• 지역사회간호학회지
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• 제29권4호
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• pp.467-475
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• 2018

Purpose: The purpose of this study is to investigate adherence to the clean intermittent catheterization (CIC) and influencing factors on the adherence following a customized intensive education program (CIEP). Methods: This work is a retrospective descriptive study. The subjects were 226 emptying failure patients who learned in a CIEP from January 2012 to July 2014. The program developed in 2011 and consisted of 1) customized theoretical education; based on the results of urologic tests, underlying disease, or surgery of the patients, 2) hands-on practice until the trainees were able to master the techniques, 3) questions about the process of catheterization and what he/she needs to know. 4) at follow-up, the survey about adherence and barrier to CIC. Clinical characteristics; the level of satisfaction, understanding, and self-confidence; the barrier in medical records were reviewed. Results: The short-term adherence rate (median 22 days) is 87.6% and the long-term adherence rate (median 112 days) is 50.4%. The biggest obstacle is time management. The levels of satisfaction, understanding, and self-confidence are very high. The variable of Income is the only factor that has influence on adherence. Conclusion: Despite the CIEP, the adherence rate is relatively low. In addition to the education, emotional and psychological supports and regular follow-up are needed to improve long-term adherence.

• 임상간호연구
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• 제22권3호
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• pp.285-293
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• 2016

Purpose: The purpose of this study was aimed to develop evidence-based nursing practice guideline for preventing intermittent urinary catheterization (IUC) related complications using guideline remake process. Methods: Guideline remake process was conducted according to guideline adaptation manual developed by Gu et al (2012) which consisted of three main phases and 9 modules including a total of 24 steps. Results: Newly developed IUC guideline consists of introduction, overview of intermittent catheterization, summary of recommendations, recommendations, references, and appendices. There were 50 recommendations in 5 sections including assessment, equipments, catheterization, complications management, and education/consult. Three recommendations (6%) were graded A, and five (10%) and 41 recommendations(82%) were B and C, respectively. Conclusion: The IUC remade-guideline was developed based on evidence-based nursing and therefore, this guideline is recommended to be disseminated and utilized by nurses nationwide to improve the quality of care for IUC and to decrease the IUC related complications.

• Journal of Yeungnam Medical Science
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• 제16권2호
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• pp.376-379
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• 1999

저자들은 전자궁적축술과 요실금 수술후 요도폐색이 발생한 43세의 여자 환자에서 장기간의 간헐적 자가도뇨법과 약물요법으로 치료되지 않아, 외요도구 상방을 통한 요도 박리술을 시행하여 좋은 결과를 볼 수 있었다. 저자들의 견해로는 과거에 부인과 수술과 동반해서 시행하거나 혹은 복측으로 치골후방으로 접근하여 시행한 요실금수술이나 요도하부 슬링수술등의 방법으로 인해 요도 폐색이 발생시 외요도구 상방을 통한 요도박리술이 바람직할 것으로 사료된다.

• 기본간호학회지
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• 제5권2호
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• pp.225-236
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• 1998

The literature review about bladder management method given to maintain and improve health of neurogenic bladder patients was done. Because the study of neurogenic bladder patients in nursing field is not enough, I tried to find report the study tendency through literature review, 1. There are five types of neurogenic bladder such as uninhibited neurogenic bladder, reflex neurogenic bladder, autonomous neurogenic bladder, sensory paralytic neurogenic bladder, and motor paralytic neurogenic bladder. 2. The accurate assessment of neurogenic bladder is done mainly through urodynamics and especially cystometrogram and urethrogram are used. 3. As the study of therapeutic management, the effect of Desmopressin, bladder auto-augmentation, incision of external urethral sphincter muscle, subarachnoid block and pudendal never block using phenol was studied. 4. For the study of general management, the effect of bladder training progam, intermittent catheterization and infection control has been studied but there has not been any obvious study in nursing field. Reviewed the study condition, it is necessary to develope bladder training program in order to increase life quality of neurogenic bladder patients.

• Journal of Korean Neurosurgical Society
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• 제63권3호
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• pp.358-365
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• 2020

To describe how to perform urological evaluation in children with tethered cord syndrome (TCS). Although a common manifestation of TCS is the development of neurogenic bladder in developing children, neurosurgeons often face difficulty in detecting urological problems in patients with TCS. From a urological perspective, diagnosis of TCS in developing children is further complicated due to the differentiation between neurogenic bladder dysfunctions and transient bladder dysfunctions owing to developmental problems. Due to the paucity of evidence regarding evaluation prior to and after untethering, I have shown the purpose and tools for evaluation in my own practice. This may be tailored to the types of neurogenic bladder, developmental status, and risks for deterioration. While the urodynamic study (UDS) is the gold standard test for understanding bladder function, it is not a panacea in revealing the nature of bladder dysfunction. In addition, clinicians should consider the influence of developmental processes on bladder function. Before untethering, UDS should reveal synergic urethral movement, which indicates an intact sacral reflex and lack of TCS. Postoperatively, the measurement of post-void residual urine volume is a key factor for the evaluation of spontaneous voiders. In case of elevation, fecal impaction, which is common in spinal dysraphism, should be addressed. In patients with clean intermittent catheterization, the frequency-volume chart should be monitored to assess the storage function of the bladder. Toilet training is an important sign of maturation, and its achievement should be monitored. Signs of bladder deterioration should be acknowledged, and follow-up schedule should be tailored to prevent upper urinary tract damage and also to determine an adequate timing for intervention. Neurosurgeons should be aware of urological problems related to TCS as well as urologists. Cooperation and regular discussion between the two disciplines could enhance the quality of patient care. Accumulation of experience will improve follow-up strategies.

• Journal of Menopausal Medicine
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• 제24권3호
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• pp.163-168
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• 2018

Objectives: To investigate the rate of postoperative urinary retention (POUR) and identify the risk factors for this complication in women who underwent transvaginal uterosacral suspension surgery. Methods: A retrospective chart review was conducted for 75 women who underwent transvaginal uterosacral suspension surgery with vaginal hysterectomy, repair of cystocele, and levator myorrhaphy with/without transobturator anti-incontinence surgery. POUR was defined as a need for continuous intermittent catheterization on the third day subsequent to removal of the urethral indwelling catheter. Results: Acute POUR was reported in 18 women (24.0%). Thirty-six of the 75 patients (48.0%) had undergone anti-incontinence surgery. Crude analysis revealed significant association between the following variables and the risk of POUR: hypertension, the lower average flow rate in the pressure-flow study (PFS), greater post-void residual (PVR) urine volume in PFS, and PVR >30% of the total bladder capacity (TBC) in PFS. In the logistic regression analysis, PVR >30% of the TBC in PFS was identified as the only significant predictor of POUR (odds ratio, 15.4; 95% confidence interval, 2.5-90.9; P = 0.003). Conclusions: The PVR >30% of the TBC in PFS was identified as the only predictive factor of acute POUR in women who underwent transvaginal uterosacral suspension surgery.