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Postoperative care
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Hypertension is also common. It may be due to pain, agitation, anxiety, bladder spasm secondary to urinary catheterisation or pre-existing poorly-controlled hypertension. Consequences include bleeding from vascular suture lines, cerebrovascular haemorrhage and myocardial ischaemia or infarction.
Evaluation of thermal dose effect in radiofrequency-induced hyperthermia with intravesical chemotherapy for nonmuscle invasive bladder cancer
Published in International Journal of Hyperthermia, 2023
Iris S. G. Brummelhuis, Johannes Crezee, J. Alfred Witjes
Descriptions of continuous variables were presented as medians and IQR. Thermal dose subgroups (high vs. low) were defined using the median value as cutoff point, in order to achieve optimal statistical power. Rates of durable response, RFS, PFS and OS were estimated with the Kaplan–Meier method. Subgroups were compared using a stratified log-rank test. The associations between thermal dose parameters and RFS, PFS and OS were determined with (uni- and multivariable) cox regression and are presented as unadjusted and adjusted hazard ratios (HR). Logistic regression (uni- and multivariable) was used to assess the associations between thermal dose parameters and CR, which are presented as unadjusted and adjusted odds ratios (OR). The association between thermal dose and the occurrence of side effects was also assessed with logistic regression. The means of the three bladder spasm groups were compared using one-way ANOVA with a post-hoc Tukey HSD test.
The impact of educational interventions for patients living with indwelling urinary catheters: A scoping review
Published in Contemporary Nurse, 2020
Joby Alex, Yenna Salamonson, Lucie M. Ramjan, Jed Montayre, Jennifer Fitzsimons, Caleb Ferguson
Nurses are ideally positioned to educate, counsel and support patients to adjust to living well with a urinary catheter in the community (Wilde & Cameron, 2003). However, the inconsistent and conflicting information received by patients may be explained by the variability in nurses’ knowledge levels. The review identified nurses’ knowledge of urinary catheter care varies widely (Giles et al., 2015; Jenkinson, 2005; Marigliano et al., 2012) and the quasi-experimental study by Giles et al. (2015) identified poor knowledge and practices among nurses in caring for patients in relation to urinary catheters. Educating nurses and providing information about useful resources and support networks will improve nurse confidence and skills in discussing catheter self-management with patients and their informal caregivers (Prinjha et al., 2016; Wilde & Cameron, 2003). As suggested by others (Prinjha et al., 2016; Wilde & Cameron, 2003), nurses should be encouraged to discuss choices of catheters and drainage systems suitable for patients’ individual lifestyles and also information about sexual activity with catheters. In the absence of professional information, patients may try to find alternative options and solutions to adjust to life with a catheter, which may be risky and lead to recurrent urinary tract infections and other problems such as catheter blockages, urine leakage, and bladder spasm (Prinjha et al., 2016).
Effect of intravesical botulinum toxin injection on symptoms of autonomic dysreflexia in a patient with chronic spinal cord injury: a case report
Published in The Journal of Spinal Cord Medicine, 2019
Il-Young Jung, Kyo Ik Mo, Ja-Ho Leigh
Subsequent to SCI, the descending central modulation of bladder activity becomes disrupted. However, as spinal bladder reflexes re-emerge several weeks to months after SCI,7 independent sacral reflex activity leads to uninhibited bladder muscle activation during filling at a given volume threshold and urinary incontinence without the sensation of bladder filling or the urge to void.8 In addition, the lack of voluntary external sphincter control, unexpected bladder spasm, and uncoordinated activity between the bladder and external sphincter are more common in people with SCI than in others with voiding problems.8 Among the chronic complications of patients with SCI, one of the most important ones is the loss of genitourinary and gastrointestinal function.1 When the symptoms of autonomic dysreflexia develop due to neurogenic bowel and bladder, irritation caused by bladder distension can be the most common cause.9 Even if a patient takes an anti-cholinergic drug, bladder compliance gradually decreases according to the change in muscle cells that line the bladder walls. A change in the bladder can cause even a small amount of urine to induce a vesical pressure increase, and the increased vesical pressure can lead to increased sympathetic tone. In other words, the symptoms of autonomic dysreflexia can be induced by little irritation, although detrusor pressure is well controlled by regular clean intermittent catheterization.