Mise en ¨¦vidence des diff¨¦rences de gestion des vessies neurologiques existantes entre urologues et m¨¦decins sp¨¦cialis¨¦s en m¨¦decine physique et de r¨¦habilitation?: enqu¨ºte r¨¦alis¨¦e aupr¨¨s de 383?sp¨¦cialistes

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• 作者：Pierre Denys¹ ; ^{pierre.denys@rpc.aphp.fr} ; Jean-Marc Soler² ; Brigitte Fatton³ ; Pascal Rischmann⁴ ; Alain Yelnik⁵ ; Philippe Aegerter⁶ ; Nabila-Yasmine Saidji-Domingo⁶ ; Emmanuel Chartier-Kastler⁷
• 刊名：La Presse M?¡ì|dicale
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：41
• 期：12_part_P1
• 页码：e599-e608
• 全文大小：272 K

文摘

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Summary

Objectives

To investigate and evaluate the quality of care and follow-up provided to neurogenic patients by urologists and physiatrists in France.

Methods

A survey was conducted by the French-speaking group of neuro-urology (GENULF) among French urologists and physiatrists in 2009. Three thousand one hundred and eighty questionnaires were sent to the members of four scientific societies. Questions focused on aetiology, consultation, clinical follow-up and symptom management.

Results

Two hundred and seventy-four urologists and 109 physiatrists completed the questionnaire, 76 % and 84 % respectively had experience in neuro-urology. Only a few specialists performed multidisciplinary consultations. Systematic follow-up frequency varied between 6 to 12 months. Eighty-three percent of physiatrists and 56 % of urologists performed a urodynamic follow-up, mostly yearly. Physiatrists used invasive imaging techniques more often than urologists. They also treated asymptomatic bacteriuria in catheterised patients more often than urologists. Self-catheterisation was a standard treatment to address urinary retention. Both specialists prescribed botulinum toxin type A injections.

Discussion

National and international guidelines related to follow-up and treatments were followed by both specialists. Urologists and physiatrists treated asymptomatic bacteriuria more often than necessary. Urodynamics testing was not carried out as often as recommended by guidelines. Urologists offered a more frequent follow-up than physiatrists. Physiatrists performed more often and better urodynamic follow-up compared to urologists.

Conclusion

Our survey revealed a good observance of national and international guidelines by French specialists for the management of neurogenic bladder patients. Nevertheless, the management of these patients could be harmonised and possibly improved by putting an accent on specialists¡¯ education, by using assessment forms regarding their practices and by increasing the amount of multidisciplinary consultations.