ORIGINAL ARTICLES   Free access

Europa Medicophysica 2001 June;37(2):111-4

Copyright © 2001 EDIZIONI MINERVA MEDICA

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.