Barriers to Implementing Intermittent Catheterisation in Spinal Cord Injury Patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.

Intermittent catheterisation is the preferred method of managing the neurogenic bladder in patients with spinal cord injury. However, spinal cord physicians experienced problems when trying to implement an intermittent catheterisation regime in some spinal cord injury patients in the northwest of En...

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Main Authors: Subramanian Vaidyanathan, Bakul M. Soni, Gurpreet Singh, Tun Oo, Peter L. Hughes
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1100/tsw.2011.12
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author Subramanian Vaidyanathan
Bakul M. Soni
Gurpreet Singh
Tun Oo
Peter L. Hughes
author_facet Subramanian Vaidyanathan
Bakul M. Soni
Gurpreet Singh
Tun Oo
Peter L. Hughes
author_sort Subramanian Vaidyanathan
collection DOAJ
description Intermittent catheterisation is the preferred method of managing the neurogenic bladder in patients with spinal cord injury. However, spinal cord physicians experienced problems when trying to implement an intermittent catheterisation regime in some spinal cord injury patients in the northwest of England. We present illustrative cases to describe practical difficulties encountered by patients while trying to adopt an intermittent catheterisation regime. Barriers to intermittent catheterisation are (1) caregivers or nurses are not available to carry out five or six catheterisations a day; (2) lack of time to perform intermittent catheterisations; (3) unavailability of suitable toilet facilities in public places, including restaurants and offices; (4) redundant prepuce in a male patient, which prevents ready access to urethral meatus; (5) urethral false passage; (6) urethral sphincter spasm requiring the use of flexible-tip catheters and α-drenoceptor–blocking drugs; (7) reluctance to perform intermittent catheterisation in patients >60 years by some health professionals; and (8) difficulty in accessing the urethral meatus for catheterisation while the patient is sitting up, especially in female patients. These cases demonstrate the urgent need for provision of trained caregivers who can perform intermittent catheterisation, and improvement in public facilities that are suitable for performing catheterisation in spinal cord injury patients. Further, vigilance should be exercised during each catheterisation in order to prevent complications, such as urethral trauma and consequent false passages. Health professionals should make additional efforts to implement intermittent catheterisation in female spinal cord injury patients and in those >60 years.
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spelling doaj-art-e57bdd4fcc5747918daf9412eb22a84d2025-02-03T01:02:09ZengWileyThe Scientific World Journal1537-744X2011-01-0111778510.1100/tsw.2011.12Barriers to Implementing Intermittent Catheterisation in Spinal Cord Injury Patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.Subramanian Vaidyanathan0Bakul M. Soni1Gurpreet Singh2Tun Oo3Peter L. Hughes4Regional Spinal Injuries Centre, District General Hospital, Southport, Merseyside, UKRegional Spinal Injuries Centre, District General Hospital, Southport, Merseyside, UKDepartment of Urology, District General Hospital, Southport, Merseyside, UKRegional Spinal Injuries Centre, District General Hospital, Southport, Merseyside, UKDepartment of Radiology, District General Hospital, Southport, Merseyside, UKIntermittent catheterisation is the preferred method of managing the neurogenic bladder in patients with spinal cord injury. However, spinal cord physicians experienced problems when trying to implement an intermittent catheterisation regime in some spinal cord injury patients in the northwest of England. We present illustrative cases to describe practical difficulties encountered by patients while trying to adopt an intermittent catheterisation regime. Barriers to intermittent catheterisation are (1) caregivers or nurses are not available to carry out five or six catheterisations a day; (2) lack of time to perform intermittent catheterisations; (3) unavailability of suitable toilet facilities in public places, including restaurants and offices; (4) redundant prepuce in a male patient, which prevents ready access to urethral meatus; (5) urethral false passage; (6) urethral sphincter spasm requiring the use of flexible-tip catheters and α-drenoceptor–blocking drugs; (7) reluctance to perform intermittent catheterisation in patients >60 years by some health professionals; and (8) difficulty in accessing the urethral meatus for catheterisation while the patient is sitting up, especially in female patients. These cases demonstrate the urgent need for provision of trained caregivers who can perform intermittent catheterisation, and improvement in public facilities that are suitable for performing catheterisation in spinal cord injury patients. Further, vigilance should be exercised during each catheterisation in order to prevent complications, such as urethral trauma and consequent false passages. Health professionals should make additional efforts to implement intermittent catheterisation in female spinal cord injury patients and in those >60 years.http://dx.doi.org/10.1100/tsw.2011.12
spellingShingle Subramanian Vaidyanathan
Bakul M. Soni
Gurpreet Singh
Tun Oo
Peter L. Hughes
Barriers to Implementing Intermittent Catheterisation in Spinal Cord Injury Patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.
The Scientific World Journal
title Barriers to Implementing Intermittent Catheterisation in Spinal Cord Injury Patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.
title_full Barriers to Implementing Intermittent Catheterisation in Spinal Cord Injury Patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.
title_fullStr Barriers to Implementing Intermittent Catheterisation in Spinal Cord Injury Patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.
title_full_unstemmed Barriers to Implementing Intermittent Catheterisation in Spinal Cord Injury Patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.
title_short Barriers to Implementing Intermittent Catheterisation in Spinal Cord Injury Patients in Northwest Regional Spinal Injuries Centre, Southport, U.K.
title_sort barriers to implementing intermittent catheterisation in spinal cord injury patients in northwest regional spinal injuries centre southport u k
url http://dx.doi.org/10.1100/tsw.2011.12
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