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Bladder Catheter (bladder + catheter)
Selected AbstractsDetecting postoperative urinary retention with an ultrasound scannerACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 3 2002L. A. Rosseland Background: Retention of urine is a common postoperative problem associated with risk of overdistention and permanent detrusor damage. Prevention of urinary retention by insertion of indwelling catheter may increase the risk of urinary infection. We have performed a reliability test of an ultrasound scanner, implemented in the postoperative monitoring equipment. Methods: Patients were monitored after different types of surgery under spinal anesthesia with an ultrasound scanner in the postanesthesia care unit (PACU). Patients: Patients who according to current guidelines required a urinary bladder catheter, were scanned before a catheter was inserted and urine volume was measured. These two urine volumes were compared and analyzed for agreement. Results: Nineteen female and 17 male patients were included. The mean difference between ultrasound estimates and catheter urine volume measurements was ,,21.5 mL, and limits of agreement, calculated as a 95% confidence interval, were ,,147 and +,104 mL. This means that the urine volume estimated by ultrasound was on average 21.5 mL smaller than the urine volume when the bladder was emptied. Conclusion: This study confirms a good agreement between the ultrasound scanner estimates of urinary bladder volume and urine volume measured after emptying the bladder. Nurses in the PACU could operate the ultrasound scanner after a brief instruction and training period. Considering the potentially serious long-term consequences of undiagnosed postoperative urinary retention, introducing this equipment for routine monitoring of urinary bladder volume should be considered. [source] Urination assessment after the removal of bladder catheter using a novel urination chartNURSING & HEALTH SCIENCES, Issue 3 2003Tomoko Owan rn, phd Abstract We investigated the difficulties involved in assessing post prostatectomy voiding according to 20 nurses working in urology and dermatology wards. Problems they encountered included completing a urination (frequency/volume) chart and performing an assessment. We constructed a hourly urination chart for basic nursing education in urinary incontinence. This was used for a 76-year-old male patient with hypertension and diabetes mellitus who underwent a prostatectomy. Urination was recorded for 17 consecutive days after catheter removal. Detailed pathological findings were more distinct in the hourly rather than daily recordings of voluntary micturition. Voluntary micturition appeared 12 h after catheter removal, but it was very scanty. After the onset of urination, frequency and amount of daily voluntary micturition was inversely related to incontinence during the 17 days after catheter removal. We drafted a set of urination recovery stages to enable the analysis of a patient's urination status. Nurses understood its importance and were able to reach a consensus on how to manage patients with postoperative incontinence. We have constructed a practical system for use by specialist urology nurses. [source] Antenatal urodynamic studies in the fetal lamb: experimental protocol and preliminary resultsPRENATAL DIAGNOSIS, Issue 3 2003Renaud de Tayrac Abstract Objectives To set up a fetal lamb model for intrauterine fetal urodynamic studies. Methods Fourteen fetal lambs underwent placement of a bladder catheter at a mean gestational age of 87 days. Three fetuses also had a partial urethral obstruction by the simultaneous placement of a peri-urethral constricting ring. Urodynamic and ultrasound studies were performed weekly by the filling cystometry method. Results Hundred and six voiding cycles were recorded during 25 urodynamic studies between 84- and 133-days gestation. All voiding profiles were biphasic with a mean duration of 4.2 min (range 1,10), a mean voiding pressure of 23 cm of water (range 7,33) and a mean periodicity of 19.2 min (range 11,50). The obstructed animals had bladder overactivity. This correlated with ultrasound and post-mortem findings of megacystis and bilateral hydroureteronephrosis. The fetal mortality rate was 85.7% and the mean duration of survival post surgery was 45 ± 5.7 days. Conclusion Serial urodynamic studies could be performed in a fetal lamb model. Following partial urethral obstruction, bladder overactivity was observed. Copyright © 2003 John Wiley & Sons, Ltd. [source] Effects of vaginal distension on urethral anatomy and functionBJU INTERNATIONAL, Issue 4 2002T.W. Cannon Objective ,To determine the effect of repeated and prolonged vaginal distension on the leak-point pressure (LPP) and urethral anatomy in the female rat, as prolonged vaginal distension has been clinically correlated with signs of stress urinary incontinence (SUI). Materials and methods ,Sixty female rats were placed into one of five groups; four groups underwent one of four vaginal distension protocols using a modified 10 F Foley catheter, i.e. prolonged (1 h), brief (0.5 h), intermittent (cycling inflated/deflated for 0.5 h) or sham distension. All animals had a suprapubic bladder catheter implanted 2 days after and were assessed urodynamically 4 days after vaginal distension. The fifth group of rats acted as controls and did not undergo vaginal distension, but did have a suprapubic bladder catheter placed and urodynamics assessed. To measure LPP the rats were anaesthetized with urethane, placed supine and the bladder filled with saline (5 mL/h) while bladder pressure was measured via the bladder catheter. LPPs were measured three times in each animal by manually increasing the abdominal pressure until leakage at the urethral meatus, when the external abdominal pressure was rapidly released. Peak bladder pressure was taken as the LPP and a mean value calculated for each animal. Immediately after measuring LPP the urethra was removed and processed routinely for histology (5 µm sections, stained with haematoxylin/eosin and trichrome). The means ( sem ) were compared using a Kruskal,Wallis one-way anova on ranks, followed by a Dunn's test, with P < 0.05 indicating a significant difference. Results ,Both LPP and the external increase in abdominal pressure were significantly lower after prolonged distension, at 31.4 (1.7) and 19.8 (1.2) cmH 2 O, than in the sham group, at 41.1 (3.2) and 32.0 (4.7) cmH 2 O, respectively. There were no significant differences in LPP or in the increase in abdominal pressure between the brief, intermittent and sham groups. Qualitative histology showed that prolonged distension resulted in extensive disruption and marked thinning of urethral skeletal muscle fibres. Brief and intermittent distension showed mild and focal disruptions, respectively. Conclusions ,As observed clinically, prolonged vaginal distension results in a lower LPP, greater anatomical injury and increased severity of SUI. These results suggest that ischaemia is important in the development of SUI after prolonged vaginal distension. [source] | ||||||||||