Patients' memory for medical information

The data presented by Dr Fontaine and his colleagues (August 2003 JRSM 1 ) suggest that perforation of an enterocystoplasty is often associated with an overfilled bladder which, in turn, can be produced by poor compliance with a strict intermittent catheterization regimen.It would be interesting to know how many of the total patients involved had diminished pain sensibility in their bladders, and what proportion of these were in the perforation group.Even the most fastidious patients may let their catheterization routine slip and this is a particular temptation when delay in performing catheterization does not result in pain.It could be that such patients need an efficient 'pain substitute'. 2Perhaps urological surgeons should reconsider the plastic surgeon's technique (when repairing pressure ulcers) of using normally innervated autografts?Such a graft, using perhaps expanded skin, might one day be incorporated into reconstructed bladders that would otherwise have absent or diminished pain sensibility.I appreciate that this would not be an easy operation, and skin might not be the best tissue to use.