From time dependent intermittent selfcatheterisation to volume dependent selfcatheterisation in multiple sclerosis...

Area of Science:

• Urology
• Neurology
• Medical Devices

Background:

• Neurogenic bladder dysfunction is a common complication in Multiple Sclerosis (MS).
• Current management often involves time-dependent intermittent catheterization, which can be suboptimal.
• Patient-controlled bladder volume measurement devices offer a potential alternative for improved management.

Purpose of the Study:

• To evaluate the efficacy and accuracy of a portable, patient-controlled ultrasound device (PCI 5000, Bladdermanager) for managing neurogenic bladder dysfunction in MS patients.
• To assess the impact of transitioning from time-dependent to volume-dependent intermittent catheterization using this device.

Main Methods:

• Twenty-three MS patients were switched from time-dependent to volume-dependent intermittent catheterization using the PCI 5000 device.
• Accuracy of bladder volume measurements was evaluated.
• Efficacy per catheterization, incontinence frequency, and need for assistance (Functional Independence Measurement - FIM score) were assessed.

Main Results:

• The ultrasound device demonstrated high accuracy (91.05%) in bladder volume measurement.
• Efficacy per catheterization improved significantly (from 260.8 cc to 297.5 cc).
• Incontinence frequency decreased substantially (from 69 to 39 episodes over 48 hours), with six patients reducing daily catheterizations. FIM scores remained stable.

Conclusions:

• The portable, patient-controlled ultrasound device is accurate and effective for managing neurogenic bladder dysfunction in MS.
• Transitioning to volume-dependent intermittent catheterization using this device improves efficacy and reduces incontinence.
• The device simplifies management without increasing the need for assistance, enhancing patient independence.