Article

Retrospective review of findings during cystourethroscopic
surveillance of symptomatic and asymptomatic patients with indwelling urethral
catheters (IUC) and suprapubic catheters (SPC) monitored between January 2003 and
December 2008.Objectives:To audit and compare findings between symptomatic and
asymptomatic patients and between SPC and IUC population. To systematically
review the literature including the recent National Institute for Health and
Clinical Excellence guidelines on cystoscopic surveillance.Methods:Theater
management system and the electronic patient records used to retrieve
demographics, injury details and operative findings.Results:Of 925 cystoscopies
performed in 507 patients, 449 were performed in 277 patients with IUC/SPC. Only
419 procedures (SPC 264; IUC 155) in 262 patients fit the inclusion criteria.
Thirty procedures in fifteen non traumatic patients were excluded. Statistically
there was no significant difference in incidence of findings between the
symptomatic and asymptomatic group. Recurrent blockage of catheter was
predominant in the SPC group and symptomatic urinary tract infections (UTIs) were
the most common indications in the IUC group. In the asymptomatic group, there
were 44 squamous metaplastic changes in 27 patients. Two of these patients had
keratinizing variants. The duration of catheterization ranged from 20 months to
27 years and mean of 13.7 years. The average duration between two cystoscopies in
the symptomatic group was 16 months compared with an average 21 months in the
asymptomatic group.Conclusion:Cystourethroscopic surveillance in high-risk
patients with IUC/SPC is essential to diagnose and manage at an early-stage
complications associated with IUC/SPC, minimize symptomatology, mitigate
aggravation of complications, maintain good health and probably good quality of
life.

Langue : ANGLAIS