Clean intermittent catheterization in the management of spina bifida: a review of 113 cases
| Autor: | Yamamoto, Masashi, Yasukawa, Motonobu, Yoshii, Masahito, Takahashi, Shoji, Natsume, Osamu, Momose, Hitoshi, Suemori, Tsuyoshi, Yamada, Kaoru, Shiomi, Tsutomu |
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| Jazyk: | japonština |
| Rok vydání: | 1991 |
| Předmět: | |
| Zdroj: | 泌尿器科紀要. 37(2):117-121 |
| ISSN: | 0018-1994 |
| Popis: | CICへの主な変更理由は, VUR (48/113例)および残尿(36/113例)によるものであった.対象症例の56.6%が低活動性利尿筋・活動性括約筋群に属する症例であり, 下肢麻痺についてはSharrard分類のGroup 1～3が29例, Group 4～6が84例であった.CICにより水腎・水尿管は37/71例に, VURは36/63例に, 尿路感染症は39/55例に, 尿失禁は72/87例に改善をみた.主な合併症としては腎盂腎炎が12例, 尿道痛が5例に認められた.膀胱機能障害を有し, 排尿障害を認める症例においてCrede法やValsalva法を採用した場合, 高圧排尿を余儀なくされる症例では, 初期の段階でCICを選択することが最も望ましい.一方, 低圧排尿が可能な症例については, Crede法, Valsalva法またはCICのいずれの方法を選択しても良い One hundred and thirteen cases of spina bifida treated with clean intermittent catheterization (CIC) were reviewed. There were 42 males and 71 females, ranging from 4 months to 50 years. The major reasons for CIC from other voiding methods were vesicoureteral reflux (VUR) (48/113) old, and residual urine (36/113). The most common type of neurogenic bladder was hypoactive detrusor-active sphincter, in 56.6% of patients (64/113). The grade of paralytic disability of lower limb (Sharrard's classification) was low (group IV-VI) in 84 patients and high (group I-III) in 29 patients. Hydroureteronephrosis and VUR improved 52.1% (37/71) and 57.1% (36/63), urinary tract infection and urinary incontinence improved 70.9% (39/55) and 81.7% (72/87). Major complications were pyelonephritis (12 cases) and urethral pain (5 cases). We discussed the choice of voiding method in the management of spina bifida. |
| Databáze: | OpenAIRE |
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