2026-02-02
In China, most hospitals use indwelling catheterization to deal with neurogenic bladder. Although intermittent catheterization has been promoted to some extent in recent years, there are still many patients who have never experienced it. Due to the lack of professional medical knowledge promotion, some patients still have misunderstandings about intermittent catheterization. In fact, intermittent catheterization has significant advantages over indwelling catheterization, and it has been widely used internationally.
Misunderstanding 1: It is more likely to cause urinary tract infections than indwelling catheterization.
Complications caused by indwelling urinary catheters are numerous, including urinary tract infections, urethral stricture, epididymitis, penile scrotal abscess or fistula, upper urinary tract calculi, and bladder tumors. Moreover, prolonged indwelling of the catheter increases the risk of upper urinary tract functional damage. Long-term indwelling of the catheter can damage the urethral mucosa, reduce its immunity, and also prevent the flow of antibacterial prostate fluid into the urethra, increasing the probability of urinary tract infection to over 90%.
Intermittent catheterization can effectively empty the bladder and reduce the residual urine volume. Studies have shown that residual urine volume in the bladder is positively correlated with urinary tract infections. This is related to the excessive expansion of the bladder causing a decrease in blood flow in the bladder wall, which makes it prone to bacterial infection.
By comparing the comprehensive intermittent catheterization therapy with indwelling catheterization and routine care, it was found that the former established reflexive bladders significantly more often than the latter; urinary tract infections, injuries, and re-admissions due to urinary obstruction were significantly fewer in the former. Intermittent catheterization is not only for restoring bladder function, but also mainly enables the bladder to regularly store and expel urine, eliminates the inconvenience of indwelling catheterization, significantly reduces the incidence of urinary tract infections and other complications, and prolongs the survival period of patients and improves their quality of life.
Misunderstanding 2: Fear of causing urethral damage and difficulty in operation
During the hospitalization of patients with spinal cord injuries, those who did not receive standardized bladder function training and intermittent catheterization operation guidance had problems with local mucosal edema and damage due to unskilled operation or insufficient lubrication of the front end of the catheter during catheterization.
In fact, studies have shown that when nurses, family members, or patients conduct intermittent catheterization themselves, after disinfecting the urethral opening and taking secretions for bacterial culture, there is no statistically significant difference in the infection rate between the intermittent catheterization group by nurses and the intermittent catheterization group by family members or patients; most patients with spinal cord injuries are paraplegic and have normal upper limb movements, so self-intermittent catheterization is feasible. Moreover, the intermittent catheterization operation is not complicated and can be easily learned.
Misunderstanding 3: Worrying about the high cost of intermittent catheterization supplies over a long period
In fact, using intermittent catheterization in accordance with the established norms in the early stage is beneficial for the recovery of bladder function. As the residual urine volume decreases, the frequency of catheterization can be reduced. Intermittent catheterization can also significantly reduce the occurrence of complications such as urinary tract infections. The cost of catheterization supplies is much lower compared to the cost of treating complications. Moreover, in recent years, China has placed greater emphasis on rehabilitation medicine, and the cost of rehabilitation treatments is expected to be included in the medical insurance coverage.
Intermittent catheterization is the "gold standard" for bladder emptying in patients with no reflex of the detrusor muscle. It is also recommended by the International Continence Society as the preferred treatment method for neurogenic bladder dysfunction, and is safe for both the short-term and long-term use of patients. Internationally, intermittent catheterization has been recommended as the best method for bladder management and has been widely applied.
The content of this article is sourced from the internet. The author assumes no responsibility for it. Without permission, copying is strictly prohibited.
|
浙公网安备33021202001967号
