Dr. Abdellatif Zayed [email protected] INSTRUMENTS.

Dr. Abdellatif ZayedDr. Abdellatif [email protected][email protected]

INSTRUMENTSINSTRUMENTS

Diagnostic:Diagnostic:

1.1. CystourethrographyCystourethrography

2.2. Urodynamic studyUrodynamic study

3.3. Measure Residual urineMeasure Residual urine Therapeutics:Therapeutics:

1.1. Relief of urine retention (BPH,…)Relief of urine retention (BPH,…)

2.2. Clot retentionClot retention

3.3. Postoperative Postoperative

Indications of catheterizations

Catheter sizes refer to the outside Catheter sizes refer to the outside circumferencecircumference

French (Fr) scale (circumference is in mm)French (Fr) scale (circumference is in mm)

1 Fr=0.33 mm in diameter. 1 Fr=0.33 mm in diameter.

French scale

Strait Strait cathetercatheter

Fixations of strait catheter by Fixations of strait catheter by plaster stripsplaster strips

Foley’s cathetersFoley’s catheters

Self retaining catheterSelf retaining catheter

Catheter (18-16F) is usually Catheter (18-16F) is usually satisfactory for adults. satisfactory for adults.

Inflating the balloon prematurely may Inflating the balloon prematurely may result in urethral ruptureresult in urethral rupture

Large-caliber catheters are used to Large-caliber catheters are used to evacuate blood clotsevacuate blood clots

Why Large balloons (30 mL)??Why Large balloons (30 mL)??

To decrease the balloon migrating into To decrease the balloon migrating into the prostatic fossa after TUR_P.the prostatic fossa after TUR_P.

Can be used as traction to control Can be used as traction to control hemorrhage from the prostatic fossahemorrhage from the prostatic fossa

The standard latex catheter can result in The standard latex catheter can result in severe reactions in patients with latex severe reactions in patients with latex allergiesallergies

Silicone varieties are good alternatives Silicone varieties are good alternatives even if it is to remain only for few days even if it is to remain only for few days

CatheterizationsCatheterizations

Catheter associated UTICatheter associated UTI

Incidence: Incidence: short term catheterization 10-20%short term catheterization 10-20% Long term catheterizations 100%Long term catheterizations 100%

Guideline to prevent catheter associated UTIGuideline to prevent catheter associated UTI Only when necessaryOnly when necessary Condom catheterCondom catheter Aseptic catheterization techniqueAseptic catheterization technique Using sterile lubricantUsing sterile lubricant

Condom catheterCondom catheter

Elastic adhesive band

The bag below the bladder levelThe bag below the bladder level

Should not touch the floorShould not touch the floor

In males, the catheter should be secured In males, the catheter should be secured above the thighabove the thigh

Guideline to prevent catheter associated UTI

The balloon may not deflateThe balloon may not deflate !!!!!!!!!!!!!!

1.1. Deflating by using Deflating by using torsiontorsion

2.2. Shortening the defective Shortening the defective lengthlength

3.3. Transluminal probing and Transluminal probing and perforationperforation

Probe

4.4. Percutaneous Percutaneous puncturepuncture

U/S guided puncture

5.5. Transrectal or transvaginal Transrectal or transvaginal puncturepuncture

Transvaginal Transrectal

6.6. Harpoon techniqueHarpoon technique

7.7. Rupture by Rupture by overdistentionoverdistention

8.8. Chemically induced ruptureChemically induced rupture

Obsolete !!!

Ureteric Ureteric stentsstents

Bilateral JJ stents, Stienstrass

Ureteric stentsUreteric stents

Facilitate internal drainage due to Facilitate internal drainage due to obstruction from internal or external ureteral obstruction from internal or external ureteral compressioncompression

To decrease sepsis or obstruction in the To decrease sepsis or obstruction in the presence of steinstrasse after ESWLpresence of steinstrasse after ESWL

Double-J catheters

1.1. performing retrograde pyelographyperforming retrograde pyelography

2.2. collecting urine for cytology or collecting urine for cytology or cultures cultures

3.3. performing brush biopsiesperforming brush biopsies

4.4. Draining an obstructed kidneyDraining an obstructed kidney

Ureteral catheterization

Suprapubic Suprapubic cathetercatheter

Suprapubic Catheter Suprapubic Catheter insertioninsertion

CystoscopeCystoscope

Flexible ureteroscopeFlexible ureteroscope

NephroscopeNephroscope

Thank you

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