داء تخزين الغليكوجين النوع الرابع مع المثانة العصبية — ماذا تفعل عندما لا يُجدي علاج التفريغ من الخط الأول

References

DOI: 10.1016/j.ymgme.2023.107525

• For patients with hesitancy, straining, slow stream, or emptying difficulties, first-line treatments include timed voiding, double voiding (i.e., attempting to void again immediately after going), optimizing bowel function, and pelvic floor muscle exercises geared toward improving relaxation and tone (see Section 5.6).
• When emptying is not adequate, clean intermittent self-catheterization is recommended over placement of an indwelling catheter to decrease the risk of recurring UTI.
• If clean intermittent self-catheterization is not possible, one can consider a suprapubic catheter for ease of catheter exchanges; a suprapubic tube is preferred over a urethral catheter to minimize risk of urethral erosion.