[Are there benefits for catheter valves for catheter-associated quality of life? : Results of an investigation in 427 catheter wearers with life-long indication].
Andreas Wiedemann, A Mourad, C Gedding, J Stein, A Manseck, R Kirschner-Hermanns, T Liebald, C Linné, A Schorn, A Wagner, V Moll, U Unger, A Eisenhardt, J Salem, A Bannowsky, S Wirz, E Brammen, H-J Heppner
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引用次数: 1
Abstract
Background: In urology, a subset of patients with lifelong urine drainage are fitted with a catheter valve. Data on catheter-related quality of life (crqol) in this subset of patients are missing.
Aim: Clarification of the whether there are advantages for valve-aided catheters in comparison with continuous urine drainage in catheter wearers with a lifelong indication.
Methods: In all, 357 patients with a catheter with lifelong indication of continuous urine drainage from a previous study were compared with 70 valve-aided patients. The crqol was evaluated by a validated assessment with 25 items and five domains.
Results: There were statistically more patients with a suprapubic catheter than with a transurethral indwelling catheter (73.4 vs. 54.4%, p = 0.005), significantly more patients with bladder voiding dysfunction (73.5 vs. 52.6%, p = 0.003) and significantly more patients with small catheter sizes (p = 0.001). Crqol was altogether slightly impaired with a median score of 4.2 (no impairment indicated by 5 points) in valve-aided patients, but crqol was more impaired in valve-aided patients compared to patients with continuous drainage (4.4 points, n. s.). Some items demonstrated more problems dealing with urinary urge in valve-aided patients, but catheter-related pain was more often worse in patients with continuous drainage.
Conclusion: There is no clear evidence for an advantage of a catheter valve over a continuous urine drainage system. Thus, the decision regarding a catheter-valve system must be made individually according to the indication and the preferences of the patient.
背景:在泌尿外科,有一部分终生尿引流的患者需要置放导尿管瓣膜。这部分患者的导管相关生活质量(crqol)数据缺失。目的:澄清在终身佩戴导尿管患者中,与持续引尿相比,瓣膜辅助导尿管是否有优势。方法:在既往研究中,共有357例患者使用导尿管终身持续尿引流,与70例瓣膜辅助患者进行比较。采用5个领域、25个项目的有效评估法进行评价。结果:耻骨上置管患者明显多于经尿道留置管患者(73.4 vs. 54.4%, p = 0.005),膀胱排尿功能障碍患者明显多于经尿道留置管患者(73.5 vs. 52.6%, p = 0.003),导管尺寸小的患者明显多于经尿道留置管患者(p = 0.001)。瓣膜辅助患者的Crqol总体轻度受损,中位评分为4.2分(5分无损伤),但与持续引流患者相比,瓣膜辅助患者的Crqol受损更严重(4.4分,n. s.)。一些项目表明,在瓣膜辅助患者中,处理尿急的问题更多,但在持续引流的患者中,导尿管相关疼痛往往更严重。结论:没有明确的证据表明导管阀优于连续尿引流系统。因此,关于导管-瓣膜系统的决定必须根据患者的适应症和偏好单独做出。