Urinary catheter management: what neurologists need to know

2021 ◽  
pp. practneurol-2020-002772
Author(s):  
Calum Clark ◽  
Collette Haslam ◽  
Sachin Malde ◽  
Jalesh N Panicker
Keyword(s):  
Evidence Base ◽  
Lower Urinary Tract Dysfunction ◽  
Indwelling Catheter ◽  
Non Invasive ◽  
Different Types ◽  
Neurological Patients ◽  
Surgical Treatments ◽  
Term Management ◽  
Lower Urinary

Patients with neurological disorders often have lower urinary tract dysfunction, manifesting as urinary retention or urinary incontinence, and so commonly use catheters. Neurologists should therefore be aware of the different types of catheters and appliances and their risks, benefits and complications. Clean intermittent self-catheterisation is preferable to an indwelling catheter; however, if this is not possible, then a suprapubic indwelling catheter is preferable to a urethral catheter for long-term management. We review the decision-making process when selecting catheters for neurological patients, the evidence base regarding the different options and how neurologists can recognise and address complications. We also discuss alternatives to catheterisation, such as non-invasive containment products and surgical treatments, and the indications for urological referral.

Long-Term Efficacy of Percutaneous Tibial Nerve Stimulation for Different Types of Lower Urinary Tract Dysfunction in Children

2009 ◽  
Vol 182 (4S) ◽  
pp. 2056-2061 ◽  
Author(s):  
Maria Luisa Capitanucci ◽  
Daniela Camanni ◽  
Francesca Demelas ◽  
Giovanni Mosiello ◽  
Antonio Zaccara ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Nerve Stimulation ◽  
Lower Urinary Tract ◽  
Tibial Nerve ◽  
Lower Urinary Tract Dysfunction ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Tibial Nerve Stimulation ◽  
Different Types ◽  
Lower Urinary

Cardiac catheterisation of patients with common arterial trunk and transposition of the great arteries

2012 ◽  
Vol 22 (6) ◽  
pp. 687-690 ◽  
Author(s):  
Gary E. Stapleton ◽  
Ivan Wilmot ◽  
Elsa J. Suh
Keyword(s):  
Interventional Procedures ◽  
Surgical Intervention ◽  
Cardiac Catheterisation ◽  
Non Invasive ◽  
Common Arterial Trunk ◽  
Arterial Trunk ◽  
Cardiac Lesions ◽  
Term Management

AbstractCardiac catheterisation continues to play an important role in the long-term management of patients with common arterial trunk and transposition of the great arteries. Although non-invasive imaging has largely eliminated the need for diagnostic catheterisation in newborns with these congenital cardiac lesions, cardiac catheterisation is an important tool for the diagnosis of a variety of problems encountered after surgical intervention, and allows interventions to be performed when feasible. We review the indications for cardiac catheterisation and describe the specifics for various interventional procedures for these patients in this manuscript.

Somatic treatments

2012 ◽  
Author(s):  
Raymond W. Lam
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Electroconvulsive Therapy ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Light Therapy ◽  
Limited Data ◽  
Non Invasive ◽  
Resistant Depression ◽  
Term Management

• Wake therapy, exercise and light therapy are non-invasive and clinically useful treatments.• Electroconvulsive therapy remains an effective, safe and well-tolerated treatment for patients with severe, psychotic or medication-resistant depression.• Repetitive transcranial magnetic stimulation is an emerging treatment with evidence for acute efficacy, but with limited data about long-term management....

scholarly journals Prostate artery embolization has long term efficacy for treatment of severe lower urinary tract symptoms from giant prostatic hyperplasia

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexander S. Somwaru ◽  
Stephen Metting ◽  
Laura M. Flisnik ◽  
Michael G. Nellamattathil ◽  
Arjun Sharma ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Prostate Volume ◽  
Prostatic Hyperplasia ◽  
Term Efficacy ◽  
Urinary Tract Symptoms ◽  
Surgical Treatments ◽  
Lower Urinary

Abstract Background Patients with severe lower urinary tract symptoms (LUTS) from giant prostatic hyperplasia (GPH): prostate volume greater than 200 mL that do not respond to medical therapy may not be eligible for surgical treatments due to morbidities, technical challenges, and patient preference. This retrospective investigation examined the long-term efficacy and safety of prostatic arterial embolization (PAE) as a treatment option for severe LUTS due to GPH in a large patient cohort. Methods Of 529 patients who underwent PAE between January 2016 and January 2020, 72 patients had severe LUTS from GPH and were retrospectively evaluated. PAE was performed with two embolic agents in sequence: 100–250 μm particles followed by 2 mm and 3 mm coils. Clinical assessment was performed with international prostate symptoms score (IPSS), quality of life (QoL), peak flow rate (Qmax), post-void residual volume (PVR), and prostate specific antigen (PSA) measurements before and 12 months and 24 months after PAE. Prostate volume (PV) was measured by multiparametric magnetic resonance (MR) imaging before and 12 months and 24 months after PAE. Results Patients with severe LUTS from GPH experienced significant clinical improvements in IPSS, QoL, Qmax, PVR, PSA, and PV at 12 months and 24 months after PAE. Mean IPSS decreased from 26.5 to 18.0 (P < 0.01) to 10.5 (P < 0.01). Mean QoL decreased from 6.0 to 4.0 (P < 0.01) to 2.0 (P < 0.01). Mean Qmax increased from 8.0 to 14 mL/s (P < 0.01) to 18 mL/s (P < 0.01). Mean PVR decreased from 198.0 to 152.0 mL (P < 0.01) to 90 mL (P < 0.01). Mean PV decreased from 303.0 mL to 258.0 mL (P < 0.01) to 209.0 mL (P < 0.01). Mean PSA decreased from 11.2 ng/mL to 9.5 ng/mL (P < 0.05) to 7.9 ng/mL (P < 0.05). No major complications occurred. Conclusions PAE is a safe treatment with long term efficacy for severe LUTS from GPH. PAE may be a viable therapeutic option for patients with severe LUTS from GPH whom fail medical therapy and are not candidates for surgical treatments.

scholarly journals Congestive Hepatopathy

2020 ◽  
Vol 21 (24) ◽  
pp. 9420
Author(s):  
José Ignacio Fortea ◽  
Ángela Puente ◽  
Antonio Cuadrado ◽  
Patricia Huelin ◽  
Raúl Pellón ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Cardiac Disease ◽  
Term Survival ◽  
Non Invasive ◽  
Surgical Treatments ◽  
Rheumatic Valvular Disease ◽  
Passive Congestion ◽  
Congestive Hepatopathy

Liver disease resulting from heart failure (HF) has generally been referred as “cardiac hepatopathy”. One of its main forms is congestive hepatopathy (CH), which results from passive venous congestion in the setting of chronic right-sided HF. The current spectrum of CH differs from earlier reports with HF, due to ischemic cardiomyopathy and congenital heart disease having surpassed rheumatic valvular disease. The chronic passive congestion leads to sinusoidal hypertension, centrilobular fibrosis, and ultimately, cirrhosis (“cardiac cirrhosis”) and hepatocellular carcinoma after several decades of ongoing injury. Contrary to primary liver diseases, in CH, inflammation seems to play no role in the progression of liver fibrosis, bridging fibrosis occurs between central veins to produce a “reversed lobulation” pattern and the performance of non-invasive diagnostic tests of liver fibrosis is poor. Although the clinical picture and prognosis is usually dominated by the underlying heart condition, the improved long-term survival of cardiac patients due to advances in medical and surgical treatments are responsible for the increased number of liver complications in this setting. Eventually, liver disease could become as clinically relevant as cardiac disease and further complicate its management.

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