Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: Brian Sutterer, MD: No financial relationships or conflicts of interest
Case Description: The patient underwent a complex spine fusion surgery and post-operatively developed lower motor neuron neurogenic bowel and bladder. Surrogate intermittent catheterization (IC) of the bladder and assisted bowel care was initiated with the goal of transitioning to independent care. His upper limbs were nearly full strength with adequate fine motor control. Unfortunately, due to his physical stature with a history of achondroplasia combined with the recent spine fusion, he was unable to physically reach his penis or sacral region to complete his own bowel and bladder care. The rehabilitation team worked to design and fabricate several assistive device prototypes that would allow him to support the penis and insert a urinary catheter independently. Bowel irrigation tools were investigated for his neurogenic bowel.
Setting: Inpatient rehabilitation unit at a tertiary care hospital
Patient: 41 year old male with achondroplasia and T5-pelvis fusion Assessment/
Results: An interdisciplinary team approach was used to develop an assistive device to support independent IC. The patient and his spouse were very supportive of these efforts, and the patient was able to use the final device in limited fashion prior to rehabilitation discharge, however he was still utilizing surrogate IC upon discharge. A once daily bowel irrigation program with a bowel irrigation device was then implemented for his neurogenic bowel.
Discussion: The creativity and team approach utilized in this case is a prime example of what defines the field of Physical Medicine and Rehabilitation. The collaboration among the patient, nursing staff, therapists and physician team were necessary in solving complex problems for a patient with unique physical limitations and neurologic sequela.
Conclusion: The unique approach a rehabilitation team can use to solve problems should inspire other providers to pursue solutions to challenging situations and to work with patients to help them overcome their physical limitations and impairments.
Level of Evidence: Level V
To cite this abstract in AMA style:Sutterer B, Garlanger K. The Use of Assistive Devices in a Challenging Case of Neurogenic Bowel and Bladder: A Case Report [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/the-use-of-assistive-devices-in-a-challenging-case-of-neurogenic-bowel-and-bladder-a-case-report/. Accessed February 27, 2024.
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