Postoperative Catheter Drainage Research Articles

Postoperative care following internal urethrotomy

A randomized prospective study was set up to assess the role of postoperative catheter drainage and the value of hydraulic self-dilatation of the urethra after internal urethrotomy. Sixty-two patients were admitted into the study and followed-up for two years. The results support the use of a no-catheter posturethrotomy management and advocate the encouragement of postoperative hydraulic self-urethral dilatation.

Cost-effective treatment of female stress urinary incontinence: Modified pereyra bladder neck suspension

We herein report on the cost effectiveness of the modified Pereyra bladder neck suspension (MPBNS) compared with the Marshall-Marchetti-Krantz (MMK) retropubic suspension procedure. A total of 82 cases was reviewed retrospectively. The MPBNS was found to provide a 41 per cent cost savings with significantly shorter duration of intravenous fluid administration, shorter duration of postoperative indwelling catheter drainage, shorter operative time, and significantly shorter postoperative hospitalization. Early postoperative intermittent catheterization was a major factor in facilitating early discharge after MPBNS.

The Treatment of Urethral Stricture Disease by Internal Urethrotomy: A Clinical Review

The results of internal urethrotomy with 6 weeks of postoperative catheter drainage and antimicrobial therapy in the treatment of urethral strictures in 28 patients are presented. Satisfactory results were obtained in 68 per cent of the patients. Because of the simplicity of this technique and the good results obtained we believe that internal urethrotomy often is the best initial approach to strictures that become difficult to manage by periodic dilation.

Bladder dysfunction after Schauta hysterectomy: One-year follow-up

The purpose of this study was to determine the long-term effect of Schauta hysterectomy on bladder function as determined by serial cystometric studies. The maximum bladder capacity, resting pressure at maximum capacity, and volume of residual urine were determined preoperatively, postoperatively, at time of final catheter removal, and one or more years after surgery. A prior report showing that the bladder decreased in capacity, increased in tone, and, emptied poorly if at all postoperatively was confirmed. The mean duration of postoperative catheter drainage in 68 patients was 33 days. One year or more after surgery the mean maximum bladder capacity had returned to the preoperative volume; persistent elevation of the mean resting pressure was significant in the pooled but not in the paired data; the mean residual urine volume of 25 ml. was significantly elevated. The assumption was that maintenance of intrinsic detrusor muscle tone by prevention of overdistention preserved balanced bladder function. Many patients initiated and maintained micturition by voluntary straining or by use of Crede's maneuver although others voided relatively normally. Presumably these bladders are denervated to varying degrees, producing a spectrum of functional disturbance. The "bladder-conscious" patient can protect and preserve bladder function but these bladders appear to remain vulnerable to infection and overdistention, perhaps permanently.

MANAGEMENT OF URINARY-VAGINAL FISTULA; TEN-YEAR SURVEY.

Two hundred sixty-two patients with urinary-vaginal fistulas were operated on at the Mayo Clinic during 1951 through 1960. A review of these cases indicates that complete investigation of the urinary tract should precede repair, since these abnormal communications appear in many varieties and may be multiple. Anatomic as well as etiologic considerations are important in diagnosis. The abdominal hysterectomy immediately preceded formation of fistula in 153 cases. Preventive measures are discussed. After complete preoperative evaluation of the patient, repair may be effected utilizing two major principles: (1) preservation of blood supply and (2) accurate tissue approximation. Unobstructed postoperative urinary catheter drainage is of primary importance. In the present series, successful surgical correction of vaginal-urinary fistula was affected at first attempt in 88.2% of cases; after reoperations on some, the eventual success was 95.0%.