QUALITY OF LIFE IN PATIENTS WITHCLEAN INTERMITTENT SELF-CATHETERIZATION WITH SPINAL CORD INJURY
M. MORALES GOMEZ1, S.URETA SANCHEZ 2, M. GOMEZ-CHAVARIN 3, D. ROJANOMEJIA 4, D. GONZALEZ MENDOZA 5;
1Urogynecology, The Spanish Hosp., Mexico City,Mexico, 2Urology, The Spanish Hosp., Mexico City, Mexico,3Biomedical Institude of Research, UNAM, Mexico City,Mexico, 4Physical Medicine and Rehabilitation, IMSS,Mexico City, Mexico, 5Urology, IMSS, Mexico City, Mexico.
Introduction: Most of the spinalcord injuries are of traumatic origin in adulthood with differentlevels of affection, such as suprapontin, pontine, suprasacras andsacra. The acute period of spinal cord injury or ¨Medullary Shock¨The most common bladder alteration is voiding dysfunction. The cleanintermittent self-catheterization (ISC) treatment, proposed byLapides in 1972, proves to be a harmless and efficient long-termalternative for the sequelae of bladderneurologicaldisease.
Objective: To determine the quality of life inpatients who practice ISC due to voiding dysfunction with spinal cordinjury, by measuring the variables of ease, convenience, discretionof use and psychological comfort, by means quality-of-lifequestionnaire (ISC-Q), validated in the literature and withcorroborating utility in the Mexican population.
Methods:Descriptive, retrospective and cross-sectional study was carried outusing a questionnaire using the telephone that evaluates the qualityof life (ISC-Q). Applied to 71 patients with spinal cord injury whichused ISC for voiding dysfunction . The questionnaire includes 4points mentioned in the objective and additionally includes fivequestions about the medical follow-up, frequency of urinary tractinfections and complications in the patient after one year of use ofISC.
Results: The population in which the presentinvestigation was carried out consisted of 71 patients with a historyof spinal cord injury and ISC use (n = 71), 34.4% were women and65.6% men, with a high age range between 20 and 40 years of age.Themechanism of injury was predominantly traumatic in 81.32%. The mainarea of lesion level was found the spinal location. In the eightquestions concerning the easely of use of ISC, the results show thatpatients report a high ease of use (1), which is relatively clean(2), easy to insert (3), sometimes seems uncomfortable (5), it iscomfortable to use (6), it is possible to lubricate it before use (7)and they are considered to be able to place and use them (8).Convenience in the use; With regard to the appropriateness of ISCuse, most patients report that it is not inconvenient to store themin the home (9), or to take them away for vacation (10,11) or theirdisposal outside the home (12). Psychological Confort for the Use ofISC; Emotional comfort using ISC, patients in a high percentage saythey are aware of their need for self-catheterization (19), and only33% feel ashamed if they discover that they use it (20,21), some feelworried if they do not empty their bladder altogether (22), very fewrefrain from socializing with friends and family for the use of thecatheter (23) and very few are worried about the long-term risks ofusing the catheter (24).
Conclusions: The ISC wasdistinguished by being a simple technique, friendly, easy toreproduce, regardless of the educational level of the patients,provoking satisfaction in the quality of life, social, sexual andindependence with the environment. Concluding, this questionnaire isfavorable in the Mexican population, since it was able to determinethe sensible values of satisfaction.
References:•Development and psychometric validation of the intermittentself-catheterization questionnaire (ISC-Q). 2013;24:10-65 •Clean,Intermittent Self-Catheterization in the Treatment of Urinary TractDisease.J Urol. 2016;21.