Given the lack of direction in the literature for managing these complex patients, we propose a management algorithm for adults with difficulty catheterizing a CCC; this is informed by our surgical and non-surgical experience (Fig.
Difficulty catheterizing a CCC can be addressed with surgical revision when non-surgical management fails.
using a coude tip catheter, the curved tip should be pointed superiorly at the 12 o'clock position.
As described above, this can be devastating in patients who have had complicated reconstruction, whereby if strict catheterizing regimens are not adhered to, complications are common and significant.
My personal experience is that catheterizing becomes an increasing burden and many patients look towards converting to an incontinent diversion.
When catheterizing only for the purpose of obtaining a specimen, a feeding tube can be used in infant boys and girls.
Meticulous aseptic technique is used when catheterizing a child who has an artificial urinary sphincter.
Chronic inflammation has been shown to be associated with an increased risk of SCC, which includes trauma (catheterizing
) and infections.[sup.11]-[sup.15] Carcinogenic effects of normal urine and urinary stasis (as in continent diversion) have also been associated with a risk of cancer in bowel segments used for urinary diversion, most commonly adenocarcinoma.
Many patients with medical conditions that require CIC (for example, prune belly syndrome, posterior urethral valves, multiple sclerosis, atonic bladder, and urethral stricture) have urethral sensation and complain of discomfort when catheterizing
A randomized trial between BTX A and an anti-cholinergic medication in patients with moderate to severe OAB with detrusor overactivity who are naive to treatment may be reasonable to address this issue, especially in the subset of neurogenic OAB who are already intermittently catheterizing
It is important to wash your hands not only before catheterizing
yourself but also before eating or performing any procedure that might involve your skin or mucous membranes.
However, female patients catheterizing
per-urethra with a compact-HC were more likely to prefer its use over the uncoated catheters; the compact-HC could be offered to this population.