title: Micturition problems after bladder distension during hospitalization in Sweden: "I'm not ill, just damaged for the rest of my life".
abstract: BACKGROUND
  Urinary retention is a common complication following hospital care, which can result in overdistension of the bladder and, at worst, chronic bladder damage and persistent micturition difficulties.
  
  
  OBJECTIVE
  The purpose of this study was to explore patients' experiences of micturition problems after bladder distension and their effects on the patients' everyday lives.
  
  
  METHODS
  The Swedish Patient Insurance LÖF was used to identify patients from January 2007 to June 2010 who have reported micturition problems after hospital care and have had their injuries classified as avoidable bladder damage due to overdistension. Narrative interviews were conducted with 20 volunteers and analyzed by qualitative content analysis.
  
  
  RESULTS
  The micturition problems affected everyday life through constraints (dependence on disposables and access to toilets, clothing restrictions, limitations on social life and career), suffering (pain, infections, impaired sex life, leakage), and concerns for the future (fear of worsening symptoms and fear of losing control with age). Aspects related to having been harmed by the healthcare system were the harm could have been avoided (lack of knowledge, insufficient routines, mistrust), obstacles to overcome when reporting an injury (difficulties in obtaining knowledge about the possibility of reporting an injury, ambivalence toward reporting their healthcare providers), and a wish to improve care (raise awareness, prevent harm to others).
  
  
  CONCLUSIONS
  Bladder distension is a healthcare-related injury that can cause suffering and practical, emotional, and psychosocial problems with a great impact on the life of the person affected and anxiety for the future. The healthcare system must, therefore, raise awareness and improve preventive routines.
authors.affiliation: Eva Joelsson-Alm, PhD, RN, is Improvement Coordinator, Claes R. Nyman, MD, PhD, is Associate Professor, and Christer Svensén, MD, PhD, is Professor, Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden. Johanna Ulfvarson, PhD, RN, is Associate Professor, Karolinska Institutet, Department of Neurobiology, Care Sciences and Society (NVS), Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Joelsson-Alm
authors.forename: Claes R
authors.initials: CR
authors.lastname: Nyman
authors.forename: Christer
authors.initials: C
authors.lastname: Svensén
authors.forename: Johanna
authors.initials: J
authors.lastname: Ulfvarson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003020:Clothing; D035881:Compensation and Redress; D005260:Female; D006760:Hospitalization; D006801:Humans; D007049:Iatrogenic Disease; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology; D012042:Registries; D012648:Self Care; D012735:Sexual Dysfunction, Physiological; D020018:Sexual Dysfunctions, Psychological; D013548:Sweden; D014546:Urinary Catheterization / Q000523:psychology; D016055:Urinary Retention / Q000150:complications*; D014552:Urinary Tract Infections / Q000209:etiology / Q000523:psychology; D014555:Urination Disorders / Q000209:etiology* / Q000523:psychology*