Are most families able to accept catheterization?

I think some children and/or their parents have a tremendous barrier to instituting this program. We can overcome most of the psychological issues related to this and can get most children to do catheterization. Years ago, there was a significant barrier to using catheterization for emptying the bladder in children with neurological impairment. But with its acceptance by the medical community and the support from nursing and other personnel, catheterization in the neurologically impaired child has become a standard and accepted way of life. It is rare to find a child or a family who just can’t accept it.

Stuart Bauer, MD, Department of Urology

 

Every child is different and some respond to it better than others. I keep going back to this, but I really believe it’s family acceptance first. If the family is reluctant to do it and the child knows it, and the family’s not buying in 110%, it’s not going to happen. As children they need a ton of support, and that support has to be there for them 24/7, and it’s got to be coming from the family. I think our job is to support that family as much as possible, provide them with as much external support as we can. I think that’s the key to getting them to break through. Once they do it, they realize they can tolerate it, it’s fine! It’s that first anxiety about doing it. And it’s amazing how some of these kids, once they start doing it, how empowered they feel about taking control.

I remember a few kids I saw as a resident, as a fellow, as an attending – they just wouldn’t cath. Families bought in, everything, but the child won’t do it because they can’t grasp the concept. That’s the hardest part, beyond the cathing itself – realizing the long term ramifications of not doing a treatment, for two, three years down the road and for the rest of their life. Unfortunately sometimes children just don’t get that. The parents get it eventually, but it’s hard to explain to a child. You have to deal with the immediate issue of: how can I try to empower them? How can I get them to try something that in the end they’re going to realize doesn’t hurt? How can I get them to break through that? And again, every child is just a little bit different.

Richard Lee, MD, Department of Urology