International Journal of Urological Nursing最新文献

Shock Wave Lithotripsy (SWL) is a technique for treating kidney stones. A Danish university hospital implemented a new pain management strategy focused on oral painkillers instead of intravenous opioid analgesics. This study aimed to evaluate patients' satisfaction with the new strategy during SWL and their overall treatment satisfaction. Patients were prospectively recruited in March 2020 to July 2021 and provided informed consent. A validated questionnaire was used to assess pain and satisfaction, pre- and post-treatment. Demographic information, characteristics of the kidney stone, and pain treatment were also recorded. Pain was measured using the Numeric Rating Scale (NRS), and satisfaction was rated using NRS 0–10. A total of 108 patients (66% men) were included, with a mean age of 56 years (SD 14.3). Most included patients (92%) received oral painkillers (paracetamol and ibuprofen) as pre-treatment pain relief, while 7% received sublingual fentanyl. Non-pharmacological pain-relieving methods, like relaxation and listening to music, were used by 64% of patients. The mean pain score during treatment was 4.9 (SD 2.9), and the median satisfaction score with pain treatment was 9 (IQR 6–10). The overall satisfaction score was 10 (IQR 8–10). 89% were highly satisfied (NRS 8–10) and willing to repeat treatment. Patients were highly satisfied with outpatient SWL and oral painkillers alone. The extensive use of non-pharmacological pain relief suggests alternative pain management strategies should be further investigated and developed.

Radical prostatectomy (RP) is a primary treatment for localised prostate cancer that can profoundly impact patients' quality of life (QoL), particularly in areas related to sexual health and emotional well-being. The study sample included 130 prostate cancer patients who underwent RP, with assessments conducted before surgery and at 6- and 12-months post-surgery. The QoL was measured using the Short-Form Health Survey (SF-36), and sexual function was assessed through the International Index of Erectile Function (IIEF-15). Findings indicated that while some aspects of social functioning showed improvement over time, other QoL domains, including erectile function, sexual desire and overall satisfaction, declined significantly after surgery. Despite these declines, patients reported slight improvements in specific areas, such as satisfaction with sexual intercourse in the later assessment. Sexual health concerns, particularly erectile dysfunction (ED), were notably prevalent post-RP, as nerve damage during surgery may reduce the ability to achieve or maintain erections. The psychological implications of these changes are substantial, with many men experiencing feelings of inadequacy and distress that can strain relationships and impact mental well-being. The study highlights the need for a holistic approach in managing prostate cancer treatment outcomes, recommending multidisciplinary interventions that address both medical and psychosocial aspects. The study underscores the importance of including the patient's partner in the recovery process and providing comprehensive counselling to manage the psychological and relational effects of RP. This approach could support patients in adapting to changes in sexual health and social functioning, ultimately enhancing their QoL.

Urinary catheterisation is an important aspect of patient care yet commonly causes discomfort or pain. Current international guidelines recommend water-based sterile lubricant during catheterisation of women, whereas local anaesthetic gel (e.g., lignocaine gel) is advocated in men, potentially highlighting a gender bias in clinical care. The purpose of this systematic literature review was to evaluate the effectiveness of 2% lignocaine gel compared to water-based lubricant in reducing pain during urethral catheterisation of women. A systematic search using key terms and their alternate spellings was used to identify relevant studies. Studies were included that examined the use of 2% lignocaine during urethral catheterisation of women. This review searched Cochrane Library, Cumulated Index in Nursing and Allied Health Literature (CINAHL), Emcare Nursing and Allied Health Database, Excerota Medica Database (EMBASE), Maternity and Infant Care Database, MEDLINE, OVID, ProQuest, PubMed and SCOPUS. In addition, clinical trial and systematic review registries were also searched from inception to May 2025. A total of 2030 studies were identified and screened. Three randomised controlled studies involving 214 female participants were included in this review. Pooled results indicated a statistically significant difference in favour of 2% lignocaine gel compared to water-based lubricant during urethral catheterisation in women (mean difference −10.81, 95% CI: −15.81 to −5.35). The application of 2% lignocaine gel is more effective in reducing catheterisation-associated pain in women compared to water-based lubricant. Current clinical guidelines suggest the use of a water-based lubricant for women, but an anaesthetic-based lubricant for men. The belief that women do not require local anaesthesia before catheterisation may be influenced by historical perspectives and warrants further investigation.

Instillation with Bacillus Calmette-Guérin (BCG) is recommended as adjuvant treatment in non-muscle invasive bladder cancer. It is well recognized that intravesical immunotherapy with BCG might cause side effects, commonly affecting the patient´s well-being. To enable detection of any symptoms important for decisions on the further treatment it is important to keep records of the patient's bladder and voiding status before and during the treatment. Management of side effects may be required and occasionally instillation must be postponed or stopped. We aimed to develop a validated instrument to capture and grade symptoms in patients with non-muscle invasive bladder cancer undergoing intravesical instillation therapy with BCG. Intravesical immunotherapy with BCG commonly results in side effects, that negatively affect the patient´s well-being. There is currently no validated instrument for follow-up of patients during long-term intravesical instillation treatment. Many individual reports as well as guideline recommendations, describe that intravesical instillation treatment with BCG can cause local or systemic side effects of both mild and severe character. Recommendations on how to treat various side effects exist and it is emphasized that patients with bladder cancers need continuous support during the instillation treatment. There is, however, shortage of information about how to best detect the patient's symptoms to give optimal support. A qualitative study design was used to gain knowledge about patients' symptoms and side effects during the instillation treatment. We used a previous study protocol to study questions, answer options and open-ended questions. In Sweden, different unvalidated forms have been applied to detect symptoms during instillation therapy. Those symptom forms were collected and analyzed. Dialogues were held with patients and representatives from various professions with knowledge in the field. All qualitative data were structured and categorized and subsequently used for the construction of a bladder instillation therapy form. The face-to-face validity method was used in the process. We developed and validated an instrument: Bladder Instillation Therapy Form (BITF), for use by patients who receive intravesical instillations with BCG. The form separately considered local and systemic symptoms. The answer options were adapted to the question and formulated to enable follow-up of the patient's symptoms. An instrument, BITF, was developed and validated for assessment of symptoms during intravesical instillation BCG therapy. BITF was designed to provide baseline information at the start of treatment as well as before each instillation. BITF can also be used for future research. The BITF enables assessment of side-effects during intravesical BCG instillation therapy and accordingly appropriate measures can be taken to support the patient throughout the treatment period. The BITF instrument will improve patient care as well