NLUTDNeurogenic Lower Urinary Tract Dysfunction
Copyright 1988-2018, All rights reserved.
References in periodicals archive ?
It must be noted, however, that until recently, studies on NLUTD were limited by sample size, sample heterogeneity and imprecise outcome measures, particularly with respect to defining UTI.[sup.5] SCIRE also indicates that both sterile (single-use) and clean (multi-use) approaches to IC have similar rates of UTI, but the studies upon which this conclusion is based were conducted primarily with an in-patient rehabilitation population.[sup.5]
If UTIs persist and there is an indication of consistently high bladder volumes (generally in excess of 500 mL), adjust fluid intake and/or increase the frequency of IC.[sup.14] Generally in the NLUTD population, catheterization with a 12 to 14 French catheter is needed 4 to 6 times per day.
The Consortium of Spinal Cord Medicine (CSCM) and the AUA update on urological care in the out-patient NLUTD indicates that best practice is to evaluate the kidneys (upper urinary tract) and bladder (lower urinary tract) in individuals who perform intermittent catheterization.[sup.2,15] In general, the recommendation is for urodynamic studies (UDS) to be conducted to assess bladder capacity and pressure, bladder and sphincter functioning, and the presence of reflux.
UDS plays an important role in the diagnosis, treatment planning and surveillance of patients with NLUTD. In South Africa these services are underdeveloped and underutilised, which results in preventable morbidity.
3 shows representative graphs of the pattern of chromophore change from an asymptomatic child (part A) and subjects 1 to 5 (Table 1) with symptoms of NLUTD (part B).
Pilot data from children suggest that those with NLUTD have a different chromophore pattern to asymptomatic children.