Duration Of Indwelling Catheter Research Articles

Curative effects of anatomic reconstruction of periurethral structure in robotic assisted laparoscopic radical prostatectomy

Objective To investigate the outcome of patients underwent anatomic periurethral reconstruction during robotic assisted laparoscopic radical prostatectomy (RARP). Methods During August 2016 to May 2018, anatomic periurethral reconstruction was performed during RARP in 58 consecutive patients. The control group consists of another 50 patients had no anatomic periurethral reconstruction procedure during RARP.Perioperative data of these patients were collected retrospectively, including operation time, anastomosis timeintraoperative blood loss, duration of indwelling catheter, length of hospital stay, complications, postoperative pathology, and continence outcome at 1, 3, 6, 12 months after surgery. Results All cases were successfully performed without conversion to open or laparoscopic surgery. There were no major intraoperative or postoperative complications. Operative time and anastomosis time was (145.3±12.3)mins and (31.6±8.2)mins in reconstruction group comparing to (122.4±11.4)mins and (21.2±4.4) in control group (both P 0.05). Postoperative pathology confirmed 53 T2a-T2b diseases and 5 pT2c diseases in reconstruction group, in comparison with 46 T2a-T2b and 4 pT2c diseases in non-reconstruction group (P>0.05). There were 19 and 15 cases with a final Gleason score of 6, 30 and 27 cases with Gleason 7, 9 and 10 cases with Gleason 8, in reconstruction group and non-reconstruction group respectively(all P>0.05). There was no significant difference between the two groups regarding incidence of positive surgical margins (3 in reconstruction group and 2 in control group, P>0.05). The percentage of patients maintain continence in reconstruction group and non-reconstruction group: at 1 month [84.5%(49/58)and 70.0%(35/50)], at 3 months [89.7%(52/58)and 78.0%(39/50)], at 6 months [91.3%(53/58)and 86.0%(43/50)] and 1 year after surgery [100.0%(58/58)and 96.0%(48/50)]. Reconstruction group showed better continence outcome at 1 and 3 month (P 0.05). Conclusion Anatomic reconstruction of periurethral structure during RARP is safe and feasible with reduced duration of indwelling catheter and better continence outcome. Key words: Robotic assisted laparoscopic surgery; Radical prostatectomy; Incontinence; Enhanced recovery after surgery

Effect of indwelling catheter after abdominal total hysterectomy by neostigmine injection in the acupuncture point of san yin chiao

Objective To investigate the duration of indwelling catheter and prevention of urinary retention in patients who used PCEA after abdominal total hysterectomy through neostigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area. Methods 200 patients who used PCEA after abdominal total hysterectomy were randomly divided into the experimental group and the control group, each group had 100 cases. Patients in experimental group received neostigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area, patients in control group received vitamin C injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area, and removed the catheter after intervention. The time to voluntary micturition was observed, the residual urine volume was measured, prevention of urinary retention and the side effect were explored. Results The time to voluntary micturition in experimental group was shorter than in control group, there was statistically significant difference( x2 =43.8,P ＜ 0. 01 ); the effective rate of urinary retention prevention in experimental group was 98%, and it was better than in control group which was 61%. There was statistically significant difference( x2 = 41.7 ,P ＜0. 01 ). No bradycardia case, no respiration inhibition case and no hypotension case in the two groups.Conclusions Necstigmine injecting in the acupuncture point of san yin chiao associated with thermo massage on vesical area can shorten the duration of indwelling catheter in patients who used PCEA after abdominal total hysterectomy and it can prevent the incidence of urinary retention. Key words: Hysterectomy; Analgesia, epidural; Urinary Retention; Neostigmine; Nursing; Acupuncture point injection

Research about the changing time of anti-reflux drainage bag

Objective To study the appropriate changing frequency of urinary drainage bag for patients with indwelling catheters using anti-reflux drainage bag in urological surgical department. Methods Of 78 in-patients with indwelling catheters using anti-reflux drainage bags 40 patients were selected randomly as the experimental group with no bag change,38 patients as the control group with bag change every day.Bloody urine samples were obtained from each drainage bag for germicuhure ev-ery day. Results Under situations of no difference existed in general information, duration of in-dwelling catheters,volume of drinking and urine and times of opening valve,the positive rate of urine germiculture was 7.5% and 10.5%( P>0.05 ),the incidence of symptomatic urinary tract infection (U-TI) was 2.5% and 2.6% in the experimental group and the control group (P>0.05). Conclusions There is no evidence for the necessity of anti-reflux drainage bag change every day for patients with in-dwelling catheters and bloody urine after operation in the urological surgical department. However the appropriate frequency of urinary drainage bag change needs additional study. Key words: Anti-reflux drainage bag; Changing time; Clinical research