Is Mitrofanoff a More Socially Accepted Clean Intermittent Catheterization (CIC) Route for Children and Their Families?

Abstract

Aim We aimed to examine the social impact of clean intermittent catheterization (CIC) on children with a neurogenic bladder and to compare the impact of urethral CIC with Mitrofanoff catheterization.

Methods Questionnaires containing 29 questions about the social impact of CIC on the children and their families were administered with their parents or caregivers of 50 children (34 boys and 16 girls) using CIC. The mean (standard deviation [SD]) age of the children was 9.6 (4.32) years and duration on CIC was 6.1 (3.97) years.

Results Seventeen children were using Mitrofanoff catheterization (group I) and 33 children urethral catheterization (group II). Of the respondents, 54% respondents reported that their children accept the use of CIC, 30% respondents reported that they do not like it, and 16% respondents reported that they always refuse and resist it. There was no difference in the level of acceptance between the two groups. Both groups reported that children were social (90%) and had close friends (88%). However, 50% felt that CIC affected mood, with 30% of the children displaying bad temper. Mitrofanoff catheterization was associated with fewer episodes of frequent urinary tract infection (p = 0.004) and greater adherence. All children from group I, who were older than 6 years, were attending school compared with 78% from group II. School performance was significantly better in group I (p = 0.022).

Conclusion There was acceptance of CIC by most children but Mitrofanoff catheterization seemed to have a lower social impact in terms of school performance, adherence to therapy, and complications.

Keywords

Mitrofanoff catheterization - neurogenic bladder - social impact - CIC

• References

• 1 Verpoorten C, Buyse GM. The neurogenic bladder: medical treatment. Pediatr Nephrol 2008; 23 (5) 717-725
• 2 Lapides J, Diokno AC, Silber SJ, Lowe BS. Clean, intermittent self-catheterization in the treatment of urinary tract disease. J Urol 1972; 107 (3) 458-461
• 3 Edwards M, Borzyskowski M, Cox A, Badcock J. Neuropathic bladder and intermittent catheterization: social and psychological impact on children and adolescents. Dev Med Child Neurol 2004; 46 (3) 168-177
• 4 Borzyskowski M, Cox A, Edwards M, Owen A. Neuropathic bladder and intermittent catheterization: social and psychological impact on families. Dev Med Child Neurol 2004; 46 (3) 160-167
• 5 McConville A. Patients' experiences of clean intermittent catheterisation. Nurs Times 2002; 98 (4) 55-56
• 6 Dykes EH, Duffy PG, Ransley PG. The use of the Mitrofanoff principle in achieving clean intermittent catheterisation and urinary continence in children. J Pediatr Surg 1991; 26 (5) 535-538
• 7 Borzi PA, Bruce J, Gough DC. Continent cutaneous diversions in children: experience with the Mitrofanoff procedure. Br J Urol 1992; 70 (6) 669-673
• 8 Neel KF, Salem MA, Soliman SM, Al-Hazmi H, Gomha AB, Khatab AA. Acceptance and compliance of clean intermittent catheterization among Saudi patients. Saudi Med J 2008; 29 (7) 1014-1017
• 9 Pohl HG, Bauer SB, Borer JG , et al. The outcome of voiding dysfunction managed with clean intermittent catheterization in neurologically and anatomically normal children. BJU Int 2002; 89 (9) 923-927
• 10 Alpert SA, Cheng EY, Zebold KF, Kaplan WE. Clean intermittent catheterization in genitally sensate children: patient experience and health related quality of life. J Urol 2005; 174 (4 Pt 2) 1616-1619 , discussion 1619
• 11 Neel KF. Feasibility and outcome of clean intermittent catheterization for children with sensate urethra. Can Urol Assoc J 2010; 4 (6) 403-405
• 12 Dik P, Klijn AJ, van Gool JD, de Jong-de Vos van Steenwijk CC, de Jong TP. Early start to therapy preserves kidney function in spina bifida patients. Eur Urol 2006; 49 (5) 908-913
• 13 De Castro R, Fouda Neel KA, Alshammari AM, Abu Daia JM, Abd Al-Aaly MA. Clean intermittent catheterization in Saudi children. Suggestion for a common protocol. Saudi Med J 2000; 21 (11) 1016-1023
• 14 Tarrado X, Rodó J, Sepúlveda JA, García Aparicio L, Morales L. [Continent urinary diversion: the Mitrofanoff principle]. Cir Pediatr 2005; 18 (1) 32-35
• 15 Donlau M, Imms C, Glad Mattsson G, Mattsson S, Sjörs A, Falkmer T. Children and youth with myelomeningocele's independence in managing clean intermittent catheterization in familiar settings. Acta Paediatr 2011; 100 (3) 429-438
• 16 Donlau M, Falkmer T. Independence in the toilet activity in children and adolescents with myelomeningocele—managing clean intermittent catheterization in a hospital setting. Acta Paediatr 2009; 98 (12) 1972-1976
• 17 Searles J. Enabling school staff to undertake clean intermittent catheterisation. Nurs Times 2010; 106 (47) 22-24