Salvador V C Lima1, Fábio O Vilar2, Eugênio S Lustosa3, Daniel C C Aragão3, Fernanda C F S Calisto4, Flávia C M Pinto4. 1. Department of Surgery, Center for Health Sciences, Federal University of Pernambuco, UFPE, Brazil. Electronic address: urology@salvador.net. 2. Graduate Medical School, Federal University of Pernambuco, UFPE, Brazil. 3. Clinical Hospital, Federal University of Pernambuco, UFPE, Brazil. 4. Department of Surgery, Center for Health Sciences, Federal University of Pernambuco, UFPE, Brazil.
Abstract
INTRODUCTION: Urinary incontinence (UI) is a challenging problem for the urological community. Clean intermittent catheterization (CIC) is the most commonly used method to restore bladder emptying to the state close to the physiological condition. This procedure can cause negative aspects such as pain and possible urethral injury. In addition, there is a negative impact on self-image and decline in quality of patient's life. The aim of the present study was to evaluate the safety and efficacy of a new intraurethral self-retaining device (ISRD), in female children and adolescents, as an attractive alternative to CIC. MATERIALS AND METHODS: A prospective clinical pilot study was performed, in a single-institution, including female children and adolescent patients with urinary incontinence secondary to myelomeningocele who were already in an intermittent bladder catheterization program. Assessments included the use of a visual analogue scale in diagnosis of UI, reported adverse events, and the King's Health Questionnaire (KHQ) to evaluate quality of life, which was answered by patients and the caregivers of younger patients before and 6 months after enrolment. DISCUSSION: The device was efficient and well tolerated by most patients (84%). The ISRD significantly improved quality of life in children and adolescents (p<0.0001 for both) (Table). The safe insertion and removal of the ISRD can be considered an advantage compared with CIC as eventual urethral trauma is significantly minimized. It was found that one of the main advantages of the ISRD is the possibility of management as an outpatient procedure both for initial insertion and replacement. The autonomy of patients to perform the bladder emptying process by themselves indicates the importance of this study, especially for school life and social interaction. ISRD use showed a tendency to improve the QoL. CONCLUSIONS: This new bladder-draining device (ISRD) was effective and secure in terms of insertion technique, and improved QoL of patients with urinary retention and incontinence, according to domains evaluated in the KHQ.
INTRODUCTION:Urinary incontinence (UI) is a challenging problem for the urological community. Clean intermittent catheterization (CIC) is the most commonly used method to restore bladder emptying to the state close to the physiological condition. This procedure can cause negative aspects such as pain and possible urethral injury. In addition, there is a negative impact on self-image and decline in quality of patient's life. The aim of the present study was to evaluate the safety and efficacy of a new intraurethral self-retaining device (ISRD), in female children and adolescents, as an attractive alternative to CIC. MATERIALS AND METHODS: A prospective clinical pilot study was performed, in a single-institution, including female children and adolescent patients with urinary incontinence secondary to myelomeningocele who were already in an intermittent bladder catheterization program. Assessments included the use of a visual analogue scale in diagnosis of UI, reported adverse events, and the King's Health Questionnaire (KHQ) to evaluate quality of life, which was answered by patients and the caregivers of younger patients before and 6 months after enrolment. DISCUSSION: The device was efficient and well tolerated by most patients (84%). The ISRD significantly improved quality of life in children and adolescents (p<0.0001 for both) (Table). The safe insertion and removal of the ISRD can be considered an advantage compared with CIC as eventual urethral trauma is significantly minimized. It was found that one of the main advantages of the ISRD is the possibility of management as an outpatient procedure both for initial insertion and replacement. The autonomy of patients to perform the bladder emptying process by themselves indicates the importance of this study, especially for school life and social interaction. ISRD use showed a tendency to improve the QoL. CONCLUSIONS: This new bladder-draining device (ISRD) was effective and secure in terms of insertion technique, and improved QoL of patients with urinary retention and incontinence, according to domains evaluated in the KHQ.
Authors: Rose A F Dantas; Fernanda C F S Calisto; Fabio O Vilar; Luiz A P Araujo; Salvador V C Lima Journal: Int Braz J Urol Date: 2019 Jul-Aug Impact factor: 1.541