Male Urethral Catheterization Research Articles

Prospective assessment of management of male urethral catheterisation problems in a tertiary centre

Prospective assessment of management of male urethral catheterisation problems in a tertiary centre

Efficacy and Safety of Oxybuprocaine Hydrochloride Gel in Alleviating Pain during Male Urethral Catheterization: A Single-Center Randomized Controlled Study.

Background The purpose of this study was to determine whether oxybuprocaine hydrochloride gel could alleviate pain during male catheterization. Methods Between September 2021 and March 2022, a randomized controlled trial was conducted at the Urology Department of Harbin Medical University Cancer Hospital (China). A total of 192 adult male patients requiring catheterization were enrolled and randomly assigned to one of two groups: 96 in the test group and 96 in the control group. The test group included patients who received oxybuprocaine hydrochloride gel as urethral lubricant, while patients in the control group received liquid paraffin. The preoperative and postoperative pain scores were compared using nonparametric tests. Results At the baseline, there was no significant difference between the two groups. There was no significant difference in preoperative pain scores between the test group (mean ± SD = 20.04 ± 2.68 mm) and the control group (mean ± SD = 20.21 ± 3.23 mm) (p=0.694). Postoperative pain scores increased significantly in the test (mean ± SD = 31.98 ± 2.57 mm, p < 0.001) and control groups (mean ± SD = 38.96 ± 2.02 mm, p < 0.001) groups. Postoperative pain scores were significantly lower in the test group (mean ± SD = 31.98 ± 2.57 mm) than those in the control group (mean ± SD = 38.96 ± 2.02 mm (p < 0.001). Conclusions The use of oxybuprocaine hydrochloride gel significantly reduced pain during male urethral catheterization. The study provides evidence for clinicians to use oxybuprocaine hydrochloride gel during male catheterization.

Clinical audit on indications and technique of male urethral catheterization in emergency department of a tertiary care hospital

Urethral catheterization (UC) is a common procedure done in the Emergency Department of a hospital. The main indications for a UC are relieving acute urinary retention and bladder outlet obstruction. This cross-sectional audit was carried out between July 2019 to February 2020, in the Emergency Department (ED). All male patients aged 18 years and above, in whom UC was performed, were included in the audit. A total of 81 male patients were surveyed. Although, sterilized technique was maintained by using sterile gloves and pyodine but hand hygiene (sterilization or hand wash) was not performed before the procedure 80% of times. CDC hand hygiene guidelines were distributed to promote hand hygiene.What do we already know about this topic ? The Lippincott guidelines are considered gold standard which includes hand hygiene as an important element of urinary catheterization UC. The CDC Center of Disease Control CDC promotes the use of mandatory gloves and generous hand sanitizing before procedures.How does your research contribute to the field For continuous improvement and patient focused practice, we must audit the technique of nursing staff, doctors and health care assistants who are involved in insertion and ordering of catheters to provide quality health care and avoid unnecessary catheterization [1]. The aim of this study was to audit the appropriateness of usage of urinary catheters by the healthcare staff and, their technique of insertion and indications for urinary catheterization.What are your research's implications towards theory, practice, or policy? Hand hygiene is an important element of patient care. If done properly it can prevent several hospital-acquired infections. Heathcare facilities must audit their staff on regular basis and provide refreshers and promote the use of proper hand hygiene before urinary catheterization.

Urethral Catheterization: A Review of the Indications, Techniques, and Complications of Male Urethral Catheterization for General Medical Practice

The physiologic process of micturition plays an essential role in the ability of the human body to regulate homeostasis. When the urinary system encounters an obstruction such as a foreign body within the bladder or other prostatic diseases like benign prostatic hyperplasia (BPH), alternative measures to drain the bladder is required, this birthed the use of urethral catheters &amp; the catheterization procedure. Urethral catheterization dates to the early days of medicine and while it is mostly a routine procedure in this era, the total understanding of its indications, proper techniques, and associated complications remains an essential tool in the arsenal of a practicing physician.

Deficits in urological knowledge and skills among family medicine residents in Canada.

The last 10-15 years has seen a decline in formal undergraduate urological education throughout Canada. Given the large volume of urological presentations in family practice, trainees need to acquire the requisite urological knowledge and skills to serve their patients. The objective of this study is to determine the perceived level of urological knowledge and skills among Canadian family medicine residents. A 15-item, anonymous, online survey was distributed via email to all Canadian family medicine program directors from September to December 2018 and distributed to their residents. The survey obtained data on demographics, training, undergraduate urology experience, self-reported proficiency in interpreting urological investigations, performing common urological procedures, and managing common urological conditions. Descriptive statistics were used to summarize data. The questionnaire was completed by 142 family medicine residents with representation from Western Canada (27.5%), Ontario (32.4%), and Quebec (40.1%); 39.4% of respondents had completed a urology rotation during medical school and only 29.1% felt that their medical training prepared them for the urological aspects of family medicine. Although the majority of respondents felt proficient in performing a digital rectal examination (58.5%) or managing urinary tract infections (97.9%), only a minority felt competent in performing male genitourinary examination (40.1%), uncomplicated male (34.5%), female (45.8%) or difficult (9.2%) urethral catheterization. Likewise, the minority of respondents felt comfortable managing erectile dysfunction (41.5%), scrotal swelling (34.7%), and scrotal pain (25.7%). There are significant deficiencies in urological knowledge and skills among family medicine residents in Canada, possibly because of insufficient educational experiences during medical training.

Comparative study of wire-integrated urethral catheter versus wire-assisted urethral catheter in difficult male urethral catheterization: a single-center experience.

This study reports the clinical experience of the wire-integrated urethral catheter (WIUC) versus wire-assisted urethral catheter (WAUC) in difficult male urethral catheterization. The clinical data of 116 male patients undergoing urinary catheterization with WIUC or WAUC after a failed attempt catheterization in Southwest Hospital from June 2018 to June 2019 were retrospectively analyzed. The time spent during urinary catheterization, cost of consumables, experience rating of catheterization methods and materials assessed by medical staff were compared between WIUC group (n=58) and WAUC group (n=58). The catheterization succeeded in all 116 patients. The time spent of urinary catheterization was (4.0±1.6) min in WIUC group and (15.4±3.3) min in WAUC group, and the cost of consumables was￥400 in WIUC group and￥706.2 in WAUC group. The medical staff's experience rating results were 9.0±0.8 vs. 7.8±0.7 for the catheterization method and 9.3±0.8 vs. 8.0±0.7 for the materials, respectively, in the WIUC group and WAUC group. WIUC is reasonably designed and easy to operate and can be used for a variety of clinical situations.

1147 - Assessment of acute male urethral catheterisation problems in a tertiary centre and usefulness of a new catheterisation protocol using portable flexible cystoscopy with disposable sterile sheets

1147 - Assessment of acute male urethral catheterisation problems in a tertiary centre and usefulness of a new catheterisation protocol using portable flexible cystoscopy with disposable sterile sheets

A new urethral catheterisation device (UCD) to manage difficult urethral catheterisation

The cost of urethral catheterisation injury (UCI) is significant, but the true incidence of patient care error is difficult to establish in the absence of specific hospital codes recording difficult urethral catheterisation (DUC) and UCI. For many years urologists are familiar passing a non-traumatic hydrophilic guidewire blindly into the bladder to aid urethral catheter insertion in difficult circumstances. However, so far, no purpose-built regulated medical device was available on the market and clinicians had to improvise. Urethrotech filled that gap and developed the Urethral Catheterisation Device (UCD®), which integrates a standard hydrophilic Nitinol guidewire into a 3-way 16F Silicone urethral catheter design to enable safe second-line urethral catheterisation when first-line catheterisation with a standard urethral catheter is unsuccessful. The safety and efficacy of UCD® catheterisation were evaluated in consecutive cohorts of men undergoing cardiac surgery and compared to the incidence of DUC and UCI with standard Foley catheterisation. A simple new Male Catheterisation Algorithm is proposed that can deliver a safe male urethral catheterisation treatment protocol for all clinical settings of healthcare services, which is easy to implement and integrate into standard catheterisation training programs to manage DUC and avoid UCI, empowering a frontline workforce to deliver better patient care.

Tips and Tricks for Difficult Urethral Catheterization

Male urethral catheterization may be difficult in patients with enlarged prostate glands or other potentially obstructive conditions as urethral stenosis, after prostatic TUR undermining bladder neck, old and recent false passages, sphincteric spasm among others. Alternative techniques or tricks to surpass problematic urinary catheterization are usually known by experienced nurses and physicians. If repeated catheterization attempts are done, the risk of failing and complications appearing increase significantly. Improper insertion of catheters also may increase healthcare costs due to prolonged hospitalization, immediate and/or delayed surgical interventions transforming a minor technique into a huge problem for the patient, doctors, and healthcare system. Improved techniques for catheter placement are essential for all healthcare personnel involved in the management of the patient needing a urethral catheterization, including nurses and doctors from both primary and hospital medicine. The aim of this article is to show some tips and tricks that may be helpful for the blind placement of urethral catheters. The phrase primum non nocere acquires its maximum meaning in this context. Sanitary personal must be prudent in the number of attempts, have a clear strategy of what can be done in each moment and know how to stop or seek help in case of not being able to probe the patient in 2 or 3 attempts. If all these recommendations fail a urologist have to be required to place a catheter in a safe way including the use of endoscopic optic devices

MP51-09 THE “PENANA”: A NOVEL, COST EFFECTIVE, AND HIGHLY EFFICACIOUS MODEL FOR TEACHING MALE URETHRAL ANATOMY AND SAFE FOLEY CATHETER TECHNIQUE

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment I1 Apr 2017MP51-09 THE “PENANA”: A NOVEL, COST EFFECTIVE, AND HIGHLY EFFICACIOUS MODEL FOR TEACHING MALE URETHRAL ANATOMY AND SAFE FOLEY CATHETER TECHNIQUE Matthew Truesdale, Maya Overland, Christy Boscardin, and Kirsten Greene Matthew TruesdaleMatthew Truesdale More articles by this author , Maya OverlandMaya Overland More articles by this author , Christy BoscardinChristy Boscardin More articles by this author , and Kirsten GreeneKirsten Greene More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.1618AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Iatrogenic urethral catheter related injuries are common and have been shown to correlate with inadequate training among medical professionals. Urethral catheterization (UC) is a common procedure and often one of the first attempted by medical trainees. Simulation training enhances medical procedure teaching by decreasing trainee anxiety, improving patient safety and efficiently tailoring the experience for the learners, thus optimizing education. We sought to create an efficacious simulation model to teach medical students and residents male UC. METHODS We developed a 50-minute educational curriculum utilizing didactic presentation and a banana with ends removed and longitudinal core created as a simulation model for the male urethra (″Penana″). The presentation focused on UC indications, male urethral anatomy, structure of standard and Coude catheters, and safe technique for UC. Procedural teaching utilized modified Payton technique; 1) Expert demonstration, 2) Explanation of steps, 3) Expert-guided Learner performance, 4) Learner-guided learner performance, 5) Independent Learner performance. Subjects completed pre and post intervention survey assessments to determine efficacy. Surveys measured learner knowledge and self-reported confidence at performing male UC. RESULTS 126 learners participated in the workshop and (29 MS1, 40 MS2, and 60 PGY1) completed pre and post assessments. Prior to intervention, among medical students 36% and 1% had observed UC and 6% and 0% had performed UC using standard Foley and Coude, respectively. Following intervention, combined knowledge scores increased from 13±16% to 85±20% correct. On a 10 point scale, learners self reported confidence increased from 3.3±2.1 to 8.2±1.5 for male urethral anatomy, 1.7±1.4 to 7.9±1.6 for standard Foley UC, and 1.2±0.6 to 7.8±1.9 for Coude UC. On a 10 point scale with 10 representing very helpful, learners described the Penana model with a mean value of 8.6±1.9. Finally, 78% and 20% were extremely likely and likely, respectively, to recommend the course to a friend. CONCLUSIONS The Penana is a highly efficacious simulation model for teaching medical students and residents safe UC technique. The low cost and universal availability of the materials makes the model easily accessible for any resource-limited education setting. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e697 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Matthew Truesdale More articles by this author Maya Overland More articles by this author Christy Boscardin More articles by this author Kirsten Greene More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Semiotics and semiology of Nursing: evaluation of undergraduate students' knowledge on procedures.

to assess the knowledge of scholars on Nursing regarding simple hands hygiene (SHH), blood pressure measurement (BP), peripheral venipuncture (PV) with venous catheter and male urethral catheterization delay (UCD) procedures. quantitative study carried out between February and May 2014, with 186 undergraduate Nursing students from 5th to 9th period of a public university of Rio Grande do Norte, with application of four questionnaires. One carried out descriptive and analytic analysis. the students presented low average percentage of right answers, especially in blood pressure measurement (55.5%); SHH's average was higher than 70%. The average of correct answers was the highest in SHH (8.6), followed by UCD (7.8), PV (7.4) and BP (6.7). The questions regarding the topic "concepts" showed less correct answers when comparing it to the topic "technique steps". it is necessary to establish knowledge monitoring strategies, in order to stimulate the constant improvement.

YouTube as an educational tool regarding male urethral catheterization

Objective. Urethral catheterization (UC) is a common procedure carried out on a daily basis. The aims of this study were to assess the quality of YouTube as an educational tool regarding male UC and to assess the experience of newly qualified doctors regarding UC. Materials and methods. YouTube was searched for videos containing relevant information about male UC. A checklist for evaluating content for male UC was devised. The top-ranked video was shown to interns and they were questioned regarding their experience of UC and the usefulness of the video. Results. A total of 100 videos was screened and 49 unique videos were identified. The median length of video was 7 min 15 s (range 1 min 44 s to 26 min 44 s). Regarding the Safe Catheter Insertion Score, the mean score was 5.18 ± 1.64. 9 (18.4%) deemed useful, 24 (49%) somewhat useful and 16 (32.7%) not useful. There was no difference in the number of views (p = 0.487), duration of video (p = 0.364) or number of days online (p = 0.123) between those categorized as useful, somewhat useful and not useful. Twenty-six interns (89.7%) attended the UC teaching session. All reported the video to be a useful educational adjunct. Nine of the respondents (42.9%) had independently inserted a urinary catheter before the educational session. Conclusions. The quality of videos on YouTube regarding male UC is widely variable. Preselected videos are deemed useful by junior doctors regarding male UC and can be used as an educational adjunct before performing hands-on tasks.

Simulators help improve student confidence to acquire skills in urology

ObjectiveTo know the level of confidence of fifth-year medical students in order to perform maneuvers in bladder catheterization and rectal examination before and after training with simulators. To be able to assess student satisfaction regarding the use of the simulation as a learning method. Materials and methodsThe study was conducted in the Simulation Center of the Faculty of Medicine. A total of 173 students who completed a practical workshop on the subject of Urology participated. The students were asked to answer anonymous questionnaires on their level of confidence in performing a bladder catheterization and rectal examination before and after the workshop as well as their satisfaction in using the simulation as a training tool. The workshops were organized using groups of 10 students. A teacher or a resident in that area of expertise supervised each student individually, resolving their doubts and teaching them the proper technique. ResultsAll the evaluations made on the different abilities were significantly higher after training (p<.001). Significant differences were found in the confidence level between men and women before the training regarding male urethral catheterization maneuvers and recognition of normal or pathological prostate, The confidence level was lower in women (p<.05). These differences disappeared after training. The level of overall satisfaction with the workshop was high, going from 4.47±0.9 to a maximum score of 5. ConclusionsSimulation is a training method that helps improve the confidence of the medical student in performing a bladder catheterization and digital rectal examination.

Avoidable iatrogenic complications of male urethral catheterisation and inadequate intern training: A 4-year follow-up post implementation of an intern training programme

ObjectiveTo assess the impact of a structured training programme in urethral catheterisation (UC) targeted at newly qualified junior doctors on rates of iatrogenic catheter morbidity within a tertiary care referral centre. Subjects and methodsMale UC-related morbidities were retrospectively identified from our computerised inpatient urology consultation system over a 1-year period from July 2010 to June 2011. Relevant medical records were also reviewed. Results were compared with an initial study performed between July 2006 and June 2007, prior the introduction of a structured training programme in our institution. An anonymous questionnaire was used for the subjective assessment of interns about confidence in catheterising post introduction of the programme. ResultsOf 725 urological consultations, 29 (4%) were related to complications arising from male UC during the 1 year period. This reflected a statistically significant decrease when compared to our 2007 figures, 51/864 (6%) (p < 0.05). Again, the most common indication for UC was monitoring urinary output for acute medical illness (19/29, 66%). The most common complication was urethral trauma (16/29, 55%). Of the 29 cases of UC-related morbidity, 18 (62%) resulted from interns performing UC, a decrease of 12% from our original paper. A drop of 27% was seen in the rates of UC related morbidity attributable to interns during the first 6 months of internship (July–December). Overall, 70% (vs 40% original study) of interns felt that their practical training was adequate since introduction of the programme (p < 0.01) with 53% considering theoretical training adequate (vs 16% original study (p < 0.01). When asked were they confident in performing UC, 63% said they were compared to 35% before introduction of the programme (p < 0.05). ConclusionsUC-related iatrogenic morbidity is not uncommon even in a tertiary-care teaching hospital. Implementation of a structured training programme in UC prior to the commencement of intern year has been shown to result in a significant decrease in the amount of iatrogenic UC related morbidity.

Unusual complication of male urethral catheterization: intussusception of prepuce into urethral meatus

We present a patient who experienced urinary retention with a comorbid phimosis and redundant prepuce, most likely complications of diabetes mellitus. Additionally, we report a rare complication of difficult catheterization, where the prepuce intussuscepted into the urethral meatus. Attempts to change the catheter with poor visualization of the external meatus secondary to diabetic phimosis resulted in telescoping of the prepuce into the urethra. Circumcision and meatotomy of the external meatus alleviated the acute issue and prevented potential problems with future catheterizations.

La simulación mejora la confianza de los estudiantes para adquirir competencias en urología

ObjectiveTo know the level of confidence of fifth year medical students in order to perform maneuvers in bladder catheterization and rectal examination before and after training with simulators. To be able to assess student satisfaction regarding the use of the simulation as a learning method. Material and methodsThe study was conducted in the Simulation Center of the Faculty of Medicine. A total of 173 students who completed a practical workshop on the subject of Urology participated. The students were asked to answer anonymous questionnaires on their level of confidence in performing a bladder catheterization and rectal examination before and after the workshop as well as their satisfaction in using the simulation as a training tool. The workshops were organized using groups of 10 students. A teacher or a resident in that area of expertise supervised each student individually, resolving their doubts and teaching them the proper technique. ResultsAll the evaluations made on the different abilities were significantly higher after training (P<.001). Significant differences were found in the confidence level between men and women before the training regarding male urethral catheterization maneuvers and recognition of normal or pathological prostate, The confidence level was lower in women (P<.05). These differences disappeared after training. The level of overall satisfaction with the workshop was high, going from 4.47±0.9 to a maximum score of 5. ConclusionsSimulation is a training method that helps improve the confidence of the medical student in performing a bladder catheterization and digital rectal examination.

Digital rectal examination and urethral catheterization by medical students: comparative study

Background and objective: To determine the difference of acquired skills of how to perform Digital Rectal Examination and Urethral Catheterization, by medical students of two groups. Group (A) large group (traditional teaching group) and Group (B) small teaching group Methods: A questionnaire containing information related to digital rectal examination (DRE) and urethral catheterization was given to all year six medical students at College of Medicine, University of Sulaimanyia , in June 2004 and 2007, just before their fina examination. The questionnaire focused on the important points in relation to ways of teaching. Results: Responses to all given questions in the questionnaire from the two groups were different, 54% of students from traditional teaching group responded as oppose to 53% from small group . Up to 93% of traditional teaching group student were taught how to perform Digital Rectal Examination, while approximately 80% of students from small teaching group have been taught to do DRE. Only 23% of those among traditional teaching group have done more than 3 DRE, while that of small teaching group was only 8%. In both groups, their findings were uncommonly checked by senior doctor. In both groups nearly 80% of the students had never felt a clinically malignant prostate and nearly the same for rectal tumor. Students from traditional teaching group, who did Digital Rectal Examination, 22% of them were not sure about their ability to give an opinion based on their clinical findings, while 33% of the small teaching groups were unable to give opinion. Nearly 73% in traditional reaching group have been taught how to perform male urethral catheterization, while that of small teaching group was 78%. In traditional teaching group, only 23% have performed 2 and less male urethral catheterization on qualification while 44% in small teaching group. 39% of small teaching group were not confident at all to do male urethral catheterization, while that of traditional teaching group was 27% only. Conclusion: There was obvious similarity between the two groups regarding the lack of basic skill in conducting DRE, urethral catheterization. This was probably due lack of objectives in the teaching curriculum.

A Randomized Controlled Study to Compare the 2% Lignocaine and Aqueous Lubricating Gels for Female Urethral Catheterization

The 2% lignocaine gel has long been used for male urethral catheterization, but aqueous gel as lubricant has been used for females. However, studies report that females experience pain during urethral catheterization. We compared the effectiveness of 2% lignocaine gel (intervention) and aqueous gel (control) for female urethral catheterization in reducing procedural pain. A double-blinded, randomized controlled trial (RCT) was conducted from November 2011 to April 2012 in an acute care hospital in Singapore. In total, 52 adult female inpatients (26 interventions vs. 26 controls) requiring urethral catheterization were included in the study. The intervention included patients receiving 2% lignocaine gel as a lubricant for urethral catheterization. Patients' pre- and postprocedural visual analog scale (VAS) were collected prospectively and nonparametric tests were used for data analysis. There was a significant reduction from the preprocedure pain score (Median = 22.0 mm) to the postprocedural pain score (Median = 6.6 mm) in the 2% lignocaine group (Z = -3.8, P < 0.001), but not in the aqueous gel group (pre vs. post: 16.5 mm vs. 18.2 mm; Z = -0.36, P = 0.716). Subjects using 2% lignocaine gel had significantly more reduction in the postprocedural pain score than the aqueous gel group (U = 209.5, P = 0.019). The 2% lignocaine gel significantly reduces the procedural pain of female urethral catheterization as compared with aqueous gel. This study provides evidence for the hospital to change the current practice in the hope of reducing procedural pain for female patients during urethral catheterization.

Clinical skills series/3: urinary catheterisation

Urinary catheterisation is a common procedure performed in the majority of healthcare environments; it is deemed an intimate healthcare activity. There are a variety of reasons why a person may need to be catheterised. The healthcare assistant and assistant practitioner (HCA and AP) must demonstrate competence and confidence if they are required to undertake catheterisation along with catheter care. HCAs and APs are undertaking a range of care aspects associated with catheters; the HCA and AP must, however, ensure that they have been deemed competent to undertake any task and that the employer has permitted him or her to undertake the activity. An overview of the urinary system is provided and the guidelines required to perform male urethral catheterisation are discussed.

A Hard Mass Discovered in the Corpus Spongiosum after Difficult Urethral Catheterization: Two Case Reports

Male urethral catheterization is a common procedure rarely causing complications. Difficult urethral catheterization, however, can be problematic for both clinician and patient, leading to unexpected complications. This article will present two unreported cases of urethral trauma during difficult catheterization that resulted in the development of a hard, tumor-like mass in the corpus spongiosum. This is a rare complication that if not recognized might lead to unnecessary invasive interventions for the patient.