RU2329787C2 - Method of treatment of urethra iatrogenic infection caused by transurethral manipulations - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, specifically to urology and concerns prevention of urethra iatrogenic infection caused by transurethral manipulations. For this purpose 5 minutes prior to urinary tracts manipulation gel is introduced to urethra that contains 2 g of 10 % lydocaine solution per 100 g of glycerine. Before introduction gel is ozonised to ozone concentration 1200 mkg/l. Method provides effective prevention of urethra iatrogenic infection at absence of lydocaine by-effects.

EFFECT: provided effective prevention of urethra iatrogenic infection at absence of lydocaine by-effects.

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Description

The invention relates to medicine, namely to urology, and can be used to reduce the number of complications after endoscopic manipulations.

Currently, in urology, endoscopic interventions are widely used. Compared to open surgery, transurethral resection (TUR) in the treatment of prostate adenoma is less traumatic, easier to tolerate, and also reduces the patient’s hospital stay. For the treatment of urolithiasis today, endoscopic operations - contact lithotripsy (KLT) have become a priority.

According to the literature, the frequency of urethral infection after TUR of prostate adenoma ranges from 15% to 40%, after KLT from 8% to 20%.

There is a method of treating iatrogenic infection of the urethra during transurethral manipulations by introducing a 5% solution of novocaine or dicain 1: 1000 into the urethra before manipulation (Cystoscopic Atlas. Medgiz., A.P. Frumkin. 1954, p. 18).

The disadvantage of this method is the presence of only anesthetic effect, which leads to low efficiency and infection of the urethra.

The closest to the achieved result (prototype) is a method of treating iatrogenic infection of the urethra during transurethral manipulations by applying lubricating gels, in particular Katejel, consisting of 10% lidocaine and chlorhexidine. The gel is injected into the urethra immediately before the introduction of the instrument, thereby achieving a disinfecting effect and local anesthesia (Journal of Urology. No. 3 1998 G. A. Hofstetter.c.21).

However, the known method is not effective enough, which leads to the development of complications.

The authors developed and proposed a method for the treatment of iatrogenic infection of the urethra during transurethral manipulations, which consists in the use of an ozonated gel with disinfectant, antibacterial, and anti-adhesive properties. According to microbiological studies, ozone can kill all known types of gram-positive and gram-negative bacteria, including Pseudomonas aeruginosa, Legionella, and many viruses (Carpendalle MT, Griffis G. Ozone therapy: Internal diseases. - N. Novgorod: “Vector TiS”, 2003, - 18 p.). This suggests that medical ozone is more effective than chlorhexidine, which is used in the prototype.

The technical result of the claimed invention is to increase the effectiveness of treatment through the use of disinfectant, antibacterial, anti-adhesive properties of the ozonated gel.

The technical result is achieved by using an ozonized gel with a bactericidal concentration of 1200 μg / l, which is injected into the urethra 5 minutes before the manipulation of the urinary tract.

The method is as follows.

Sterile glycerin is used as the gel base, which gives a good lubricating effect and does not distort the optical picture. Glycerin is mixed with 10% lidocaine to a uniform consistency (100 g of glycerin contains 2 g of 10% lidocaine), which acts as a local anesthetic. Used 10% lidocaine produced by FSUE "Moskhimpharmpreparaty" named after N. A. Semashko. The gel is ozonized to a bactericidal concentration of 1200 μg / l for 2 hours, for example, on a Medozons BM apparatus (Nizhny Novgorod).

10 ml of ozonated gel is poured into a sterile syringe, since the capacity of the male urethra is on average 10.6 ml. Immediately before the introduction of the instrument, the contents of the syringe are instilled into the urethra. The gel is left in the urethra for 5 minutes, after which manipulations are performed on the urinary tract. During this period, a complete anesthetic and disinfecting effect is achieved.

The inventive method can reduce the number of complications, reduce signs of inflammation.

Clinical examples.

1. Tretyakov A. V., 67 years old, entered the Department of Urology of GB No. 11 in a planned manner 05.12.2005. Diagnosis: Adenoma of the prostate 2 tbsp. Cystostomy. 12/07/2005 the patient underwent TUR of prostate adenoma. Instead of the Katedzhel gel, the proposed ozonated gel was used, which was introduced, as mentioned above, into the urethra immediately before endoscopic manipulation. The operation went well. The postoperative period was uneventful, the patient restored self-urination. According to the microbiological study, microflora growth was not found. The patient was discharged December 16, 2005 with recovery.

2. Kolmagorov S.A., 40 years old, was admitted to the Department of Urology of GB No. 11 in ambulance with renal colic. The examination was diagnosed with Urolithiasis. Stone of the lower third of the left ureter. The next day, emergency contact lithotripsy of the left ureter was performed. Also, instead of a conventional gel, ozonized according to the claimed method was used. The stone was crushed, fragments removed. In the postoperative period, the patient had no complications, according to the immunogram, inflammation was not expressed, pathogenic microorganisms were not detected. The patient was discharged with recovery.

Thus, the use of the ozonized gel in the claimed method reduces the risk of iatrogenic infection of the urethra, improves the course of the postoperative period, and reduces the patient’s hospital stay. The inventive method is simple to use, does not require the use of expensive drugs, equipment. Therefore, it will be widely used in urological hospitals.

Claims (1)

A method for the prevention of iatrogenic infection of the urethra during transurethral manipulations by introducing a gel into the urethra, characterized in that they use a gel containing 100 g of glycerol 2 g of a 10% solution of lidocaine, which is ozonized to a concentration of 1200 μg / l, then injected into the urethra for 5 min before the manipulation of the urinary tract.