The Real Daily Need for Incontinence Aids and Appliances in Patients with Neurogenic Bladder Dysfunction in a Community Setting in Germany

Abstract

Ralf Böthig,1 Burkhard Domurath,2 Johannes Kutzenberger,3 Jörn Bremer,4 Ines Kurze,5 Albert Kaufmann,6 Jana Pretzer,7 Jens-Peter Klask,8 Birgitt Kowald,9 Christian Tiburtius,1 Klaus Golka,10 Sven Hirschfeld,11 Roland Thietje11 1Department of Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Hamburg, Germany; 2Centre for Neuro-Urology, Kliniken Beelitz, Neurologische Rehabilitationsklinik, Beelitz-Heilstätten, Germany; 3Department of Neuro-Urology, Kliniken Hartenstein UKR, Bad Wildungen, Germany; 4Centre for Spinal Cord Injuries, BDH-Klinik Greifswald, Greifswald, Germany; 5Centre for Spinal Cord Injuries, Department of Paraplegiology and Neuro-Urology, Zentralklinik Bad Berka, Bad Berka, Germany; 6Department of Neuro-Urology, Kliniken Maria Hilf GmbH, Mönchengladbach, Germany; 7Department of Urology and Neuro-Urology, BG Trauma Hospital Berlin, Berlin, Germany; 8BG Trauma Hospital Duisburg, Duisburg, Germany; 9Biomechanical Laboratory, BG Klinikum Hamburg, Hamburg, Germany; 10Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund(IfADo), Dortmund, Germany; 11Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Hamburg, GermanyCorrespondence: Ralf BöthigDepartment of Neuro-Urology, Centre for Spinal Cord Injuries, BG Klinikum Hamburg, Bergedorfer Str. 10, Hamburg 21033, GermanyTel [phone]Fax [phone]Email [email protected]: For successful long-term rehabilitation of patients with neurogenic lower urinary tract dysfunction (NLUTD), it is necessary to define the objective requirement for urological aids based on a scientifically validated basis.Methods: This was a cross-sectional multicenter study, based on a questionnaire. Data concerning bladder management and daily consumption of urological appliances for patients with NLUTD in a community setting were collected through a standardized survey.Results: Seven hundred and sixty-seven records were analyzed: 543 males, 221 females (N/A = 3). Patients using intermittent catheterization (n= 608) required 5.06 (mean) single-use catheters per day. Out of them, 94 (15.5%) required additional pads (mean: 2.29 per day), 34 patients (5.6%) additionally used pants (mean: 2.55 per day) and 46 patients (7.6%) utilized condom catheters (mean: 3.81 per day) between catheterizations. Among all, 126 patients (16.4%) used pads (mean: 5.03 per day), and 51 patients (6.6%) used pants (mean: 3.03 per day). Women needed both pads (p <  0.0001) and diapers (p =  0.0084) significantly more frequently than men. Eighty-two of the male patients (15.1%) applied condom catheters (mean: 2.8 per day). The target value of the objective daily requirement of incontinence aids for adult patients with NLUTD (based on the upper twofold standard deviation from the mean value) was defined as follows: up to nine single-use catheters, seven condom catheters, nine pads and/or seven pants. A “mixed supply” of different incontinence aids is part of the daily supply for many patients.Conclusion: For the first time, these results allow a reasonable regulation of urological aids and appliances based on scientific data for patients with neurogenic bladder.Keywords: neurogenic lower urinary tract dysfunction, urological aids and appliances, bladder management, intermittent catheterization, incontinence, spinal cord injury

Keywords

• neurogenic lower urinary tract dysfunction
• urological aids and appliances
• bladder management
• intermittent catheterization
• incontinence
• spinal cord injury
• spina bifida