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Renal & Urogenital

On-going Research

Bladder Inflammation Secondary to Catheterisation: A Possible Role for Local and Systemic Pro-inflammatory Mediator This study is designed to compare inflammatory markers in matched patients with indwelling catheters, managed by both regimes. Blood plasma and urinary levels of four pro-inflammatory cytokines or mediators (tissue factor, interleukin-6, tumour necrosis factor-alpha and interferon gamma) will be measured. Results are expected to indicate whether catheter valves are associated with less bladder inflammation (and therefore be better for bladder health) than free-drainage systems. This will help to contribute to optimising the management of urinary catheters thereby minimising associated morbidity and improving patient care
MIC Module 1 - Study to Develop Catheter Cleaning Methods to Enable Re-use of Intermittent Catheters Evaluating the safety and acceptability of reusing catheters for intermittent catheterisation (passing a tube into the bladder to drain urine) is one of the top 10 continence research priorities. Globally both single-use catheters (thrown away after use) and multi-use ones (cleaned between uses) are used, but uniquely the UK supplies most patients with single-use catheters. Using multi-use catheters as well as single-use ones could bring benefits to patients (more choice, eco-friendly) and substantial savings to the NHS. But before the use of multi-use catheters is promoted, it is important to test whether reusing catheters is as safe and acceptable to users as using only single-use ones. The aim of this programme is to prepare for a trial by finding out the best ways of cleaning catheters and developing ways of measuring things that matter to users (acceptability, preferences and infections).
MIC Module 2 - The Interview Module The Intermittent catheterisation (IC) process is repeated, as needed, often up to 4-5 times per day. Despite lack of evidence to support the use of any particular catheter, the UK has slipped into a unique position of supplying single-use (mainly coated) catheters to virtually all patients. This has resulted in patients and staff lacking confidence, knowledge and experience in using multi-use methods such as reusable catheters. This research project is part of a larger research programme on the reuse of intermittent catheters. It will provide important information to guide the development of a randomised controlled trial. This project will explore people’s experience of their current catheter in terms of urine infection, and of what they value in their catheter. They are also looking to establish what people would value in a [hypothetical] reusable or multiuse catheter regime. The user experience in a range of contexts [e.g. home, work, etc] will be explored.
Prostate Cancer UK Module 4 Phase 1: Evaluation of Existing Products Long-term Urinary Incontinence (UI) is a common consequence of treatment for prostate cancer and has a major effect on the quality of life, leaving men depressed and isolated. Incontinence is ranked higher than erectile dysfunction in impacting on quality of life after radical prostatectomy. Moreover, it is associated with long term morbidities including skin irritation and urinary tract infection and increased hospital stays. The majority of men use disposable absorbent products to manage night time incontinence, but often find disposable products to be unsuitable at night because they provide inadequate absorbency, particularly at the sides. A recent study found that simple cotton towelling squares, folded and worn with waterproof pants, were the most effective and comfortable method of managing night time incontinence. However, the appearance of cotton towelling squares was considered to be highly unacceptable; they are bulky, aesthetically unappealing (particularly resembling babies’ nappies) and sweaty when worn with plastic pants. The aim of this project is to compare the performance of existing washable absorbent products (pads and pants) through user testing. A group of men will test a range of up to five washable products in their own homes. The results will then inform the development of a design specification for an improved, effective and aesthetically acceptable product.
Prostate Cancer UK Module 3 Phase 1: Evaluation of Existing Clamps Long-term urinary incontinence (bladder leakage) is a common consequence of treatment for prostate cancer and between 10-15% of men who have had surgery for prostate cancer will suffer life-long urinary incontinence. Initially most men will use absorbent products (pads). However, recent research indicates that men appreciate being able to choose from a selection of devices and pads to fully meet their lifestyle needs. Clamps (or penile compression devices) are more secure, less likely to leak and allow greater clothing choice than other devices and pads. They are particularly useful for short energetic activities (such as exercise or dancing) but the drawback of existing clamps is that they can be significantly more painful than other products. This study aims: a. To review all existing clamps and to compare the performance of a maximum of five clamps for use by men with long-term (over 12 months) urinary incontinence following treatment for prostate cancer. b. To identify the strengths and limitations of a selection of available clamps. c. To investigate which of the clamps are most effective at preventing / reducing urinary incontinence. d. To investigate the effect of wearing a clamp on penile blood flow and skin health. If through this study the study team are unable to identify a clamp which is safe to use, effective at preventing urine leakage and acceptable to men, we will continue to a second (already funded) study in which we plan to either modify an existing clamp or develop a new clamp.