RU2737217C1 - Method of low-traumatic installation of urethral catheter - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to urology. Foley catheter inserted into the urethra, a urethral catheter and a rigid ureteroscope are inserted into the lumen. In visual detection of urethral constriction by inflatable balloon of Foley catheter, lumen widens and the urethral catheter under endoscopic control is guided by a natural extended urethra stroke, excluding the unnatural catheter installation.

EFFECT: method enables visual monitoring of the correctness of the urethral catheter installation and prevents the urethral catheter from mounting unnaturally, which can occur, in addition, method can be used in cases of eliminating acute retention of urination in patients with benign prostatic hyperplasia, when it is impossible to conduct an elastic Foley catheter, Nelaton's catheter, and a metal catheter encounters an obstacle.

3 cl, 1 ex

Description

The invention relates to medicine, namely to urology, and can be used to improve the results of treatment of urethral strictures and acute urinary retention in patients with benign prostatic hyperplasia.

State of the art

There are many different types of catheters and methods of their introduction [1, 2, 3]. One of the main disadvantages of their use is the high invasiveness of the urethra during their introduction, especially in the presence of narrowing of the canal. Prototype [4].

Disclosure of invention

The essence of the method consists in the introduction into the lumen of a Foley catheter inserted into the urethra, a urethral catheter and a rigid uterescope. With visual detection, with the help of a ureterescope, urethral narrowing, with the help of an inflatable balloon of the Foley catheter, the narrowing expands and the urethral catheter under endoscopic control is guided along the natural expanded, with the help of a Foley catheter balloon, the course of the urethra, excluding the installation of the urethral catheter along an unnatural course. Also, after installing the urethral catheter in its natural course, it is possible to install a Foley catheter in the bladder and move it along the catheter as a guide. It is possible to cut the blunt end of the Foley catheter for better passage of the urethral catheter and ureteroscope, that is, the Foley catheter will be a tube without plugs on both sides.

A rigid ureteroscope is inserted into the inner lumen of the Foley urethral catheter 5 mm further than the projection of the cuff, after which the blunt end of the Foley urethral catheter is cut off with scissors and the rigid ureteroscope is advanced 3 mm. This allows the urethral catheter to be guided through the urethra under video endoscopic guidance.

Example. Patient K, 63 years old. Complaints upon admission to a sharp difficulty in urinating. Considers himself ill for 2 weeks, when urination has become sharply difficult, urine stream - about 1 mm in diameter. History 1 year ago performed transurethral resection of the prostate gland for benign prostatic hyperplasia. The patient underwent clinical and laboratory examination. Revealed 450 ml of residual urine, the volume of the prostate gland - 16 ml. When trying to install a Foley urethral catheter, it was unsuccessful; Nelaton's catheter and metal catheter were also not inserted. When trying to bougie the urethra, an insurmountable obstacle was encountered in the membranous part of the urethra. Ureteroscopy was performed with a rigid ureteroscope - a stricture was revealed in the membranous urethra with a length of 3-4 mm. Installed ureteral catheter No. 4. Next, an internal optical urethrotomy was performed and a resectoscope was held in the bladder. With endoscopic revision - no features. The resectoscope is removed, when trying to install a Foley urethral catheter - encounters an obstacle. Then the decision was made to install a Foley catheter under video endoscopic control. The rigid ureteroscope is inserted into the inner lumen of the Foley urethral catheter 5 mm further than the projection of the cuff, after which the blunt end of the Foley urethral catheter is cut with scissors and the rigid ureteroscope is advanced 3 mm. This made it possible to pass the Foley urethral catheter # 20 through the urethra without hindrance. On the 10th day, the urethral catheter was removed and the patient's natural urination was restored.

Every 3 months the patient was examined - an ultrasound examination of residual urine was performed. Within 4 years, no relapse was detected, no complaints.

This method treated 29 patients with the structure of the urethra and 32 patients with acute urinary retention due to benign prostatic hyperplasia.

Implementation of the invention

To implement this method, it is possible to use any known types of medical equipment.

Sources of information:

1. "Textbook on urology for students" edited by N.А. Lopatkina - 1995

2. Weinberg ZS "Clinical urology for a polyclinic doctor". - M., 2000.

3. N.A. "Guide to Urology". - M., 1998, volume 1-3.

4.2629788 RU

Claims (3)

1. A method of minimally traumatic installation of a urethral catheter in the urethra under video endoscopic control by introducing a urethral catheter and a rigid ureteroscope into the internal lumen of a Foley urethral catheter inserted into the urethra, characterized in that when a narrowing of the urethra is detected by means of an inflatable balloon, the narrowed Foley catheter expands and further direction of movement of the urethral catheter along the natural course of the urethra. 2. The method according to claim 1, characterized in that the urethral catheter installed in the urethra moves along the urethra under video endoscopic control. 3. The method according to claim 1, characterized in that when the rigid ureteroscope is inserted into the internal lumen of the Foley urethral catheter 5 mm further than the cuff projection, the blunt end of the Foley urethral catheter is cut with scissors and the rigid ureteroscope is advanced 3 mm.