New developments in urinary home self-care for patients in Belgium

Home self-drilling is the urinary sampling that patient does himself at home or that is done by someone who has been trained for this purpose and who is able to apply this technique.

The purpose of self-sounding is to ensure a regular emptying of the bladder by introducing a probe through the urethra. Patients who undergo home self- drilling are often faced with additional costs due to the purchase of additional probes or the high cost of the probes used. In order to remedy these situations and better meet the real needs of patients, new regulations have been developed; it will enter into force on 1 November 2017.

Currently maximum 5 probes per day are reimbursed if the patient has any of the following conditions:

• Retention of bladder with significant post-void residual urine (equal to or greater than 100 ml) due to acquired or congenital spinal cord injury;
• Retention of bladder with significant post-void residual urine (equal to or greater than 100 ml) due to peripheral neuropathy;
• Paraplegia or paraparesis, tetraplegia or tetraparesis, when the progression of incontinence is prevented by combination of parasympathicolytic drug (s) and self-probe;
• Bladder retention in the absence of isolated neurological injury: surrogate bladder; enlargement of bladder.

The new regulations allow for the following improvements:

• Increase the maximum number of probes reimbursed daily: from 4 to 5 probes per day to from 4 to 8 probes per day for two specific conditions;
• Expansion of the target group;
• Development of a list of reimbursable probes, with a price control;
• No amount is charged to patients for the purchase of probes, except for an additional charge of maximum 1 EUR per probe for so-called "advanced" probes (probes with integrated lubricant and other additional functions, if the decision to use these probes has been made on the basis of patient-doctor consultation).

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