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

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

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

Spinal cord injury (SCI) may lead to urinary system disturbances. Patients with SCI usually have neurogenic bladder, and treatment optionss for this condition include clean intermittent catheterization and a permanent indwelling urethral or suprapubic catheter. Complications of catheterization include urinary tract infection, calculi, urinary tract injury, bladder contraction, bladder spasm, renal dysfunction, bladder cancer, and so forth. To the best of our knowledge, ureteral rupture is an unusual complication of catheterization, and ureteral rupture has been rarely reported in SCI patients. Therefore, here we report a case of ureteral rupture caused by a suprapubic catheter used for the treatment of neurogenic bladder with vesicoureteral reflux in a male patient with SCI. Due to SCI with neurogenic bladder, ureteral size can be reduced and the suprapubic catheter tip can easily migrate to the distal ureteral orifice. Thus, careful attention is required when a catheter is inserted into the bladder in patients with SCI.
Catheterization ; Catheters* ; Humans ; Intermittent Urethral Catheterization ; Male* ; Rupture* ; Spasm ; Spinal Cord Injuries* ; Spinal Cord* ; Ureter* ; Urinary Bladder ; Urinary Bladder Neoplasms ; Urinary Bladder, Neurogenic ; Urinary Calculi ; Urinary Catheterization ; Urinary Tract Infections ; Vesico-Ureteral Reflux

From 1986 to 1993, we analyzed experiences in clean intermittent catheterization(CIC) of 62 patients with neurogenic bladder who were closely follow up for averaging 25months. Initial urodynamic study revealed hyperreflexic bladder in 21patients: 11 with detrusor sphincter dyssynergia. Areflexic bladder was found in 41patients: l5 with low compliance. Although positive urine culture were relatively frequent(61%), febrile urinary tract infections were rare(3%) and upper urinary tract function was stable. Other complications of CIC(29%) were burning sensation, resist on urethral catheter, epididymitis, scrotal abscess, bladder stone, etc. Although minor complications are not rare, we can conclude that preservation of renal function and improvement of urinary incontinence can achieved with intermittent catheterization and that patient must be well motivated and cooperative and be able to use their hands for continuation of CIC.
Abscess ; Ataxia ; Burns ; Catheterization ; Catheters ; Compliance ; Epididymitis ; Follow-Up Studies* ; Hand ; Humans ; Intermittent Urethral Catheterization* ; Male ; Sensation ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Bladder, Neurogenic* ; Urinary Catheters ; Urinary Incontinence ; Urinary Tract ; Urinary Tract Infections ; Urodynamics

PURPOSE: Clean intermittent catheterization is considered the treatment of choice for incomplete bladder emptying, however, many patients find it discouraging and unsatisfactory, imposing lower quality of life and decreased sense of self-esteem. The aim of the present study was to evaluate the efficacy of a newly designed, remote-controlled, intraurethral insert for the treatment of voiding dysfunction in women. MATERIALS AND METHODS: This article describes our experience with 53 patients previously treated by self intermittent catheterization, suprapubic catheter, diapers or indwelling catheter. A valve-pump assembly is encased in a shorts, temporary silicone catheter available in various lengths and diameters to adapt to the individual patient's urethra. A hand held, remote-control unit activates the device allowing complete and controllable bladder evacuation and continence between urinations. RESULTS: The age of patients is 16-88 years old(mean 53.4years old). Mean follow-up is 7 months(range 1-26 months). Urinary flow ranged from 11.3+/-0.64m1/second. The device was replaced every 5-99 days(mean 38 days), mainly due to salt deposits in and around the insert leading to urine leakage. Fourteen patients experienced urinary tract infection, all of which subsided with oral antibiotics. All patients were satisfied with the treatment and preferred it to previous treatment modalities used. CONCLUSIONS: We consider that this new, remote controlled intraurethral insert is another useful treatment for the management of women with voiding difficulties.
Anti-Bacterial Agents ; Catheterization ; Catheters ; Catheters, Indwelling ; Female ; Follow-Up Studies ; Hand ; Humans ; Intermittent Urethral Catheterization ; Quality of Life ; Silicones ; Urethra ; Urinary Bladder ; Urinary Tract Infections

PURPOSE: Multiple parameters were preoperatively examined to determine if any could predict successful voiding after a prostatectomy in male patients presenting with acute urinary retention due to a benign prostatic hyperplasia. MATERIALS AND METHODS: A total of 93 men, between 58 and 87 years old (mean age 72.9 years), who presented with acute urinary retention were investigated pre and post-operatively with an urodynamic study, transrectal ultrasonography (TRUS) and a completed International Prostatic Symptom Score (IPSS). RESULTS: 3 months postoperatively, 6 patients (15.8%) with detrusor hyporeflexia or detrusor instability required clean intermittent catheterization to empty their bladders. All patients with a prostate volume over 40 gm were able to void without catheterization after the prostatectomy. The IPSS, age, residual urine, cystoscopic findings, preoperative creatinine and resected prostate weight were not predictive of voiding failure after a prostatectomy. CONCLUSIONS: The urodynamic study and TRUS findings are important predictors of the improvements in symptoms and flow rates for the acute urinary retention associated with a benign prostatic hyperplasia. (Korean J Urol 2004;45:998-1001)
Aged, 80 and over ; Catheterization ; Catheters ; Creatinine ; Humans ; Intermittent Urethral Catheterization ; Male ; Prognosis ; Prostate ; Prostatectomy* ; Prostatic Hyperplasia* ; Reflex, Abnormal ; Ultrasonography ; Urinary Bladder ; Urinary Retention* ; Urodynamics