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Feasibility and outcome of clean intermittent catheterization for children with sensate urethra
1Department of Surgery, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
Insights
Clean intermittent catheterization (CIC) is effective for children with noncompliant bladders. Early treatment and compliance with CIC in children with sensate urethras can improve bladder function and reduce the need for surgery.
Area of Science:
- Pediatric Urology
- Pediatric Nephrology
Background:
- Noncompliant bladders in children often require management strategies.
- Clean intermittent catheterization (CIC) is a key intervention for managing these conditions.
- Assessing the feasibility and long-term outcomes of CIC in children with normal urethral sensation is crucial.
Purpose of the Study:
- To evaluate the feasibility and late outcomes of clean intermittent catheterization (CIC) in pediatric patients with normal urethral sensation.
- To determine factors influencing the success and compliance with CIC.
- To assess the impact of CIC on bladder function and the need for surgical intervention.
Main Methods:
- Retrospective review of pediatric patients with posterior urethral valve (PUV) or non-neuropathic bladder sphincter dysfunction (NNBSD) who initiated CIC.
- Analysis included patient age, indication for CIC, acceptance, and compliance rates.
- Long-term follow-up assessed bladder function and surgical intervention requirements.
Main Results:
- 52 patients (38 with PUV, 14 with NNBSD) were initiated on CIC; 48% were under 4 years old.
- 85% accepted CIC, and 65% remained compliant after 2 years.
- Younger age (≤4 years) was significantly associated with successful CIC (p=0.03); 54% avoided further surgery.
Conclusions:
- Clean intermittent catheterization (CIC) is a feasible and effective management option for pediatric patients with sensate urethras and noncompliant bladders.
- Early initiation of CIC is recommended.
- Patient compliance with CIC is linked to better long-term bladder function and reduced need for surgical interventions.
Objective:
Clean intermittent catheterization (CIC) is an important asset in managing children with noncompliant bladders. We review the feasibility and late outcomes of patients with normal urethral sensation who began CIC.
Materials And Methods:
We reviewed all patients with posterior urethral valve (PUV) or non-neuropathic bladder sphincter dysfunction (NNBSD) who began on CIC, and had at least 2 years of follow-up. We considered their age, indication, acceptance and compliance with CIC. Additionally, we examined the late outcome of bladder function and the need for any surgical intervention at follow-up.
Results:
Between 1999 and 2006, 52 patients with PUV (38 patients) or NNBSD (14 patients) were started on CIC. Of these 52 patients, 48% were under the age of 4. A total of 44 patients (85%) accepted the recommendation for CIC, and 34 patients (65%) were compliant with the protocol after at least 2 years of follow-up. The age of the patients was the only significant factor related to the success of the protocol (4 years old or younger, p = 0.03). After at least 2 years of follow-up, 28 patients (54%) remained on CIC and have not required urinary diversion or bladder reconstruction.
Conclusion:
The current study showed that CIC is a feasible option for patients with sensate urethra, which necessitates the introduction of treatment as early as possible. Further, those patients who are compliant with the CIC demonstrated a better chance of avoiding subsequent surgical intervention for the management of a non-compliant bladder.
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