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A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 2001 June;37(2):111-4

language: English

From intermittent catheterisation to time-volume dependent catheterisation in patients with spinal cord injuries, through the use of a portable, ultrasound instrument

Suardi L., Cazzaniga M., Spinelli M., Tagliabue A. *

From ­the Division of Rehabilitative Medicine Valduce Hospital Villa Beretta, Costa Masnaga, Lecco
*Urology Division Section ­for Spinal Cord Injuries at Urologic ­risk Fornaroli Hospital, Magenta, Milan


Background. 1) To ­assess ­the ­use in clin­i­cal prac­tice of ­time ­and vol­ume depen­dent cath­et­er­isa­tion ­and pos­sible advan­tag­es com­pared ­with inter­mit­tent cath­et­er­isa­tion in ­terms of: reduc­tion in ­the num­ber of cath­et­er­isa­tions, reduc­tion in epi­sodes of blad­der ­over-dis­ten­sion; 2) ­assess ­the accu­ra­cy of ­the instru­ment ­used to meas­ure blad­der vol­umes.
Methods. Twenty ­patients suf­fer­ing ­from spi­nal ­cord inju­ries hos­pit­al­ised at ­the Villa Beretta Rehabilita-tion Centre pre­sent­ing a clin­i­cal ­and urod­y­nam­ic diag­no­sis of neu­ro­gen­ic blad­der ­being treat­ed ­with inter­mit­tent cath­et­er­isa­tion ­are con­sid­ered in ­this ­study; ­the ­data result­ing ­from ­the mic­tu­ri­tion­al ­diary com­piled with­in ­the con­text of clin­i­cal rou­tine by ­the nurs­ing ­staff ­were col­lect­ed ­and ana­lysed sta­tis­ti­cal­ly. Each ­patient ­was ade­quate­ly ­informed ­and mon­i­tored ­for a ­total peri­od of 14 ­days; in ­the ­first 7 ­days, blad­der drain­age ­was car­ried ­out by ­means of inter­mit­tent cath­et­er­isa­tion (IC), in ­the fol­low­ing peri­od of 7 ­days by ­time-vol­ume depen­dent cath­et­er­isa­tion (­TVDC).
Results. Using ­TVDC ­there is a sig­nif­i­cant reduc­tion in ­the ­total num­ber of cath­et­er­isa­tions (p<0.001) ­with no sig­nif­i­cant vari­a­tion in blad­der ­over-dis­ten­sion epi­sodes (p>0.05); ­the pre­ci­sion of ­the instru­ment ­used to meas­ure blad­der vol­umes var­ies ­with ­the ­range of meas­ure­ments car­ried ­out. It is ­good (with­in 10% of ­bin cen­tre val­ue) in ­the 200-499 ml ­range, ­while it is ­much ­less pre­cise out­side ­this ­range.
Conclusions. In ­the every­day man­age­ment of blad­der drain­age in ­patients ­with neu­ro­gen­ic blad­der, ­TVDC ­can be advan­ta­geous in select­ed cas­es com­pared to IC ­because it ­leads to a reduc­tion in ­the num­ber of super­flu­ous cath­et­er­isa­tions. The ­use of a port­able instru­ment pre­sent­ing ­good pre­ci­sion ­for ­the meas­ure­ment of blad­der vol­umes is deci­sive ­for ­the appli­ca­tion of ­TVDC.

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