| Popis: |
Although lower urinary tract symptoms such as dysuria, frequency, and bladder spasms may not be life-threatening, these symptoms can have a large impact on a patient’s quality of life as well as the lives of the patient’s family and caregivers in the palliative care setting. A range of medical problems can contribute to common causes of irritative voiding symptoms; the goal is to identify these potential problems and address them, taking into account the palliative care patient’s severity of symptoms, frailty, and life expectancy. In the evaluation and treatment of the patient’s symptoms, a methodical approach is best offered with the treatment options ranging from the least conservative to the more invasive. Clinicians should begin with a history and physical examination, urine analysis and/or culture to rule out urinary tract infection, and obtain post-void residual to rule out urinary retention. Patient education regarding normal urinary tract function should be reviewed and then treatment goals solidified. Conservative options include behavioural and dietary modification. If treatment goals are not yet achieved, then additional pharmacological or procedural options can be considered. The potential risks and benefits for each treatment option should be specifically tailored to the palliative care setting and the unique clinical situations presented. The goal being to decrease the most physical distress while not confounding the palliative care situation with potential complications. |
