 260 consecutive new patients having problems with LTC were assessed; the evaluation consisted of basic demographics, a detailed history, clinical examination, urine analysis and flexible cystoscopy (FC) via the catheterization route. Patients with bladder stones were screened with FC for recurrence of stones at 3, 6 and 12 months after treatment. RESULTS In all, 117 men and 143 women (mean age 67.7 years, range 23,97) were assessed; 147 (55.5%) had catheter encrustation. FC showed that 66 of the 147 patients (45%) had bladder stones. Forty-eight patients (73%) were successfully treated at the same clinic appointment and their stones were removed with the help of a tip-less stone basket. Eighteen patients (27%) were referred for inpatient treatment of bladder stones under general anaesthesia. Twenty of 66 patients with bladder stones (30%) formed recurrent bladder stones at a mean (range) follow-up of 8.1 (3,18 months). In addition, 36 patients had successful insertion of suprapubic catheter (SPC) under local anaesthetic in the clinic, and 11 were referred for SPC insertion under general anaesthesia. Two patients were diagnosed with bladder transitional cell carcinoma. CONCLUSION The introduction of a dedicated catheter clinic, equipped with facilities such as FC and a hoist, enables patients to be treated in an environment that meets their needs and potentially reduces the risk of more complex stone removal and catheter problems at a later date. It can also act as a potential source of data for use in research and development. A significant proportion (45%) of patients with catheter encrustation and blockage had formed bladder stones. Our study provides a rationale for FC of all such patients to detect and remove stones. [source] | ||||||||||