International Journal of Urological Nursing最新文献

Nurse-led clinics are known to positively impact and benefit patients; however, there is little understanding of the role of the nurse in a nurse-led male Lower Urinary Tract Symptoms (LUTS) clinic. LUTS affect up to 30% of males over 65 in the United Kingdom and can significantly impact the quality of life of the person experiencing them. LUTS can be managed with conservative changes, as well as with medication and surgical intervention. The aim of this scoping review is to map what is known about the role of the nurse in a nurse-led male LUTS clinic and what research tells us regarding, the barriers and enablers in nurses leading a male LUTS clinic. This scoping review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-SCR) checklist and the methodological guidelines set out by the Joanna Briggs institute. A literature search was carried out over three databases (CINAHL, Medline Ovid, ProQuest health and medical collection) and systematically searched from 2000 to 2021. Grey literature was also searched, and citation chaining was undertaken. Following a systematic review of the literature, four papers met the inclusion criteria for this scoping review. The emergent themes across the four papers consisted of structure, assessment and resources, and effectiveness of the nurse-led male LUTS clinic. There was clear agreement across the literature regarding the investigations and assessment the nurse should carry out. Ongoing practical, theoretical, and observational training and education is required to ensure the nurse is competent in running a male LUTS clinic. The papers reviewed showed the nurse provided a supportive role to the consultant. However, there is evidence indicating there is a move towards autonomous practice. There is a dearth of the current research relating to the role of the nurse in nurse-led male LUTS clinics and the enablers and barriers in nurses leading male LUTS clinics. Further research should be considered to gain a better understanding of where nurse-led male LUTS clinics currently take place, what the role of the nurse is in leading a LUTS clinic and what enablers and barriers exist.

Bladder dysfunction is physically and mentally stressful. Long-term catheterization is indicated as conservative therapy for chronic urinary retention as well as urinary incontinence; although an indwelling, transurethral catheter still represents a risk factor for ascending urinary tract infection and urosepsis. The primary outcome of this study was the impact of the DFree ultrasonic sensor on the subjectively perceived quality of life and satisfaction of patients. The secondary outcomes evaluated were usefulness, ease of use (user-friendliness), quality of care, and self-reported degree of autonomy. In this pilot study, 18 urological patients with various kind of bladder dysfunction were treated with an ultrasonic sensor for at least 12 h a day over a 3-month period. Assessment was conducted using the Kings Health Questionnaire (KHQ) and the German version of the Client Satisfaction Questionnaire (ZUF-8) (quantitative data) and guided interviews (qualitative data). Eighteen participants were included in this study. Participants highly appreciated the ideas and concepts of the device. A change in KHQ after treatment could not be statistically confirmed; however, the average value in ZUF-8 showed satisfaction with Dfree. However, no significant improvement was observed in the quantitative data. During the interviews at the end of the testing phase, the participants provided positive feedback with specific suggestions to improve device usability. The application was described as helpful and easy to use. Data triangulation illustrates that an improvement in technical implementation could increase device usefulness. This would imply higher patient satisfaction when using the device for bladder dysfunction.

The objective of this study is to determine if there was a difference in rate of post-transplantation urinary tract infection (UTI) in patients who have an indwelling catheter inserted using sterile versus clean technique. UTI is the most common nosocomial infection in the post-transplantation period. We aim to describe risk factors associated with postoperative UTI in our institution and determine if there was a difference between those who have an indwelling catheter inserted using sterile versus clean technique. Risk factors for UTIs can be divided into recipient, donor, and procedure related factors. While an indwelling urinary catheter increases the risk of infection, it is vital for post-operative fluid balance monitoring. Given the morbidity of UTIs in transplant recipients, a number of studies have investigated modifiable risk factors; however, investigation of the technique of indwelling catheter insertion at the time of renal transplantation is yet to be examined. A retrospective analysis of a contemporaneously maintained database was performed of renal transplant recipients over a 2-year period from 2019–2021. Patients were divided into sterile versus clean technique, defined as the use of sterile gloves, gown and fenestrated drape following a surgical scrub, or sterile gloves alone following the use of alcohol-based hand sanitiser respectively. A p value of <0.05 was considered statistically significant. One hundred sixty-nine patients were included in analysis, with 31 UTIs (18.3%) within 30 days of renal transplantation. Female gender and autosomal dominant polycystic kidney disease were associated with a higher rate of UTI. One hundred twenty-three patients had a catheter inserted via sterile technique, and 46 with clean technique, with no significant difference in rate of post-operative UTI (p = 0.52). Inserting an indwelling catheter either by sterile or clean technique at the time of renal transplantation was not associated with the rate of postoperative UTI within 30 days.

What is the difference regarding pelvic floor muscle training (PFMT) between women with and without UI, employed at a medical centre? There is a dearth of literature comparing PFMT between women with or without UI in the general population and none, specifically, for women employed at a medical centre. Urinary incontinence (UI) is a common problem for all ages, including females employed at medical centres. PFMT is the first-line intervention recommended for women with UI. The study aimed to compare women with and without UI employed at a medical centre, regarding knowledge, source of knowledge and practices of PFMT. This was a cross-sectional comparative study, with a convenience sample of 323 women who were employed at a medical centre, aged 20–50 years old. Two validated questionnaires were used: The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and a new questionnaire, developed for this study, entitled the PFMT Patient reported Outcome Measures (PFMT-P). Ethical approval was granted with questionnaire completion and implied consent. Data was analysed by SPSS version 22, including descriptive statistics, independent t-test and Mann–Whitney. From the 323 participants, 56 (17.3%) had UI (UI group—UIG), 221 (68. 4%) were without UI (continence group—CG), and 46 (14.2%) did not answer the ICIQ-SF. Most of the participants were nurses (208 [66.5%]). There was a high level of knowledge for both groups without a significant difference between the groups. Regarding knowledge about recommended PFMT frequency, 37 (68.5%) in the UIG knew the correct answer compared to 108 (52.2%) in the CG, p = 0.03. The most common information source for all participants was the internet (79 [28.9%]). Most of the participants did not receive information from nurses, doctors and physiotherapists during their post-partum period. For both groups, lower scores were found for PFMT practice, 9.9 [6.4] in the UIG, 7.8 [4.10] in the CG, (with a maximum score of 35), p = 0.02. Two hundred and ninety-five (91%) participants reported that they are not currently practicing PFMT, and of them, 46 (15.6%) would like to learn PFMT. Knowledge and exposure to a source of knowledge regarding PMFT were not translated into actual technique practice. Women with UI practice PFMT more frequently than women without UI. A limitation of the study was that it was cross-sectional with a convenience sample of women employees with the majority being nurses. This may also have affected the knowledge component, as PFMT is studied in nursing school. Future studies can assess the difference between women with and without UI regarding PFMT who are employed in other work settings, as well as in the general population.

Medical literature on infection rates for certain specific endourological procedures is available. However, literature is lacking in providing a comprehensive view of the overall post endoscopic infection rates and their risk factors. This article attempts to provide an understanding of overall bacteriuria rate and discuss the contributory factors for common endourological procedures performed in a dedicated urology unit. This was a retrospective analysis of all patients who underwent endourological procedures at our Institute between January 2019 and December 2019. The following factors were assessed as contributors to post-operative bacteriuria: gluteraldehyde versus plasma sterilization of endoscopic equipments, elective versus emergency procedures, age group, the presence of pre-operative foreign bodies, post-operative stent, chronic kidney disease (CKD), diabetes mellitus (DM), procedure time and American Society of Anaesthesiology (ASA) grades. The overall post-operative bacteriuria rate was 17.85% in our total study population, 6.37% had symptomatic urinary tract infection (UTI). Chronic kidney disease (OR 3.5, p < 0.003) and higher ASA grade (OR 1.92, P < 0.002) appear to confer the highest risk of bacteriuria. The factors which were associated with a trend towards a higher incidence of UTI without reaching statistical significance included: the use of gluteraldehyde versus plasma sterilization, pre-operative implants (Foley and ureteric stents), diabetes, advanced age, endoscopy time, post-operative stent emergency surgeries and a clinical decision against the use of prophylactic antibiotics. The overall rate of bacteriuria in all endourological procedures was 17.8%, 6.37% had symptomatic UTI. Chronic kidney disease and higher ASA grades were the most important contributing factors to develop post-operative bacteriuria.

Only limited data evaluating coping methods in patients with bladder cancer are available in the literature. Also, it is unclear how the mental status of these patients affects their stress coping strategies. The aim of the study was to evaluate the stress coping strategies in patients with non-muscle-invasive bladder cancer (NMIBC) and to assess the impact of sociodemographic factors, presence of anxiety and depressive symptoms and degree of sexual satisfaction on stress coping strategies. This prospective cohort study included 100 male patients qualified for control cystoscopy who underwent at least one transurethral resection of bladder tumour (TURB) procedure in the past for NMIBC and at least one control cystoscopy. The minimal follow-up period after primary TURB was 1 year. The MiniCOPE, the Hospital Anxiety and Depression Scale and the Sexual Satisfaction Questionnaire were used. The questionnaires were completed anonymously before cystoscopy in a room that provided privacy. Majority patients with NMIBC chosen adaptive strategies, with ‘accepting’ and ‘seeking emotional support’ being the most common. The choice of strategy was influenced by the severity of anxiety and depressive symptoms as well as the level of sexual satisfaction and pain sensations. Also, sociodemographic variables, such as marriage status, progeniture or the level of education played a role in strategy selection. The results of this study indicate that patients with NMIBC choose adaptive stress coping strategies. It also provides a better understanding of the impact of various aspects of mental health in patients with NMIBC on coping with stress. Each patient treated for NMIBC should undergo appropriate psychological and sociodemographic evaluation, which will allow easier identification of patients at high risk of treatment and postoperative surveillance discontinuation.

What is the state of knowledge on the use of phytotherapy in the following urological benign diseases: prostatic hyperplasia, erectile dysfunction, male infertility, urolithiasis and low-urinary tract symptoms? Supplements derived from natural products are used in medicine alone or in combination with drugs. In urology, there are many products used for symptom management in benign conditions. The aim of this review was to investigate the use of herbal medicines to treat benign urological diseases. A systematic review was conducted using the PubMed, CINAHL, Cochrane Library, Embase and Scopus (2010–2021) databases. The inclusion criteria were studies describing the use of phytotherapeutic strategies to treat adult patients with urological diseases. Quality assessments were performed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Nineteen studies were included in this systematic review: 13 randomized controlled trials, 3 pilot studies, 1 quasi-experimental study, 1 retrospective observational study and 1 post hoc analysis. Phytotherapeutic agents used to treat benign prostatic hyperplasia included royal jelly, Viola odorata, Echium amoenum, Physalis alkekengi, soy isoflavones, Serenoa repens, Trigonella foenum-graecum, lycopene and selenium. Tribulus terrestris is widely used to treat erectile dysfunction and male infertility. Lycopene, Korean ginseng berries, Indian ginseng and Curcuma improve sperm characteristics and motility. Lupeol therapy reduces kidney stone size, improving urolithiasis symptoms and accelerating the expulsion of small stones. No standard of care has been established for the use of phytotherapeutic agents to manage patients with symptomatic urological disorders. Although randomized controlled trials were the most common study type in our review, the sample sizes were limited, and the study duration and follow-up periods were often very short.

The aim of the present study is to find the frequency of chronic prostatitis in Antioquia, Colombia. There are epidemiological gaps in this issue in the Colombian population. Chronic prostatitis is a prevalent disease with a high impact on life quality. The NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) is a commonly used 13-item questionnaire to assess symptom severity in men with chronic prostatitis/chronic pelvic pain syndrome. A validated Spanish version of the NIH-CPSI questionnaire was distributed through social media and institutional e-mails from the University of Antioquia database and other institutions in the Metropolitan Area. Of the distributed questionnaires, 2022 were filled. The vast majority of participants were students, teachers, and professionals. A frequency of 16.4% chronic prostatitis symptoms was observed, 10.1% of individuals had severe symptoms with a median age of 32 years, accompanied by perineal pain and ejaculatory symptoms. Using the NIH-CPSI, the reported worldwide prevalence of chronic prostatitis is range between 1.8% and 65%. This report shows the disease's frequency in Colombia and Latin America for the first time. Chronic prostatitis is a frequent disease in the Antioquia population, with a high impact on the quality of life. Therefore, public health policies should be implemented focusing on men's health.

What are the experiences of post-prostatectomy cancer patients regarding self-management of lower urinary tract symptoms? Individuals with prostate cancer are required to self-manage their post-operative lower urinary tract symptoms and issues associated with them. Clarifying the various aspects of self-management can help in improving patient-tailored support. This study therefore aimed to clarify the self-management of lower urinary tract symptoms in prostate cancer patients who underwent total prostatectomy. Most post-prostatectomy cancer patients have multiple lower urinary tract symptoms. They have a reduced quality of life due to the symptoms and associated physical, psychological, and social issues. Self-management of the symptoms in uncomplicated cases has been shown to be effective, but this has not been clarified for post-prostatectomy cancer patients. The study setting consisted of two designated cancer centres. A survey with semi-structured interviews was conducted among 13 patients with prostate cancer that underwent total prostatectomy. Data were analysed using the qualitative content analysis techniques of Mayring. A total of 410 codes were extracted from which 42 subcategories and 10 categories emerged. The categories were: (1) recognition of issues associated with lower urinary tract symptoms to be solved; (2) examination of strategies for coping with these symptoms; (3) incorporation of actions that lead to an improvement in the symptoms; (4) avoidance of behaviours that cause worsening of the symptoms; (5) devising ways to prevent interference with one's daily life; (6) dealing with problems associated with the symptoms; (7) building relationships with medical staff and surroundings; (8) self-evaluation of bladder control status; (9) positive acceptance of the symptoms; and (10) sensing the effectiveness of strategies regarding the control of urination. The results suggest that health care professionals need to provide feedback to patients on LUTS strategies and their effects to help support patient coping strategies. In addition, determining individual patients' strengths and deficiencies in self-management will allow us to tailor assistance to patients. This is the first step towards the development of self-management scales to objectively assess self-management.