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The Connected Catheter for management of Chronic Urinary Retention (CUR) in an adult male with Neurogenic Bladder - Case study.

ABSTRACT: Millions of adults suffer from chronic urinary retention or disorders that require catheterization for bladder management. The current standard of care for these patients consists of three different methods of catheterization, all of which present varying levels of infection, urethral trauma, and patient discomfort or inconvenience. We studied a 34 -year-old man with chronic urinary retention, frequent urinary tract infections and strictures, with a fully internal, extended use, wirelessly controlled catheter system. This new system was designed to improve overall Quality of Life and potentially decrease the rate of catheter associated clinical complications.

SUBMITTER: Agatstein E

PROVIDER: S-EPMC6597782 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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The Connected Catheter for management of Chronic Urinary Retention (CUR) in an adult male with Neurogenic Bladder - Case study.

Agatstein Ernest E Aynehchi Shahrad S

Urology case reports 20190615

Millions of adults suffer from chronic urinary retention or disorders that require catheterization for bladder management. The current standard of care for these patients consists of three different methods of catheterization, all of which present varying levels of infection, urethral trauma, and patient discomfort or inconvenience. We studied a 34 -year-old man with chronic urinary retention, frequent urinary tract infections and strictures, with a fully internal, extended use, wirelessly contr ...[more]

PMID: 31297331

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Project description:IntroductionNeurogenic lower urinary tract dysfunction (NLUTD) both threatens the health of affected patients long-term and also has a significantly negative impact on the patients' quality of life. present, many clinical practice guidelines (CPGs) have been developed for NLUTD patients, but these CPGs may confuse healthcare professionals and patients due to their great difference in terms of scope, quality and content. This review aims to identify the CPGs for NLUTD patients published from 2012 to 2022, assess their quality and then analyse them in an integrated manner.Methods and analysisWe will systematically search electronic healthcare databases (English databases including PubMed, EMBASE, OVID, Scopus, Web of Science, Cochrane Library, CINAHL, UpToDate, and Best Practice and Chinese databases including China National Knowledge Infrastructure, Wanfang Database, VIP Periodical Resource Integration Service Platform and SinoMed), online CPG repositories and relevant professional association websites to identify eligible CPGs. The CPGs published in English and Chinese with full texts available within the period from January 2012 to March 2022 will be included in this study. The Appraisal of Guidelines for Research and Evaluation (AGREE) II will be used to assess the quality of included CPGs. According to the predesigned data table, the general characteristics of these CPGs, proposed recommendations and their quality of evidence, strength of recommendation and other information will be extracted. Qualitative thematic analysis will be applied to the extracted recommendations. A summary of the proposed recommendations, their quality of evidence, strength of recommendation and other information will eventually be described in a table. This review is expected to identify knowledge gaps in current CPGs and to identify the areas of the proposed recommendations derived from low-level evidence. ETHICS AND DISSEMINATION : This systematic review does not involve the participation of any subjects, and therefore no ethical approval is required. The findings of this review will be published in a peer-reviewed journal and disseminated via conference presentations.Prospero registration numberCRD42022318180.

Project description:ObjectiveInappropriate diagnosis and treatment of asymptomatic bacteriuria (ASB) and urinary tract infection (UTI) are leading causes of antibiotic overuse but have not been well-studied in patients with risks for complicated UTI such as neurogenic bladder (NB). Our aim was to describe ASB and UTI management in patients with NB and assess factors associated with inappropriate management.DesignRetrospective cohort study.SettingFour Department of Veteran's Affairs (VA) medical centers.ParticipantsAdults with NB due to spinal cord injury/disorder (SCI/D), multiple sclerosis (MS), or Parkinson disease (PD) and encounters with an ASB or UTI diagnosis between 2017 and 2018. Clinical and encounter data were extracted from the VA Corporate Data Warehouse and medical record reviews for a stratified sample of 300 encounters from N=291 patients.InterventionsNone.Main outcome measuresPrevalence of appropriate and inappropriate ASB and UTI diagnosis and treatment was summarized. Multivariable logistic regression models assessed factors associated with inappropriate management.ResultsN=200 UTI and N=100 ASB encounters were included for the 291 unique patients (SCI/D, 39.9%; MS, 36.4%; PD, 23.7%). Most patients were men (83.3%), >65 years (62%), and used indwelling or intermittent catheterization (68.3%). Nearly all ASB encounters had appropriate diagnosis (98%). 70 (35%) UTI encounters had inappropriate diagnosis, including 55 (27.5%) with true ASB, all with inappropriate treatment. Among the remaining 145 UTI encounters, 54 (27%) had inappropriate treatment. Peripheral vascular disease, chronic kidney disease, and cerebrovascular disease were associated with increased odds of inappropriate management; indwelling catheter (aOR 0.35, P=.01) and Physical Medicine & Rehabilitation provider (aOR 0.29, P<.01) were associated with decreased odds.ConclusionUp to half of UTI encounters for patients with NB had inappropriate management, largely due to inappropriate UTI diagnosis in patients with true ASB. Interventions to improve ASB and UTI management in patients with NB should target complex patients with comorbidities being seen by non-rehabilitation providers.

Dataset Information

The Connected Catheter for management of Chronic Urinary Retention (CUR) in an adult male with Neurogenic Bladder - Case study.

Publications

The Connected Catheter for management of Chronic Urinary Retention (CUR) in an adult male with Neurogenic Bladder - Case study.

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