For many people, reimbursed catheters are a chance for a dignified life, because emptying the bladder is not only a physiological activity, but also a medical procedure. The more difficult it is because the system condemns patients to the use of outdated catheters, which cause infections and injuries of the urethra. Check which catheters are reimbursed in Poland.
Anyone who has had acatheterat least once due to a major surgery does not mention this surgery pleasantly. So how do people who have to perform such a procedure several times a day feel, especially since in Poland the technique of self-catheterization remained at the level of the 1960s?
Catheterization , which is the mechanical drainage of urine from the bladder, involves inserting a catheter through the urethra into the bladder and removing urine from it. There are several methods of performing this procedure. The catheter can be inserted permanently, and then the patient only empties the bag in which the urine is collected.
Another way -intermittent catheterizationis to insert the catheter several times a day and drain urine from the bladder. The latter method is used in people with diseases of the bladder and urethra. This necessity arises when the bladder detrusor muscle fails, which happens after spinal cord injury. Among the neurological diseases that can lead to catheterization are spina bifida, multiple sclerosis (MS), strokes, cerebral palsy, Parkinson's disease and Alzheimer's disease, cancers of the central nervous system, but also long-standing diabetes.
Reimbursed catheters in Poland
In Poland, only uncoated disposable catheters are reimbursed, for which the patient must buy a moisturizing gel, disinfectant liquid and disposable gloves. One gel pack should only be used once. Polish patients, out of necessity, do not follow this recommendation. They open and close the package, which increases the risk of infection many times over.
According to specialists, in Europe only Polish patients use old-type catheters, which cause urinary tract infections and urethral damage.
Prices of catheters in Poland
One catheter costs 85 groszy on average (the current refund is 56 groszy each), but you need to buy it to use itgel (dispenser for about PLN 6), saline for washing the urethra (ampoule for about PLN 30), sterile gloves (a pair of about PLN 1.60). You also need sterile forceps to hold the catheter. When we add up the expenses, it turns out that in order to urinate 5 times a day, the patient has to spend about PLN 40, most of which is from his own pocket. The National He alth Fund is against the refund of hydrophilic catheters, because one costs almost PLN 6.
Throughout Europe, it pays off to finance modern catheters, because it is known that their use means fewer complications, the treatment of which is very expensive, less expenditure on antibiotics, less hospitalization and - which may not be of concern to officials - a better quality of life. The lack of reimbursement of hydrophilic catheters is also a violation of the recommendations of the Council of Europe, which obligated all EU member states to act to improve the lives of people with disabilities.
The risk of infection depends on the type of catheter
Why sufficiently frequent self-catheterization, i.e. insertion of a catheter into the bladder by the patient himself and emptying it, is so important for patients? Inserting a catheter on a daily basis increases the risk of infections by 7%. After 10 days it is already 70%, and after two weeks you can be sure that the infection has already developed.
Complications of such infections are usually serious - from kidney abscesses, acute pyelonephritis, through kidney and bladder stones, to the need for dialysis and transplantation (20% of patients). There are also inflammations of the epididymides and testicles. These complications typically occur when patients use outdated, rigid, and non-lubricated catheters.
Types of catheters for self-catheterization:
- disposable hydrophilic catheters, ready to use out of sterile packaging;
- disposable catheters coated with a hydrophilic substance, which must be moistened before use to activate the lubricant of the catheter;
- uncoated catheters, to which the patient must apply a moisturizing gel on his own before using them.
Most of the world's urological societies recommend the use of aseptic, disposable, hydrophilic catheters because their use minimizes the risk of urinary tract infections and the risk of kidney damage. Hydrophilic catheters facilitate self-catheterization, which significantly increases the quality of life of patients. The catheter is evenly coated with a lubricant, which allows it to be gently and traumatically introduced into the bladder. The great advantage is that the patient does not have to touch the catheter, which clearly reduces the risk of infection. Besides, the use of such catheterssignificantly reduces the costs of hospitalization and the use of expensive antibiotics.
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