The Experts below are selected from a list of 300 Experts worldwide ranked by ideXlab platform
Sanjay Saint - One of the best experts on this subject based on the ideXlab platform.
-
Condom Catheters versus Indwelling Urethral Catheters in Men: A Prospective, Observational Study
Journal of hospital medicine, 2019Co-Authors: Sanjay Saint, Sarah L. Krein, Karen E. Fowler, John Colozzi, David Ratz, Erica Lescinskas, Kristin Chrouser, Barbara W. TrautnerAbstract:To assess complications of Condom Catheters compared with indwelling urethral Catheters, we conducted a prospective cohort study in two Veterans Affairs hospitals. Male patients who used a Condom Catheter or indwelling urethral Catheter during their hospital stay were followed for one month by interview and medical record review. Participants included 36 men who used Condom Catheters and 44 who used indwelling urethral Catheters. At least one Catheter-related complication was reported by 80.6% of Condom Catheter users and 88.6% of indwelling Catheter users (P = .32), and noninfectious complications (eg, leaking urine, pain, or discomfort) were more common than infectious complications in both groups. Condom Catheter patients were significantly less likely than indwelling Catheter patients to report complications during Catheter placement (13.9% vs 43.2%; P < .001). Patients reported approximately three times more noninfectious complications than the number recorded in the medical record.
-
Condom versus indwelling urinary Catheters a randomized trial
Journal of the American Geriatrics Society, 2006Co-Authors: Sanjay Saint, Samuel R Kaufman, Mary A M Rogers, Paul D Baker, Kathleen Ossenkop, Benjamin A LipskyAbstract:OBJECTIVES: To compare Condom and indwelling urinary Catheters in terms of infection risk and patient satisfaction. DESIGN: A prospective, randomized, unblinded, controlled trial. SETTING: An academically affiliated Veterans Affairs Medical Center. PARTICIPANTS: Hospitalized men aged 40 and older who required a urinary collection device. MEASUREMENTS: The incidence of adverse outcomes (bacteriuria, symptomatic urinary tract infection (UTI), or death) and patient device-related satisfaction as determined according to a questionnaire. Dementia status was recorded to assess effect modification by the presence of dementia. RESULTS: Seventy-five subjects were randomized: 41 receiving an indwelling Catheter and 34 a Condom Catheter. The incidence of an adverse outcome was 131/1,000 patient-days with an indwelling Catheter and 70/1,000 patient-days with a Condom Catheter (P=.07). The median time to an adverse event was 7 days in the indwelling group and 11 days in the Condom group. After adjusting for other risk factors, it was found that Condom Catheter use reduced adverse outcomes (P=.04). Patients without dementia who had an indwelling Catheter were approximately five times as likely to develop bacteriuria or symptomatic UTI or to die (hazard ratio=4.84, 95% confidence interval=1.46–16.02) as those with a Condom Catheter (P=.01). Patients reported that Condom Catheters were more comfortable (P=.02) and less painful (P=.02) than indwelling Catheters. CONCLUSION: The use of Condom Catheters is less likely to lead to bacteriuria, symptomatic UTI, or death than the use of indwelling Catheters. This protection is especially apparent in men without dementia.
-
Urinary Catheters: What Type Do Men and Their Nurses Prefer?
Journal of the American Geriatrics Society, 1999Co-Authors: Sanjay Saint, Paul D Baker, Benjamin A Lipsky, Linda Mcdonald, Kathleen OssenkopAbstract:OBJECTIVES: Urinary Catheters are used frequently, but the relative risks and benefits of different types of devices are not clear. We sought to determine the beliefs of both older male patients and nursing staff about the relative merits and problems of Condom and indwelling Catheters. DESIGN: Patient and nurse survey using convenience sampling. SETTING: A University-affiliated Veterans Affairs medical center. PARTICIPANTS: Men hospitalized on medical, rehabilitation and nursing home units using either an indwelling or a Condom Catheter were invited to participate as were all members of the nursing staff on these units. Of 116 eligible patients, 104 were interviewed (response rate = 90%). Of 107 eligible nursing staff members, 99 completed the questionnaires (response rate = 92%). INTERVENTION AND MEASUREMENTS: Consenting patients were interviewed personally about their urinary Catheter. The nursing staff were asked to complete a self-administered questionnaire. RESULTS: Patients were mostly older and predominantly hospitalized on the medical service. Compared with those using an indwelling Catheter, patients using a Condom Catheter were more likely to believe that their Catheter was comfortable (86 vs 58%, P = .04) and less likely to believe it was painful (14 vs 48%, P = .008) or to restrict their activity (24 vs 61%, P = .002). The nursing staff had a mean of 13 years nursing experience, and the majority worked in the nursing home unit. Most of the nursing staff respondents believed that Condom Catheters were less painful and restrictive for patients and were easier to apply, but they also believed that they fell off and leaked more often and required more nursing time. CONCLUSIONS: Both patients and nursing staff prefer Condom to indwelling Catheters for patient comfort, but they recognize that dislodgment and leaking are major drawbacks of Condom Catheters. A more secure Condom Catheter would greatly improve the management of male incontinence. J Am Geriatr Soc 47:1453–1457, 1999.
Benjamin A Lipsky - One of the best experts on this subject based on the ideXlab platform.
-
Condom versus indwelling urinary Catheters a randomized trial
Journal of the American Geriatrics Society, 2006Co-Authors: Sanjay Saint, Samuel R Kaufman, Mary A M Rogers, Paul D Baker, Kathleen Ossenkop, Benjamin A LipskyAbstract:OBJECTIVES: To compare Condom and indwelling urinary Catheters in terms of infection risk and patient satisfaction. DESIGN: A prospective, randomized, unblinded, controlled trial. SETTING: An academically affiliated Veterans Affairs Medical Center. PARTICIPANTS: Hospitalized men aged 40 and older who required a urinary collection device. MEASUREMENTS: The incidence of adverse outcomes (bacteriuria, symptomatic urinary tract infection (UTI), or death) and patient device-related satisfaction as determined according to a questionnaire. Dementia status was recorded to assess effect modification by the presence of dementia. RESULTS: Seventy-five subjects were randomized: 41 receiving an indwelling Catheter and 34 a Condom Catheter. The incidence of an adverse outcome was 131/1,000 patient-days with an indwelling Catheter and 70/1,000 patient-days with a Condom Catheter (P=.07). The median time to an adverse event was 7 days in the indwelling group and 11 days in the Condom group. After adjusting for other risk factors, it was found that Condom Catheter use reduced adverse outcomes (P=.04). Patients without dementia who had an indwelling Catheter were approximately five times as likely to develop bacteriuria or symptomatic UTI or to die (hazard ratio=4.84, 95% confidence interval=1.46–16.02) as those with a Condom Catheter (P=.01). Patients reported that Condom Catheters were more comfortable (P=.02) and less painful (P=.02) than indwelling Catheters. CONCLUSION: The use of Condom Catheters is less likely to lead to bacteriuria, symptomatic UTI, or death than the use of indwelling Catheters. This protection is especially apparent in men without dementia.
-
Urinary Catheters: What Type Do Men and Their Nurses Prefer?
Journal of the American Geriatrics Society, 1999Co-Authors: Sanjay Saint, Paul D Baker, Benjamin A Lipsky, Linda Mcdonald, Kathleen OssenkopAbstract:OBJECTIVES: Urinary Catheters are used frequently, but the relative risks and benefits of different types of devices are not clear. We sought to determine the beliefs of both older male patients and nursing staff about the relative merits and problems of Condom and indwelling Catheters. DESIGN: Patient and nurse survey using convenience sampling. SETTING: A University-affiliated Veterans Affairs medical center. PARTICIPANTS: Men hospitalized on medical, rehabilitation and nursing home units using either an indwelling or a Condom Catheter were invited to participate as were all members of the nursing staff on these units. Of 116 eligible patients, 104 were interviewed (response rate = 90%). Of 107 eligible nursing staff members, 99 completed the questionnaires (response rate = 92%). INTERVENTION AND MEASUREMENTS: Consenting patients were interviewed personally about their urinary Catheter. The nursing staff were asked to complete a self-administered questionnaire. RESULTS: Patients were mostly older and predominantly hospitalized on the medical service. Compared with those using an indwelling Catheter, patients using a Condom Catheter were more likely to believe that their Catheter was comfortable (86 vs 58%, P = .04) and less likely to believe it was painful (14 vs 48%, P = .008) or to restrict their activity (24 vs 61%, P = .002). The nursing staff had a mean of 13 years nursing experience, and the majority worked in the nursing home unit. Most of the nursing staff respondents believed that Condom Catheters were less painful and restrictive for patients and were easier to apply, but they also believed that they fell off and leaked more often and required more nursing time. CONCLUSIONS: Both patients and nursing staff prefer Condom to indwelling Catheters for patient comfort, but they recognize that dislodgment and leaking are major drawbacks of Condom Catheters. A more secure Condom Catheter would greatly improve the management of male incontinence. J Am Geriatr Soc 47:1453–1457, 1999.
Emad Darwish - One of the best experts on this subject based on the ideXlab platform.
-
Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without Condom-Catheter uterine balloon tamponade.
PloS one, 2021Co-Authors: Holly Anger, Rasha Dabash, Jill Durocher, Nevine Hassanein, Gillian Burkhardt, Sam Ononge, Laura J. Frye, Ayisha Diop, Seynabou Bop Moctar Beye Diop, Emad DarwishAbstract:Objective We aimed to determine the risk of postpartum infection and increased pain associated with use of Condom-Catheter uterine balloon tamponade (UBT) among women diagnosed with postpartum hemorrhage (PPH) in three low- and middle-income countries (LMICs). We also sought women’s opinions on their overall experience of PPH care. Methods This prospective cohort study compared women diagnosed with PPH who received and did not receive UBT (UBT group and no-UBT group, respectively) at 18 secondary level hospitals in Uganda, Egypt, and Senegal that participated in a stepped wedge, cluster-randomized trial assessing UBT introduction. Key outcomes were reported pain (on a scale 0–10) in the immediate postpartum period and receipt of antibiotics within four weeks postpartum (a proxy for postpartum infection). Outcomes related to satisfaction with care and aspects women liked most and least about PPH care were also reported. Results Among women diagnosed with PPH, 58 were in the UBT group and 2188 in the no-UBT group. Self-reported, post-discharge antibiotic use within four weeks postpartum was similar in the UBT (3/58, 5.6%) and no-UBT groups (100/2188, 4.6%, risk ratio = 1.22, 95% confidence interval [CI]: 0.45–3.35). A high postpartum pain score of 8–10 was more common among women in the UBT group (17/46, 37.0%) than in the no-UBT group (360/1805, 19.9%, relative risk ratio = 3.64, 95% CI:1.30–10.16). Most women were satisfied with their care (1935/2325, 83.2%). When asked what they liked least about care, the most common responses were that medications (580/1511, 38.4%) and medical supplies (503/1511, 33.3%) were unavailable. Conclusion UBT did not increase the risk of postpartum infection among this population. Women who receive UBT may experience higher degrees of pain compared to women who do not receive UBT. Women’s satisfaction with their care and stockouts of medications and other supplies deserve greater attention when introducing new technologies like UBT.
-
The effectiveness and safety of introducing Condom-Catheter uterine balloon tamponade for postpartum haemorrhage at secondary level hospitals in Uganda, Egypt and Senegal: a stepped wedge, cluster-randomised trial.
BJOG : an international journal of obstetrics and gynaecology, 2019Co-Authors: Holly Anger, Rasha Dabash, Jill Durocher, Nevine Hassanein, S. Ononge, L.j. Frye, A Diop, S.b. Beye, Gillian Burkhardt, Emad DarwishAbstract:Objective To assess the effectiveness of introducing Condom-Catheter uterine balloon tamponade (UBT) for postpartum haemorrhage (PPH) management in low- and middle-income settings. Design Stepped wedge, cluster-randomised trial. Setting Eighteen secondary-level hospitals in Uganda, Egypt and Senegal. Population Women with vaginal delivery from October 2016 to March 2018. Methods Use of Condom-Catheter UBT for PPH management was introduced using a half-day training and provision of pre-packaged UBT kits. Hospitals were randomised to when UBT was introduced. The incident rate (IR) of study outcomes was compared in the control (i.e. before UBT) and intervention (i.e. after UBT) periods. Mixed effects regression models accounted for clustering (random effect) and time period (fixed effect). Main outcome measures Combined IR of PPH-related invasive surgery and/or maternal death. Results There were 28 183 and 31 928 deliveries in the control and intervention periods, respectively. UBT was used for 9/1357 and 55/1037 women diagnosed with PPH in control and intervention periods, respectively. PPH-related surgery or maternal death occurred in 19 women in the control period (IR = 6.7/10 000 deliveries) and 37 in the intervention period (IR = 11.6/10 000 deliveries). The adjusted IR ratio was 4.08 (95% confidence interval 1.07-15.58). Secondary outcomes, including rates of transfer and blood transfusion, were similar in the trial periods. Conclusions Introduction of Condom-Catheter UBT in these settings did not improve maternal outcomes and was associated with an increase in the combined incidence of PPH-related surgery and maternal death. The lack of demonstrated benefit of UBT introduction with respect to severe outcomes warrants reflection on its role. Tweetable abstract Stepped wedge trial shows UBT introduction does not reduce the combined incidence of PPH-related surgery or death.
Anne P. Cameron - One of the best experts on this subject based on the ideXlab platform.
-
Non-surgical urologic management of neurogenic bladder after spinal cord injury
World Journal of Urology, 2018Co-Authors: Paholo G. Barboglio Romo, Christopher P. Smith, Ashley Cox, Márcio A. Averbeck, Caroline Dowling, Cleveland Beckford, Paul Manohar, Sergio Duran, Anne P. CameronAbstract:Purpose To review the available data on non-surgical management for neurogenic bladder in patients with spinal cord injury (SCI). Before the introduction of urinary Catheters and antibiotics, neurogenic bladder was one of the main culprits for death in those patients with SCI. Currently, the management of neurogenic bladder is focused in improving quality of life and preserving renal function. Methods A literature review was performed and therapeutic management for neurogenic bladder was divided in six sections: (1) intermittent bladder Catheterization; (2) indwelling Catheters; (3) Condom Catheter drainage; (4) reflex voiding and bladder expression with Valsalva or Credé; (5) oral drug therapy of the spinal cord injured bladder; and (6) botulinum neurotoxin (BoNT). Results Intermittent Catheterization is recommended as the preferable method for management of neurogenic bladder in patients with SCI based on limited high-quality data. However, this may not be feasible or available to all and other alternative options include Condom Catheter drainage or indwelling Catheters such as urethral Catheters or suprapubic tube, reflex voiding, and bladder expression with Valsalva or Credé. Non-invasive medical therapies are the key to improve incontinence, urodynamic parameters, and quality of life in this population. Botulinum neurotoxin has revolutionized the management of neurogenic bladder in the last two decades decreasing the need for reconstruction or diversion. Conclusion The Joint SIU-ICUD (Société Internationale d’Urologie) (International Consultation on Urological Diseases) International Consultation reviewed the available presented data and provided specific conclusions and recommendations for each non-surgical urologic method to address neurogenic bladder after SCI.
-
Non-surgical urologic management of neurogenic bladder after spinal cord injury.
World journal of urology, 2018Co-Authors: Paholo Barboglio Romo, Christopher P. Smith, Ashley Cox, Márcio A. Averbeck, Caroline Dowling, Cleveland Beckford, Paul Manohar, Sergio Duran, Anne P. CameronAbstract:To review the available data on non-surgical management for neurogenic bladder in patients with spinal cord injury (SCI). Before the introduction of urinary Catheters and antibiotics, neurogenic bladder was one of the main culprits for death in those patients with SCI. Currently, the management of neurogenic bladder is focused in improving quality of life and preserving renal function. A literature review was performed and therapeutic management for neurogenic bladder was divided in six sections: (1) intermittent bladder Catheterization; (2) indwelling Catheters; (3) Condom Catheter drainage; (4) reflex voiding and bladder expression with Valsalva or Crede; (5) oral drug therapy of the spinal cord injured bladder; and (6) botulinum neurotoxin (BoNT). Intermittent Catheterization is recommended as the preferable method for management of neurogenic bladder in patients with SCI based on limited high-quality data. However, this may not be feasible or available to all and other alternative options include Condom Catheter drainage or indwelling Catheters such as urethral Catheters or suprapubic tube, reflex voiding, and bladder expression with Valsalva or Crede. Non-invasive medical therapies are the key to improve incontinence, urodynamic parameters, and quality of life in this population. Botulinum neurotoxin has revolutionized the management of neurogenic bladder in the last two decades decreasing the need for reconstruction or diversion. The Joint SIU-ICUD (Societe Internationale d’Urologie) (International Consultation on Urological Diseases) International Consultation reviewed the available presented data and provided specific conclusions and recommendations for each non-surgical urologic method to address neurogenic bladder after SCI.
Bakul M Soni - One of the best experts on this subject based on the ideXlab platform.
-
Urinary retention and acute kidney injury in a tetraplegic patient using Condom Catheter after partying: a preventable complication.
International medical case reports journal, 2015Co-Authors: Subramanian Vaidyanathan, Fahed Selmi, Peter L Hughes, Gurpreet Singh, Bakul M SoniAbstract:Background Spinal cord injury patients, who manage their bladder using a Condom Catheter, are at risk of developing urine retention when they consume large volumes of alcoholic drinks within a short period of time. Case presentation A male tetraplegic patient had been managing satisfactorily penile sheath drainage for 8 years. He went out socializing during which he consumed large volumes of alcohol but did not take any recreational drugs. The following morning, he noticed distension of the lower abdomen and passed urine in dribbles. He then developed a temperature and became unwell. He was seen by district nurses and a doctor, who prescribed antibiotics. He continued to feel unwell. After 8 days, he referred himself to a spinal unit at Regional Spinal Injuries Centre, Southport. The blood test results showed the following: blood urea: 19.8 mmol/L; creatinine: 172 μmol/L; and C-reactive protein: 336.4 mg/L. Urethral Catheterization led to immediate drainage of 1,400 mL of urine. A computed tomography scan revealed an enlarged, swollen left kidney, indicating acute bacterial nephritis. He was prescribed intravenous fluids and Meropenem. Creatinine decreased to 46 μmol/L. Conclusion Spinal cord injury patients using Condom Catheters should be made aware of the risk of urine retention when they consume large amounts of alcoholic drinks in a short period of time. Patients and caregivers should be informed to consider intermittent Catheterizations for 24-48 hours or insert indwelling urethral Catheter when planning for an evening out.
-
Hydronephrosis and renal failure following inadequate management of neuropathic bladder in a patient with spinal cord injury: Case report of a preventable complication
Patient safety in surgery, 2012Co-Authors: Subramanian Vaidyanathan, Fahed Selmi, Peter L Hughes, Gurpreet Singh, Kottarathil Abraham Abraham, Bakul M SoniAbstract:Background: Condom Catheters are indicated in spinal cord injury patients in whom intravesical pressures during storage and voiding are safe. Unmonitored use of penile sheath drainage can lead to serious complications. Case report: A 32-year old, male person, sustained complete paraplegia at T-11 level in 1985. He had been using Condom Catheter. Eleven years after sustaining spinal injury, intravenous urography showed no radio-opaque calculus, normal appearances of kidneys, ureters and bladder. Blood urea and Creatinine were within reference range. A year later, urodynamics revealed detrusor pressure of 100 cm water when detrusor contraction was initiated by suprapubic tapping. This patient was advised intermittent Catheterisation and take anti-cholinergic drug orally; but, he wished to continue penile sheath drainage. Nine years later, this patient developed bilateral hydronephrosis and renal failure. Indwelling urethral Catheter drainage was established. Five months later, ultrasound examination of urinary tract revealed normal kidneys with no evidence of hydronephrosis. Conclusion: Spinal cord injury patients with high intravesical pressure should not have penile sheath drainage as these patients are at risk for developing hydronephrosis and renal failure. Intermittent Catheterisation along with antimuscarinic drug should be the preferred option for managing neuropathic bladder. Background Hydronephrosis in persons with spinal cord injury is associated with the neural damage, urinary infection and back pressure; the importance of each factor varying considerably with the individual. [1] The appearance of the hydronephrosis associated with neurogenic bladder dysfunction has been attributed to the increased intravesical pressure which forces the ureter to pump urine into the bladder at increasingly higher pressures until a state of hydronephrosis is reached. [2]. Rosen and associates [3] recommend that all spinal cord injury patients functioning in the Catheter-free state must be followed regularly at no longer than 6-month intervals. Changes in the resistance to the outflow of urine may occur at any time, even years after injury. When an event occurs, such as increased spasticity, which may be associated with increased sphincter resistance, the patient should be checked for evidence of outflow obstruction. Condom Catheters are convenient to spinal cord injury patients and their carers, but they can lead to problems and complications, sometimes severe. Newman and Price [4] found bacteriuria in more than 50% of patients using a Condom Catheter. Lesions of the penis can be secondary to mechanical damage to the skin from an excessively tight Condom worn for a prolonged time. Another common cause of skin lesions is allergy to the material of the Condom, usually to latex. Wyndaele and associates [5] concluded that a Condom Catheter may be indicated in male spinal cord injury patients with urinary incontinence provided that they have no penile lesion and that intravesical pressures during storage and voiding are urodynamically safe. We report a paraplegic