Application of detrusor leak point pressure and bladder safe capacity of intermittent catheterization in patients with neurogenic bladder

English Keywords:Neurogenic bladder  Urine detrusor leak point pressure  Safety bladder capacity  Intermittent catheterization

English Abstract:

  【Abstract】 Objectives: To study the value of the detrusor urine leakage point pressure(detrusor leak point pressure, DLPP) and the bladder safe capacity(safe bladder capacity, SBC) in patients with neurogenic bladder undergoing intermittent catheterization. Methods: From July 2015 to July 2016 40 patients with neurogenic bladder in our hospital accept intermittent catheterization.Randomly, cases were divided into observation group and control group with 20 cases in each group. The control group were given conventional intermittent catheterization, according to the amount of residual urine to determine the number of intermittent catheterization. Observation group was processed to blood test to check kidney function by parallel urinary tract ultrasound images and urine dynamics test to determine the upper urine tract, at same time, the SBC and DLPPwere measured, intermittent catheterization, was oerformed on the basis of water project and the regularity of voiding diary, the amount of urinary bladder was measured prior to the SBC time, the intermittent catheterization was performed strictly in SBC. 40 cases with urinary leakage accepted pelvic floor muscle training on bed. All patients underwent 1 year of intervention, and all underwent the examination of the urine dynamics[including DLPP, SBC, residual urine volume(residual urine volume, RUV)], renal function examination (including blood urea nitrogen, creatinine), self-assessment lists of anxiety(self-rating anxiety scale, SAS), self rating scale for depression(self-rating depressive scale, SDS), the SF-36 quality of life scale(including diet, mental, and psychological sleep four dimensions) score to assess the patient′s quality of life prior to intervention, and intervention after 1 year respectively. Results: Patients in each group of intervention 1 year later had obviously improved of DLPP, SBC, RUV, blood urea nitrogen, creatinine, SAS and SDS scores and diet, mental, sleep, psychological score than those before intervention(P<0.05). Before intervention, the above indexes between the two groups showed no statistical difference(P>0.05). Intervention after 1 year, DLPP, RUV in observation group were significantly lower than those in the control group, SBC was significantly higher than control group; Blood urea and creatinine were significantly lower than the control group; SAS, SDS scores were significantly lower than the control group, diet, mental, sleep, the psychological scores were significantly higher than that of control group(P<0.05). Conclusions: For patients with neurogenic bladder to inspect, DLPP and SBC test are help to guide intermittent catheterization, which can effectively improve the patient′s urine dynamics index, promote the recovery of renal function, while eliminating patients psychological feelings, and can significantly improve the quality of life.