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Fernandez-Lasquetty Blanc B, Hernández Martínez A, Lorenzo García C, Baixauli Puig M, Estudillo González F, Martin Bermejo MV, Ortega Checa MA, Alcaraz Zomeño E, Torres Bacete A, Ferrández Franco G, Benito Santos B, Fernández Llorente G, Guerrero Andrádes MC, Rodríguez Diaz M, Louis Lauture MP, Jiménez Mayorga I, Serrano-Abiétar R, Garrido Mora MA, Barcia Barrera F, Asensio Malo G, Morcillo Marín M, Lluesma Martinez V, Valero Escribá ML, Tendero Ruiz S, Romay Cea RA, Marín Valero M, Rodríguez-Almagro J. Evolution of Quality of Life and Treatment Adherence after One Year of Intermittent Bladder Catheterisation in Functional Urology Unit Patients. J Clin Med 2023; 12:jcm12082928. [PMID: 37109264 PMCID: PMC10145256 DOI: 10.3390/jcm12082928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVE To determine patient difficulties and concerns when performing IBC (Intermittent Bladder Catheterisation), as well as the evolution of adherence, quality of life, and emotional state of patients one year after starting IBC. METHOD A prospective, observational, multicentre study conducted in 20 Spanish hospitals with a one-year follow-up. Data sources were patient records and the King's Health Questionnaire on quality of life, the Mini-Mental State Examination (MMSE), and the Hospital Anxiety and Depression Scale (HADS). Perceived adherence was measured using the ICAS (Intermittent Catheterization Adherence Scale) and perceived difficulties with IBC were assessed using the ICDQ (Intermittent Catheterization Difficulty Questionnaire). For data analysis, descriptive and bivariate statistics were performed for paired data at three points in time (T1: one month, T2: three months, T3: one year). RESULTS A total of 134 subjects initially participated in the study (T0), becoming 104 subjects at T1, 91 at T2, and 88 at T3, with a mean age of 39 years (standard deviation = 22.16 years). Actual IBC adherence ranged from 84.8% at T1 to 84.1% at T3. After one year of follow-up, a statistically significant improvement in quality of life (p ≤ 0.05) was observed in all dimensions with the exception of personal relationships. However, there were no changes in the levels of anxiety (p = 0.190) or depression (p = 0.682) at T3 compared to T0. CONCLUSIONS Patients requiring IBC exhibit good treatment adherence, with a significant proportion of them performing self-catheterisation. After one year of IBC, a significant improvement in quality of life was noted, albeit with a significant impact on their daily lives and their personal and social relationships. Patient support programmes could be implemented to improve their ability to cope with difficulties and thus enhance both their quality of life and the maintenance of their adherence.
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Affiliation(s)
| | - Antonio Hernández Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
| | - Carlos Lorenzo García
- Department of Nursing, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain
| | | | | | | | | | - Elena Alcaraz Zomeño
- Department of Nursing, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain
| | | | | | | | | | | | - Monica Rodríguez Diaz
- Department of Nursing, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain
| | | | | | - Rosario Serrano-Abiétar
- Department of Nursing, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain
| | | | | | - Gemma Asensio Malo
- Department of Nursing, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain
| | | | | | | | - Silvia Tendero Ruiz
- Department of Nursing, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain
| | | | | | - Julián Rodríguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain
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Akkoç Y, Bardak AN, Yıldız N, Özlü A, Erhan B, Yürü B, Öztekin SNS, Türkoğlu MB, Paker N, Yumuşakhuylu Y, Canbaz Kabay S, Ekmekçi Ö, Elbi H, Yüceyar AN. The relationship between severity of overactive bladder symptoms and cognitive dysfunction, anxiety and depression in female patients with multiple sclerosis: Running head: OAB-V8, BICAMS and HAD scale in MS. Mult Scler Relat Disord 2023; 70:104476. [PMID: 36603290 DOI: 10.1016/j.msard.2022.104476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 12/15/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Overactive bladder (OAB), cognitive dysfunction, depression and anxiety are common problems encountered in MS. This study was planned to investigate the relationship between the severity of OAB symptoms and cognitive function, anxiety and depression in MS. METHODS 100 patients with MS diagnosis with OAB symptoms were recruited. OAB symptoms was assessed with the OAB-V8 questionnaire. Symbol Digit Modalites Test (SDMT), California Verbal Learning Test II (CVLT-II) and Brief Vasospatial Memory Test-Revised (BVMT-R) in BICAMS Battery were used to evaluate cognitive function. Depression and anxiety were assessed with the Hospital Anxiety Depression (HAD) Scale. RESULTS The mean age of the patients was 40.9±12.3, the duration of the disease was 9.03±6.89 years, and the mean OAB-V8 score was 17.6±8.9. SDMT test (r=-0.299, p<0.01) showed a moderately significant, CVLT-II (r= -0.219, p<0.05) and BVMT-R (r=-0.218, p<0.05) tests showed a weakly significant negative correlation with OAB-V8 score. There was a moderate positive correlation between the OAB-V8 score and HAD-D (r=0.279, p=0.005) and HAD-A (r=0.318, p=0.001) scores. SDMT and BVMT-R scores were significantly lower in anticholinergic (Ach) drug users (especially oxybutynin users) compared to those who did not use Ach drugs. CONCLUSIONS It has been observed that the severity of OAB symptoms is related to worsening of information processing speed and an increase in depression and anxiety. It has been determined that there is a significant effect on information processing speed, visual learning and memory in patients using Ach drugs, especially in those using oxybutynin, compared to those who do not use Ach drugs.
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Affiliation(s)
- Yeşim Akkoç
- Ege University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Izmir, Turkey.
| | - Ayşe Nur Bardak
- Health Sciences University, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Necmettin Yıldız
- Pamukkale University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Denizli, Turkey
| | - Aysun Özlü
- Kutahya Health Sciences University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kutahya, Turkey
| | - Belgin Erhan
- Istanbul Medeniyet University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Burak Yürü
- Health Sciences University, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Saadet Nur Sena Öztekin
- Pamukkale University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Denizli, Turkey
| | - Meryem Burcu Türkoğlu
- Ege University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Izmir, Turkey
| | - Nurdan Paker
- Health Sciences University, Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Yasemin Yumuşakhuylu
- Istanbul Medeniyet University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Sibel Canbaz Kabay
- Kutahya Health Sciences University, Faculty of Medicine, Department of Neurology, Kutahya, Turkey
| | - Özgül Ekmekçi
- Ege University Faculty of Medicine, Department of Neurology, Izmir, Turkey
| | - Hayriye Elbi
- Ege University Faculty of Medicine, Department of Psychiatry, Izmir, Turkey
| | - Ayşe Nur Yüceyar
- Ege University Faculty of Medicine, Department of Neurology, Izmir, Turkey
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Blanc BFL, Rodríguez-Almagro J, Lorenzo-García C, Alcaraz-Zomeño E, Fernandez-Llorente G, Baixauli-Puig M, Martín-Bermejo MV, Estudillo-González F, Ortega-Checa MA, Lluesma-Martinez V, Ferrández-Franco G, Benito-Santos B, Rodríguez-Díaz M, Torres-Bacete A, Guerrero-Andrades MC, Louis-Lauture MP, Jiménez-Mayorga I, Serrano-Abielar R, Garrido-Mora MA, Barcia-Barrera F, Asensio-Malo G, Morcillo-Marín M, Tendero-Ruiz S, Hernández-Martínez A. Quality of Life and Autonomy in Patients with Intermittent Bladder Catheterization Trained by Specialized Nurses. J Clin Med 2021; 10:3909. [PMID: 34501357 PMCID: PMC8432259 DOI: 10.3390/jcm10173909] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022] Open
Abstract
Intermittent bladder catheterization (IBC) involves regular urine draining using a catheter, which is removed immediately after urinary elimination. It allows for the patient's urological health to be managed and their renal function to be preserved, and it promotes autonomy. Compliance with the prescribed number of daily catheterizations, which must be conducted by the patient, and infection prevention measures are crucial. To identify the patients requiring IBC, and to determine their adherence (whether they followed the prescribed guidelines and their difficulty in carrying out the procedure, as well as to assess how the IBC influences their quality of life and state of mind after receiving self-care training from a specialized nurse), we carried out a prospective, multicenter observational study in 24 Spanish hospitals with one month of monitoring and a sample of 99 patients. The sources of information were the patients' clinical records, the King's Health Questionnaire, the Mini-Mental State Examination (MMSE), and the hospital anxiety and depression scale (HADS). Descriptive and bivariate statistics were used to analyses the paired data. After recruitment (n = 99), 79 patients completed the questionnaire at a mean age of 35.2 years (SD = 20.5 years). In total, 53.5% (53) of the sample consisted of men and 32.3% (32) had neurological damage as the reason for prescription; 67% (67.7) performed self-catheterization and 86.7% adhered to the IBC. After one month of monitoring, a statistically significant improvement in quality of life was observed in all criteria, with the exception of personal relationships (p < 0.005), as well as an improvement in anxiety and depression levels (p < 0.001). Patients who require IBC show good adherence to the IBC with a significant percentage of self-catheterization. After one month of IBC, a significant improvement in the patients' quality of life and mood was observed. These results could be attributed to adequate patient training and adequate personalization of the IBC materials by the specialized nurses.
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Affiliation(s)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Carlos Lorenzo-García
- Department of Nursing, Hospital Universitario Clínico San Carlos, 28040 Madrid, Spain;
| | - Elena Alcaraz-Zomeño
- Department of Nursing, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | | | | | | | | | | | - Vicenta Lluesma-Martinez
- Department of Nursing, Hospital Universitari I Politecnic La Fe, 46026 Valencia, Spain; (M.A.O.-C.); (V.L.-M.)
| | | | - Begoña Benito-Santos
- Department of Nursing, Hospital General Universitario de Alicante, 03010 Alicante, Spain; (G.F.-F.); (B.B.-S.)
| | - Mónica Rodríguez-Díaz
- Department of Nursing, Hospital Universitario Virgen de las Nieves, 18014 Granada, Spain;
| | | | | | | | | | - Rosario Serrano-Abielar
- Department of Nursing, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain;
| | | | | | - Gemma Asensio-Malo
- Department of Nursing, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain;
| | | | - Silvia Tendero-Ruiz
- Department of Nursing, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain;
| | - Antonio Hernández-Martínez
- Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, 13071 Ciudad Real, Spain;
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Roberts F, Hobbs H, Jessop H, Bozzolini C, Burman J, Greco R, Ismail A, Kazmi M, Kirgizov K, Mancardi G, Mawson S, Muraro PA, Puyade M, Saccardi R, Withers B, Verhoeven B, Sharrack B, Snowden JA. Rehabilitation Before and After Autologous Haematopoietic Stem Cell Transplantation (AHSCT) for Patients With Multiple Sclerosis (MS): Consensus Guidelines and Recommendations for Best Clinical Practice on Behalf of the Autoimmune Diseases Working Party, Nurses Group, and Patient Advocacy Committee of the European Society for Blood and Marrow Transplantation (EBMT). Front Neurol 2020; 11:556141. [PMID: 33362684 PMCID: PMC7759663 DOI: 10.3389/fneur.2020.556141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/06/2020] [Indexed: 12/29/2022] Open
Abstract
Autologous haematopoietic stem cell transplantation (AHSCT) is increasingly used to treat people with multiple sclerosis (MS). Supported by an evolving evidence base, AHSCT can suppress active inflammation in the central nervous system and induce long-term changes in immune cell populations, thereby stabilizing, and, in some cases, reversing disability in carefully selected MS patients. However, AHSCT is an intensive chemotherapy-based procedure associated with intrinsic risks, including profound cytopenia, infection, and organ toxicity, accompanied by an on-going degree of immuno-compromise and general deconditioning, which can be associated with a transient increase in functional impairment in the early stages after transplantation. Although international guidelines and recommendations have been published for clinical and technical aspects of AHSCT in MS, there has been no detailed appraisal of the rehabilitation needed following treatment nor any specific guidelines as to how this is best delivered by hospital and community-based therapists and wider multidisciplinary teams in order to maximize functional recovery and quality of life. These expert consensus guidelines aim to address this unmet need by summarizing the evidence-base for AHSCT in MS and providing recommendations for current rehabilitation practice along with identifying areas for future research and development.
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Affiliation(s)
| | - Helen Hobbs
- Hobbs Rehabilitation, Winchester, United Kingdom
| | - Helen Jessop
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | | | - Joachim Burman
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Raffaella Greco
- Hematology and Bone Marrow Transplantation Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Hospital, Milan, Italy
| | - Azza Ismail
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - Majid Kazmi
- Kings Health Partners, Department of Haematology, Guys Hospital, London, United Kingdom
| | - Kirill Kirgizov
- Institute of Paediatric Oncology and Haematology, N.N. Blokhin National Medical Research Center of Oncology, Moscow, Russia
| | - Gianluigi Mancardi
- Department of Neuroscience, University of Genova and Clinical Scientific Institutes Maugeri, Genoa, Italy
| | - Susan Mawson
- School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - Paolo A Muraro
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Mathieu Puyade
- CHU de Poitiers, Service de Médecine Interne et Maladies Infectieuses, Poitiers, France.,CHU de Poitiers, CIC-1402, Poitiers, France
| | | | - Barbara Withers
- Department of Haematology and Blood Stem Cell Transplantation, St Vincent's Health Network Sydney and Senior Lecturer, St Vincent's Clinical School, University of New South Wales Medicine, Sydney, NSW, Australia
| | - Bregje Verhoeven
- Patient Advocacy Committee, EBMT Executive Office, Barcelona, Spain
| | - Basil Sharrack
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom.,School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
| | - John A Snowden
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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Jacq C, Hubeaux K, Ramanantsitonta J. [Multiple sclerosis and intermittent self-catheterization]. Prog Urol 2020; 31:195-203. [PMID: 33277166 DOI: 10.1016/j.purol.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/24/2020] [Accepted: 11/02/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Lower urinary tract dysfunctions are frequent in patients with multiple sclerosis (MS). These disorders impair quality of life and can cause urological complications. In cases of urinary retention or incomplete bladder emptying, clean intermittent self-catheterization is the preferred option where possible. OBJECTIVE To identify data concerning the use of intermittent self-catheterization by patients with MS. BIBLIOGRAPHIC SOURCE A review was done using Medline/Pubmed with selection of articles in either English or French. The key words were: « multiple sclerosis and intermittent catheterization, self-catheterization, neuro-urology/urinary guidelines, continent stoma, continent vesicostomy». STUDY SELECTION Studies were selected if they concerned either multiple sclerosis exclusively or with a majority of cases concerning MS. RESULTS Intermittent self-catheterization is recommended and commonly used in patients with MS. Studies are rare in this specific population. Questions still remain about indications and practicalities in this disease. Indications must be individually evaluated according to symptoms and complications. The use of self-catheterization can improve symptomatology or quality of life, however, global urinary management is necessary. Urinary infection is the most frequently reported side effect. The teaching of self-catheterization should take into account physical and cognitive impairment. Due to the developing nature of the pathology, indications and the patients' ability to carry out self-catheterization should be regularly assessed. LIMITATIONS The search was limited to a single bibliographic source and studies are rare. CONCLUSION Further studies are necessary to increase knowledge of self-catheterization specificities in MS patients compared to other neurogenic patients.
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Affiliation(s)
- C Jacq
- Service de MPR, site d'Auray, Centre hospitalier Bretagne Atlantique, 20, boulevard du Général-Maurice-Guillaudot, BP 70555, 56017 Vannes cedex, France.
| | - K Hubeaux
- Service d'explorations fonctionnelles, site de Perharidy, Fondation Ildys, route de Perharidy, 29680 Roscoff, France
| | - J Ramanantsitonta
- Service de MPR, site d'Auray, Centre hospitalier Bretagne Atlantique, 20, boulevard du Général-Maurice-Guillaudot, BP 70555, 56017 Vannes cedex, France
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Orlandin L, Nardi A, Costa RRDO, Mazzo A. Difficulties of patients and caregivers in performing clean intermittent catheterization: scoping review. ESTIMA 2020. [DOI: 10.30886/estima.v18.907_in] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective: To identify the main difficulties reported by patients and caregivers in the use of clean intermittent catheterization described in the scientific literature. Methods: Scoping review with studies published in Portuguese, English or Spanish, without date limit, in electronic databases and digital libraries, using descriptors and keywords. Results: 790 studies were identified, including 34 studies published between 1984 and 2019. The main difficulties reported in performing clean intermittent catheterization were related to catheter insertion, pain, discomfort, urethral trauma, public bathrooms with inadequate facilities, physical difficulties and lack of access to necessary inputs. Conclusion: The studies analyzed show the difficulties that patients who use clean intermittent catheterization and their caregivers face on a daily basis, which are related to intrinsic and extrinsic, institutional and governmental factors and can decrease satisfaction and adherence to rehabilitation programs bladder, with an impact on the quality of life of patients and their caregivers. Therefore, it highlights the need for health education for the proper teaching of performing clean intermittent catheterization, emphasizing the importance of the nurse’s role in this process.
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Affiliation(s)
- Leonardo Orlandin
- Universidade de São Paulo – Escola de Enfermagem de Ribeirão Preto – Programa de Pós-Graduação em Enfermagem Fundamental – Ribeirão Preto (SP), Brasil
| | - Aguinaldo Nardi
- Universidade de São Paulo – Faculdade de Odontologia de Bauru – Curso de Medicina – Bauru (SP), Brasil.o
| | | | - Alessandra Mazzo
- Universidade de São Paulo – Faculdade de Odontologia de Bauru – Curso de Medicina – Bauru (SP), Brasil.o
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Orlandin L, Nardi A, Costa RRDO, Mazzo A. Dificuldades de pacientes e cuidadores na realização do cateterismo intermitente limpo: revisão de escopo. ESTIMA 2020. [DOI: 10.30886/estima.v18.907_pt] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objetivo: Identificar as principais dificuldades relatadas pelos pacientes e cuidadores no uso do cateterismo intermitente limpo descritas na literatura científica. Métodos: Revisão de escopo com estudos publicados em português, inglês ou espanhol, sem limite de data, em base de dados eletrônicas e bibliotecas digitais, utilizando descritores e palavras-chave. Resultados: Foram identificados 790 estudos, sendo incluídos 34 estudos publicados entre 1984 e 2019. As principais dificuldades relatadas na realização do cateterismo intermitente limpo foram referentes a inserção do cateter, dor, desconforto, trauma uretral, banheiros públicos com instalações inadequadas, dificuldades físicas e falta de acesso aos insumos necessários. Conclusão: Os estudos analisados evidenciam as dificuldades que os pacientes usuários do cateterismo intermitente limpo e seus cuidadores enfrentam no dia a dia, que estão relacionadas à fatores intrínsecos e extrínsecos, institucionais e governamentais e podem diminuir a satisfação e a aderência aos programas de reabilitação vesical, com impacto na qualidade de vida dos pacientes e seus cuidadores. Portanto destaca-se a necessidade de educação em saúde para o adequado ensino da realização do cateterismo intermitente limpo, enfatizando a importância do papel do enfermeiro nesse processo.
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Affiliation(s)
- Leonardo Orlandin
- Universidade de São Paulo – Escola de Enfermagem de Ribeirão Preto – Programa de Pós-Graduação em Enfermagem Fundamental – Ribeirão Preto (SP), Brasil
| | - Aguinaldo Nardi
- Universidade de São Paulo – Faculdade de Odontologia de Bauru – Curso de Medicina – Bauru (SP), Brasil.o
| | | | - Alessandra Mazzo
- Universidade de São Paulo – Faculdade de Odontologia de Bauru – Curso de Medicina – Bauru (SP), Brasil.o
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Use of a symptom-based questionnaire to screen for the presence of significant voiding dysfunction in patients with multiple sclerosis and lower urinary tract symptoms: a pilot study. J Neurol 2020; 267:3683-3688. [PMID: 32671529 PMCID: PMC7674358 DOI: 10.1007/s00415-020-10068-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/08/2020] [Accepted: 07/09/2020] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Lower urinary tract dysfunction is common in people with multiple sclerosis, leading to overactive bladder symptoms, voiding difficulties or a combination. First-line medications for overactive bladder symptoms are effective. Current guidelines recommend measuring post-void residual volume (PVR) before commencing these treatments, as they can potentially exacerbate voiding difficulties in those with significant underlying voiding dysfunction (pre-treatment PVR > 100 ml). However, facilities to do so are not readily available to all clinicians, potentially delaying effective therapy. AIMS To conduct a pilot study investigating the association between lower urinary tract symptoms and PVR volume in people with multiple sclerosis using a validated questionnaire and to determine if questionnaire scores can be used to exclude a significantly elevated (> 100 ml) PVR volume. METHODS Patients with multiple sclerosis referred to a tertiary hospital uro-neurology service completed the Urinary Symptom Profile questionnaire and underwent PVR measurement by bladder ultrasound. A ratio of the questionnaire low stream score/total score was calculated to standardise the relative degree of voiding symptoms compared to overall lower urinary tract symptoms. RESULTS Of 40 patients (29 females, mean age 50 years), 30% had an elevated PVR volume. PVR volume was correlated with low stream score and ratio of low stream/total score. A cut-off of > 0.15 for low stream/total score ratio had 92% sensitivity and 71% specificity in predicting an elevated PVR volume. CONCLUSION A symptom-based questionnaire maybe a useful screening tool to distinguish patients in whom PVR measurement is required from those who could safely start on treatment for overactive bladder symptoms.
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10
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Autologous haematopoietic stem cell therapy for multiple sclerosis: a review for supportive care clinicians on behalf of the Autoimmune Diseases Working Party of the European Society for Blood and Marrow Transplantation. Curr Opin Support Palliat Care 2019; 13:394-401. [PMID: 31599815 PMCID: PMC6867671 DOI: 10.1097/spc.0000000000000466] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW In this review, we summarize the recently published literature that demonstrates the efficacy and safety of autologous haematopoietic stem cell therapy (AHSCT) in multiple sclerosis (MS) and highlight the importance of supportive care required for the safe and well-tolerated delivery of AHSCT. RECENT FINDINGS MS is an autoimmune inflammatory and degenerative disorder of the central nervous system (CNS). In the majority of patients, the illness runs a relapsing remitting course (RRMS), culminating in a secondary progressive phase with gradual accumulation of fixed disabilities. Currently available disease-modifying therapies suppress CNS inflammation but have a limited effect on preventing disease progression for which there remains no effective therapy. Over the last two decades, there has been increasing evidence that AHSCT is a highly effective therapeutic strategy for treatment-resistant inflammatory types of MS, especially RRMS. Concerns about the safety of AHSCT in MS, usually a nonlife-threatening disease, have previously limited its use. However, AHSCT can now be delivered safely with major long-term benefits because of increasing transplant centre experience, judicious patient selection and good supportive care. SUMMARY MS is currently the fastest growing indication for AHSCT in Europe. Supportive care before, during and after the transplant period is key to the successful delivery of AHSCT.
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Turmel N, Hentzen C, Miget G, Chesnel C, Charlanes A, Le Breton F, Tan E, Amarenco G. [Urethral pain during clean intermittent self catheterization: Retrospective analysis of 77 patients]. Prog Urol 2019; 29:360-365. [PMID: 31109758 DOI: 10.1016/j.purol.2019.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 04/19/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Clean self-intermittent catheterization (CIC) is the gold standard of the therapeutic approach of chronic urinary retention. Usually, CIC are safe, effective but in some cases catheterization can determine urethral pain during catheter insertion or withdrawal leading to poor adherence and compliance. To determine prevalence of pain during CIC and verify its impact on adherence to treatment. METHOD Retrospective study with evaluation of pain during CIC one month following CIC teaching session by means specific and validated questionnaires: ICDQ (Intermittent Catheterization Difficulties Questionnaire), InCasaq (Intermittent Catheterization Satisfaction Questionnaire), I-CAS (Intermittent Catheterization Adherence Scale). RESULTS Seventy-seven patients were recruited and 28 (36%) described pain during CIC. There is a strong relationship between pain and poor adherence (P<0.01). Female patients had a higher risk of urethral pain during CIC and in contrary BMI>25kg/m2 seems to be a protective factor of pain. CONCLUSION In this series, urethral pain was associated with low compliance and adherence to CIC. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- N Turmel
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France.
| | - C Hentzen
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - G Miget
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - C Chesnel
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - A Charlanes
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - F Le Breton
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - E Tan
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
| | - G Amarenco
- GRC 001, GREEN groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne université, AP-HP, 75020 Paris, France
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Joussain C, Levy J, Charlanes A, Even A, Falcou L, Chartier Kastler E, Denys P. Urological dysfunction in patients with hereditary spastic paraplegia. Neurourol Urodyn 2019; 38:1081-1085. [PMID: 30848841 DOI: 10.1002/nau.23957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/26/2019] [Accepted: 02/18/2019] [Indexed: 11/06/2022]
Abstract
AIMS Purposes of this study were to describe lower urinary tract symptoms (LUTS) and related urodynamic patterns in patients with hereditary spastic paraplegia (HSP), and to characterize LUTS management and associated uronephrological complications. METHODS We retrospectively reviewed medical files of HSP patients, consecutively followed in our Physical and Rehabilitation Medicine Department between 1999 and 2016. Clinical, urodynamic, and radiological data were collected and analyzed. Different treatments which have been prescribed and uronephrological complications were also recorded. Patients with other neurological or urological diseases were excluded. RESULTS Thirty-three patients with HSP were included. Mean duration of follow-up was 8.1 ± 5 years, mean age 62 ± 14 years, and 70% were men. The most frequent LUTS was urgency and voiding dysfunction (both 69.7%). Incontinence and retention with a significant postvoid residue above 100 mL accounted for 66.7% and 57.6% of initial symptoms respectively. Neurogenic detrusor overactivity was diagnosed in 80.7% of patients. Two-thirds of our cohort were treated with anticholinergics and 9.1% required intradetrusor botulinum-toxin injections. Only 27.3% of patients performed clean intermittent self-catheterization. Febrile urinary tract infections (21.2%), urolithiasis (15,1%), hydronephrosis (6%), and chronic renal failure (9.1%) were found. CONCLUSION Given their high prevalence and the risk of uronephrological complications, LUTS should be systematically assessed in HSP patients. The systematic screening of urological dysfunction in this population would improve its management, decrease the incidence of uronephrological complications, and increase the quality of life.
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Affiliation(s)
- Charles Joussain
- Inserm U1179, UFR des sciences de la santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France.,Department of Physical Medicine and Rehabilitation, APHP-Raymond-Poincaré Hospital, Garches, France
| | - Jonathan Levy
- Inserm U1179, UFR des sciences de la santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France.,Department of Physical Medicine and Rehabilitation, APHP-Raymond-Poincaré Hospital, Garches, France
| | - Audrey Charlanes
- Department of Neurourology and Urodynamics Unit, APHP-Tenon Hospital, Pierre et Marie Curie Medical School, Paris, France
| | - Alexia Even
- Department of Physical Medicine and Rehabilitation, APHP-Raymond-Poincaré Hospital, Garches, France
| | - Laetitia Falcou
- Department of Physical Medicine and Rehabilitation, APHP-Raymond-Poincaré Hospital, Garches, France
| | - Emmanuel Chartier Kastler
- Inserm U1179, UFR des sciences de la santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France.,Department of Urology, APHP-Pitié-Salpétrière Hospital, Pierre et Marie Curie Medical School, Paris, France
| | - Pierre Denys
- Inserm U1179, UFR des sciences de la santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France.,Department of Physical Medicine and Rehabilitation, APHP-Raymond-Poincaré Hospital, Garches, France
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Tibial Nerve and Sacral Neuromodulation in the Multiple Sclerosis Patient with Voiding Dysfunction. CURRENT BLADDER DYSFUNCTION REPORTS 2018. [DOI: 10.1007/s11884-018-0495-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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