583 OnabotulinumtoxinA reduces urinary incontinence and improves quality of life in overactive bladder patients regardless of use of clean intermittent catheterisation or the presence of urinary tract infection

Background: Clean intermittent catheterisation (CIC) is often recommended for people with multiple sclerosis (MS). Objective: To determine the variables that affect continuation or discontinuation of the use of CIC. Methods: A three-part mixed-method study (prospective longitudinal cohort ( n = 56), longitudinal qualitative interviews ( n = 20) and retrospective survey ( n = 456)) was undertaken, which identified the variables that influenced CIC continuation/discontinuation. The potential explanatory variables investigated in each study were the individual’s age, gender, social circumstances, number of urinary tract infections, bladder symptoms, presence of co-morbidity, stage of multiple sclerosis and years since diagnosis, as well as CIC teaching method and intensity. Results: For some people with MS the prospect of undertaking CIC is difficult and may take a period of time to accept before beginning the process of using CIC. Ongoing support from clinicians, support at home and a perceived improvement in symptoms such as nocturia were positive predictors of continuation. In many cases, the development of a urinary tract infection during the early stages of CIC use had a significant detrimental impact on continuation. Conclusion: Procedures for reducing the incidence of urinary tract infection during the learning period (i.e. when being taught and becoming competent) should be considered, as well as the development of a tool to aid identification of a person’s readiness to try CIC.

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Maintenance of indwelling urinary catheters with a novel polyhexanide-based solution: user experience

British Journal of Nursing ◽

10.12968/bjon.2020.29.18.s18 ◽

2020 ◽

Vol 29 (18) ◽

pp. S18-S28

Author(s):

Litti Andersen ◽

Marianne Bertelsen ◽

Vicki Buitenhuis ◽

Annette Carstensen ◽

Jane Hannibalsen ◽

...

Keyword(s):

Quality Of Life ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Healthcare Costs ◽

Product Evaluation ◽

Improve Quality ◽

Urinary Catheters ◽

User Experiences

Background: Catheter-associated urinary tract infection (CAUTI) can significantly affect patients' quality of life and increase healthcare costs. Aims: This study aimed to capture patients' and nurses' experience of catheter maintenance using a polyhexanide-based solution (PS) in everyday practice. Methods: Retrospective analysis of data was collected for a product evaluation. PS was used twice a week for five weeks. Findings: The study included 42 patients, 30 (71%) men and 12 women (29%). After five weeks of rinsing catheters with PS, nine patients reported no or decreased frequency of CAUTI, eight a better quality of life, eight reduced blockage, seven a decrease in odour and five fewer catheter changes. Three patients reported no benefit from PS use. Nurses reported that fewer visits were needed and consumption of disposables was lower. Conclusions: User experiences suggest that, as a novel means of catheter maintenance, PS has the potential to reduce catheter-associated complications such as CAUTI, improve quality of life and reduce healthcare costs.

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Intermittent catheterisation: the common complications

British Journal of Community Nursing ◽

10.12968/bjcn.2021.26.6.272 ◽

2021 ◽

Vol 26 (6) ◽

pp. 272-277

Author(s):

Salma Balhi ◽

Rym Baati Arfaouni ◽

Ali Mrabet

Keyword(s):

Quality Of Life ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Gold Standard ◽

Risk Of Infection ◽

Intermittent Catheterisation ◽

The Common ◽

Neurological Bladder

Intermittent catheterisation (IC) has been in practice for more than 40 years and is considered the gold standard in the management of urinary retention in the neurological bladder. IC has many advantages over indwelling urethral or suprapubic catheterisation, including reducing the risk of infection, protecting the bladder and improving quality of life. However, complications can be caused by the practice of this technique, the most common of which is infection. This review discusses some of the common complications that can occur with the use of intermittent catheterisation, including urinary tract infection (UTIs) and urethral complications. It also highlights the role of the nurse in the management of its complications.

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Association between age and low risk of clean intermittent catheterisation with onabotulinumtoxinA in overactive bladder patients with accompanying improvements in urinary symptoms and quality of life

European Urology Supplements ◽

10.1016/s1569-9056(17)30624-3 ◽

2017 ◽

Vol 16 (3) ◽

pp. e985-e986

Author(s):

M. Drake ◽

K. Everaert ◽

E. Rovner ◽

R. Dmochowski ◽

D. Ginsberg ◽

...

Keyword(s):

Quality Of Life ◽

Overactive Bladder ◽

Low Risk ◽

Urinary Symptoms ◽

Intermittent Catheterisation ◽

Clean Intermittent Catheterisation

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Spinal Cord Injury Creates Unique Challenges in Diagnosis and Management of Catheter-Associated Urinary Tract Infection

Topics in Spinal Cord Injury Rehabilitation ◽

10.1310/sci2504-331 ◽

2019 ◽

Vol 25 (4) ◽

pp. 331-339 ◽

Cited By ~ 2

Author(s):

Felicia Skelton-Dudley ◽

James Doan ◽

Katie Suda ◽

S. Ann Holmes ◽

Charlesnika Evans ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Diagnostic Tools ◽

Diagnosis And Management ◽

Cord Injury

Background: Catheter-associated urinary tract infection (CAUTI) is associated with increased morbidity and mortality and influences the quality of life of patients with spinal cord injury (SCI). Objectives: This clinical review aims to highlight the unique surveillance, prevention, diagnosis, and management challenges of CAUTI in the SCI population. Methods: Narrative review of the current literature on catheter use in persons with SCI was conducted to determine gaps in knowledge and opportunities for improvement. Results: Surveillance of CAUTI is challenging in the SCI population as the ability to detect symptoms used to diagnose CAUTI (ie, suprapubic pain, dysuria) is impaired. In terms of prevention of CAUTI, current strategies refocus on appropriate catheter insertion and care and early removal of catheters, which is not always feasible for persons with SCI. Prophylactic antibiotics, nutraceuticals, and coated catheters show limited efficacy in infection prevention. Diagnosing CAUTI after SCI is challenging, often resulting in an overdiagnosis of CAUTI when truly asymptomatic bacteriuria exists. In the management of CAUTI in patients with SCI, the use of multiple antibiotics over time in an individual increases the rate of multidrug-resistant organisms; therefore, the exploration of novel non-antibiotic treatments is of importance. The patient experience should be at the center of all these efforts. Conclusion: Better diagnostic tools or biomarkers are needed to define true CAUTI in people with SCI. SCI-specific evidence to inform catheter management and CAUTI treatment guidelines is needed, with the goal to minimize catheter-related harm, reduce antibiotic resistance, and improve satisfaction and overall quality of life for SCI patients.

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VALORACIÓN NUTRICIONAL CON LA SITUACIÓN FUNCIONAL TRAS SUFRIR UN ICTUS.

Nutrición Hospitalaria ◽

10.20960/nh.874 ◽

2017 ◽

Author(s):

Fidel López-Espuela ◽

Juan Carlos Portilla-Cuenca ◽

Marta Holguín Mohedas ◽

José Manuel Párraga Sánchez ◽

Sergio Cordovilla-Guardia ◽

...

Keyword(s):

Quality Of Life ◽

Urinary Tract Infection ◽

Urinary Tract ◽

Tract Infection ◽

Nutritional Status ◽

Nutritional Assessment ◽

Mini Nutritional Assessment ◽

Calidad De Vida ◽

The Relationship

Objetivo: Valorar el estado nutricional (EN) del paciente a los tres meses de sufrir un ictus, y establecer la relación del EN con la recuperación funcional y las complicaciones en este periodo.Material y métodos: Estudio observacional y transversal. Pacientes supervivientes a un ictus mayores de 65 años. La valoración del EN se realizaba a los 3 meses del ictus Se recogieron datos sociodemograficos, antropométricos, factores de riesgo cardiovascular, así como el estado funcional y las complicaciones sufridas (infección urinaria, fiebre, neumonía, etc.). La valoración nutricional fue evaluada con el Mini Nutritional Assessment (MNA).Resultados: 103 pacientes, edad media de 75,81(±6,73) años.. La puntuación en el MNA fue de 23,13 puntos; el 8,2% presentaba malnutrición, el 38,1% riesgo de malnutrición.No se observaron diferencias en el EN entre mujeres y hombres (p=0,076); ni relación del EN con la edad. El estado nutricional deficitario se asoció a peor situación funcional (r=0,608;p<0,001), al desarrollo de complicaciones (infección urinaria y fiebre) (p=0,044) y con la disfagia (p=0,014). Además, aquellos pacientes con mejor EN presentaban mejor calidad de vida (r=0,506;p<0,001).También se relaciono con el nivel socioeconómico (p=0,020) y la institucionalización en centros sociosanitarios (p=0,004).Conclusiones: El Estado nutricional deficitario es frecuente en los supervivientes a un ictus a los 3 meses, y se relaciona con la dependencia funcional y la aparición de complicaciones.Además, el estado nutricional afecta a la calidad de vida autopercibida por estos pacientes.La disfagia es una secuela importante y que afecta al estado nutricional. Title: Nutritional status and the relationship regarding to functional status after stroke. ABSTRACTAims: To assess the Nutritional Status (NS) for a patient after three months of suffering an stroke, and to establish the relationship between functional recovery and their complications, in this period.Material and methods: It realized a cross-sectional observational study. The sample consisted of patients who had suffered the stroke over 65 years old. The NS assessment was performed 3 months later of stroke. They were collected sociodemographic, anthropometric data, cardiovascular risk factors, functional status and dependence. Also, they were analyzed the suffered complications during 3 months after stroke (urinary tract infection, fever, pneumonia). Nutritional assessment was evaluated by the Mini Nutritional Assessment (MNA.Results: 103 patients were included, with a medium age of 75.81(±6.73). The MNA score was 23.13 points; 8.2% had malnutrition, 38.1% with risk of malnutrition. It didn´t detect any difference between women and men (p=0.076); either the NS with age. Nutritional status deficit was associated with poorer function (r=0.608;p<0.001), with the development of complications (urinary tract infection and fever) (p=0.044) and dysphagia (p=0.014). In addition, those patients with better nutritional status punctuating had a better quality of life (r=0.506; p<0.001). I was also associated with socioeconomic status (p = 0.020) and institutionalization, in health centers (p=0.004). Conclusions:The Nutritional status deficit is common in ictus´ survivors at 3 months, and It´s related to dependence and the appearance of complications. In addition, the nutritional status affects the self-perceived quality of life for these patients. Dysphagia is an important sequel that affects the nutritional status.

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