No abstract available.
Follow-Up Studies* ; Intermittent Urethral Catheterization*

PURPOSE: To evaluate changes in quality of life (QoL) in patients with neurogenic bladder treated with clean intermittent catheterization (CIC), who changed from a multiple use catheter (MUC) to single use catheter (SUC). METHODS: The Modified Intermittent Self-Catheterization Questionnaire (mISC-Q) was used to determine potential changes in patients'QoL as a result of switching from MUC to SUC. The mISC-Q consists of questions within four categories: ease of use, convenience, discreetness, and symptomatic benefit. Answers were graded as Strongly agree (+2), Agree (+1), Not sure (0), Disagree (−1), and Strongly disagree (−2). Overall patient QoL, as well as by sex, disease (presence of augmentation cystoplasty), and catheterization route (via urethra or urinary diversion), were analyzed. RESULTS: Thirty-eight patients (21M:17F; mean age: 21.7±5.3 y) submitted questionnaires. For ease of use, SUC was significantly better than MUC (score: 0.364, P=0.002) in all patients. Patients with catheterization via the urethra showed significant favor for SUC in ease of use (score: 0.512, P<0.001) and convenience (score: 0.714, P=0.011), but patients with catheterization via the abdominal stoma of urinary diversion gave negative scores in all categories, though no categories were significant. CONCLUSION: This study suggested that changing from MUC to SUC may lead to improvements in QoL, especially regarding ease of use. This benefit was clearly found in patients with catheterization via urethra rather than abdominal stoma of urinary diversion.
Catheterization ; Catheters* ; Humans ; Intermittent Urethral Catheterization* ; Quality of Life* ; Urethra ; Urinary Bladder, Neurogenic* ; Urinary Diversion

PURPOSE: To evaluate changes in quality of life (QoL) in patients with neurogenic bladder treated with clean intermittent catheterization (CIC), who changed from a multiple use catheter (MUC) to single use catheter (SUC). METHODS: The Modified Intermittent Self-Catheterization Questionnaire (mISC-Q) was used to determine potential changes in patients'QoL as a result of switching from MUC to SUC. The mISC-Q consists of questions within four categories: ease of use, convenience, discreetness, and symptomatic benefit. Answers were graded as Strongly agree (+2), Agree (+1), Not sure (0), Disagree (−1), and Strongly disagree (−2). Overall patient QoL, as well as by sex, disease (presence of augmentation cystoplasty), and catheterization route (via urethra or urinary diversion), were analyzed. RESULTS: Thirty-eight patients (21M:17F; mean age: 21.7±5.3 y) submitted questionnaires. For ease of use, SUC was significantly better than MUC (score: 0.364, P=0.002) in all patients. Patients with catheterization via the urethra showed significant favor for SUC in ease of use (score: 0.512, P<0.001) and convenience (score: 0.714, P=0.011), but patients with catheterization via the abdominal stoma of urinary diversion gave negative scores in all categories, though no categories were significant. CONCLUSION: This study suggested that changing from MUC to SUC may lead to improvements in QoL, especially regarding ease of use. This benefit was clearly found in patients with catheterization via urethra rather than abdominal stoma of urinary diversion.
Catheterization ; Catheters* ; Humans ; Intermittent Urethral Catheterization* ; Quality of Life* ; Urethra ; Urinary Bladder, Neurogenic* ; Urinary Diversion

PURPOSE: In recent years, the importance of patient satisfaction and quality of life—referred to as patient-related outcomes— has been emphasized, in addition to the evaluation of symptoms and severity through questionnaires. However, the questionnaires that can be applied to Korean patients with neurogenic bladder are limited. Therefore, the current study linguistically validated the Intermittent Self-Catheterization Questionnaire (ISC-Q) as an instrument to evaluate the quality of life of Korean patients with neurogenic bladder who regularly perform clean intermittent catheterization (CIC). METHODS: The validation process included permission for translation, forward translations, reconciliation, backward translation, cognitive debriefing, and proofreading. Two bilingual translators independently translated the original version of the ISC-Q into Korean and then combined the initial translations. A third bilingual translator performed a backward translation of the reconciled version into English. Five Korean-speaking patients with neurogenic bladder carried out the cognitive debriefing. RESULTS: During the forward translation process, the 24 questions of the ISC-Q were translated into 2 Korean versions. The terms used in each version were adjusted from the original version to use more conceptually equivalent expressions in Korean. During the backward translation process, several changes were involving substitutions of meaning. In the cognitive debriefing process, 5 patients were asked to complete the questionnaire. All patients agreed that the questionnaire explained their situation well. CONCLUSIONS: This study presents a successful linguistic validation of the Korean version of the ISC-Q, which could be a useful tool for evaluating treatment satisfaction in patients with neurogenic bladder performing CIC regularly.
Catheterization ; Catheters ; Humans ; Intermittent Urethral Catheterization ; Linguistics ; Patient Satisfaction ; Quality of Life ; Translations ; Urinary Bladder, Neurogenic ; Urination

We report our experience with a case of urethrolysis using a transvaginal suprameatal approach without lateral perforation of the urethropelvic ligament. A 43-year-old woman suffered from voiding difficulties such as hesitancy, frequency, urgency, decreased urinary flow, residual urine sensation after Marshall-Marchetti-Krantz operation concurrent with hysterectomy. The results of multidisciplinary work-ups of urethral obstruction such as history, vaginal examination, voiding cystourethrography, urodynamic study, showed that she had urethral obstruction due to a previous operation. Since clean intermittent catheterization and alpha-blocker therapy did not improve her symptoms, suprameatal transvaginal urethrolysis was performed to resolve the symptoms. Postoperative follow-up for 5 months showed that the patient remained free from voiding difficulty in their life. We believe that suprameatal transvaginal urethrolysis is worth attempting for urethral obstruction associated with anti-incontinence surgery.
Adult ; Female ; Follow-Up Studies ; Gynecological Examination ; Humans ; Hysterectomy ; Intermittent Urethral Catheterization ; Ligaments ; Sensation ; Urethral Obstruction* ; Urodynamics

PURPOSE: The aims of this study were to analyze the types of voiding dysfunction following a tension free vaginal tape (TVT) procedure, and to report our experience of diagnosing and treating post-TVT voiding dysfunction. MATERIALS AND METHODS: A TVT procedure was performed on 201 patients, of which, 51 (25.4%) developed a voiding dysfunction. The TVT was incised or released to increase the uroflow and decrease the residual urine volume for those whose symptoms were not controlled by anticholinergics (tolterodine, propiverine) and/or alpha-blockers (alfuzocin, terazocin) or clean intermittent catheterization (CIC). The success rate and degree of satisfaction were investigated for the correction of stress incontinence. RESULTS: In 36 patients, the voiding symptoms improved after medication administration, with a mean interval of 16.5 days. Another 15 patients required a TVT incision or release at means of 27 and 8 days, respectively. After the incision or release of the TVT sling, the mean maximal flow rate (MFR) increased from 9.3+/-4.3 to 21.7+/-6.7ml/sec, and mean residual urine volume (RU) decreased from 277.9+/-156.2 to 24.6+/-16.0ml. The success rate and satisfaction of the TVT procedure were 98.0 and 90.4%, respectively. Lastly, 88.3% of the subjects reported they would recommend the TVT procedure to people they know with symptoms of stress urinary incontinence. CONCLUSIONS: This study suggests that voiding dysfunction, with normal uroflow and RU, may be effectively controlled with conservative treatment. However, when the voiding dysfunction is accompanied by a decreased MFR and an increased RU, an additional procedure, such as the TVT incision or release, is recommended.
Cholinergic Antagonists ; Humans ; Intermittent Urethral Catheterization ; Suburethral Slings* ; Urinary Incontinence* ; Urinary Incontinence, Stress

PURPOSE: Today, many patients with voiding dysfunction select suprapubic cystostomy (SPC) instead of clean intermittent catheterization (CIC) for practical reasons. There is thus a need to reconsider SPC as a management for voiding dysfunction. We designed SPC with timed drainage (TSPCD) and evaluated its effectiveness compared with continuous drainage with a urine bag (CSPCD). MATERIALS AND METHODS: Between January 2006 and January 2010, a total of 82 patients underwent SPC. Patients undergoing SPC were randomly assigned to CSPCD or TSPCD. Patient characteristics, complications, and the results of urine cultures were compared between the two groups through retrospective chart reviews. Also, preferences for CSPCD and TSPCD in another 15 patients who had experienced both CSPCD and TSPCD were investigated. RESULTS: The CSPCD and TSPCD groups comprised 46 and 36 patients, respectively. In a comparison of complications between the two groups, the incidence of acute symptomatic cystitis was significantly lower in the TSPCD group than in the CSPCD group (43% vs. 20%, p=0.032). The incidence of symptomatic urinary tract infection (UTI) was lower in the TSPCD group. Positive urine culture rates were 89.7% and 72.4% in groups 1 and 2, respectively. There was a significant difference between the two groups (p=0.004). In another 15 patients who experienced both CSPCD and TSPCD, 14 patients (93%) stated a preference for TSPCD after converting from CSPCD to TSPCD, and one patient (7%) returned to CSPCD only at night. CONCLUSIONS: In this study, TSPCD had the advantages of less morbidity as UTI and being more preferable by patients with relatively good daily activity compared with CSPCD. TSPCD is an alternative to CSPCD for the treatment of voiding dysfunction.
Cystitis ; Cystostomy ; Drainage ; Humans ; Incidence ; Intermittent Urethral Catheterization ; Retrospective Studies ; Urinary Bladder ; Urinary Tract Infections

Dynamic urethral pressure profilometry is a urodynamic study that records the detrusor pressure and eternal sphincter pressure simultaneously during the filling and emptying phase. With this study to the patients who have voiding dysfunction we could differentiate the hyperreflexia from simple frequency and urgency without incontinence, check the detrusor pressure and volume and the point of clean intermittent catheterization schedule. It was also possible to differentiate the voluntary detrusor sphincter dyssynergia from obstruction due to BPH in CVA patients with frequency and residual urine by checking the external sphincter pressure during the emptying phase with dynamic urethral pressure profilometry. In conclusion, dynamic urethral pressure profilometry is a very useful urodynamic study to check the detrusor and external sphincter function simultaneously at one full urodynamic study to check the detrusor and external sphincter function simultaneously at one session within 15 minutes.
Appointments and Schedules ; Ataxia ; Catheters* ; Humans ; Intermittent Urethral Catheterization ; Reflex, Abnormal ; Urodynamics*

PURPOSE: Our aim was to evaluate the effects of the centralized intensive education system (CIES) compared with an individualized ward education system (IWES) in the degree of acquisition of the proper clean intermittent catheterization (CIC) method as a treatment of patients with voiding dysfunction. MATERIALS AND METHODS: From March 2002 to March 2003, a prospective questionnaire study was performed on 122 patients (age 55.7+/-17.0 years; 52 males and 70 females). Patients were randomly divided into two groups (the CIES group versus the IWES group) at the time of the urologic consultation for voiding dysfunction. After the CIC education, the patients were asked to complete a self-administered questionnaire about the CIC education. Under the protocol of CIES or IWES for CIC, patients were instructed by doctors or nurses at their wards and performed self- catheterization under supervision. RESULTS: There were 122 patients with 72 patients in CIES, 50 patients in IWES, respectively. There were no differences between two groups in age, sex, education level, and socioeconomic status (p>0.05). CIES was superior to IWES in terms of the patient's understanding on the need for CIC, cause of their voiding dysfunction, help from pictures and the use of instruments related to CIC, sufficient explanation of questions about CIC, overall satisfaction of education, and confidence for CIC after education (p<0.05). There was a significant difference in the number of acquisitions of confidence for CIC between CIES and IWES, which were 3.1 (+/-2.0) times and 5.9 (+/-5.5) times, respectively (p<0.05). CONCLUSIONS: Our result shows that the CIES is superior to the IWES in CIC education. Further efforts are needed to enhance the understanding on the more detailed knowledge of the CIC and to increase the motivation of the patients.
Catheterization ; Catheters ; Education* ; Humans ; Intermittent Urethral Catheterization* ; Male ; Motivation ; Organization and Administration ; Prospective Studies ; Surveys and Questionnaires ; Social Class

PURPOSE: Clean intermittent self-catheterization (CISC) is now considered the gold standard for the management of urinary retention. In the literature, several articles on patients’ perspectives on CISC and adherence to this technique have been published. No studies have yet explored the points of view of professional caregivers, such as nurses and doctors. The aim of this study was to explore the opinions of urologists about CISC and to evaluate the need for dedicated nurses specialized in CISC through a self-administered questionnaire. METHODS: A questionnaire was developed to explore the opinions of professional caregivers about self-catheterization and to evaluate the need to provide nurses with specialized education in CISC. Questionnaires were sent to 244 urologists through email. We received 101 completed questionnaires. The response rate was 41.4%. RESULTS: Hand function, the presence or absence of tremor, and visual acuity were rated as the most important determinants for proposing CISC to a patient. Twenty-five percent of the urologists reported that financial remuneration would give them a greater incentive to propose CISC. The lack of dedicated nurses was reported by half of the urologists as a factor preventing them from proposing CISC. A meaningful number of urologists thought that patients perceive CISC as invasive and unpleasant. Although most urologists would choose CISC as a treatment option for themselves, almost 1 urologist out of 5 would prefer a permanent catheter. CONCLUSIONS: This questionnaire gave valuable insights into urologists’ perceptions of CISC, and could serve as the basis for a subsequent broader international study. Further research should also focus on the opinions of nurses and other caregivers involved in incontinence management. Apart from financial remuneration, it is also clear that ensuring sufficient expertise and time for high-quality CISC care is important. This could be a potential role for dedicated nurses.
Caregivers ; Catheters ; Education ; Electronic Mail ; Hand ; Humans ; Intermittent Urethral Catheterization ; Motivation ; Remuneration ; Tremor ; Urinary Catheterization ; Urinary Retention* ; Visual Acuity