Cystostomy Tube Research Articles

Unitary Drainage Bag

A urinary bag in which the collection bag is part of a panel that hangs from a belt around the patient's waist avoids local irritation of the thigh and embarrassment of the superficial venous circulation. The bag can be used with nephrostomy and cystostomy tubes as well as urethral catheters.

Graft reconstruction to treat disease of the abdominal aorta in patients with colostomies, ileostomies, and abdominal wall urinary stomata

Abdominal aortic reconstruction combined with colon or urinary tract operations is generally not acceptable because of a supposed greater incidence of graft infection. Similar fears exist regarding aortic reconstruction in the presence of colostomies, ileostomies, and permanent urinary diversion stomata. In fact, the presence of a colostomy has been reported to be a contraindication for abdominal aortic reconstruction. This report is concerned with vascular operations in 13 such patients with aortic disease referred to us for fear of these complications. Eleven patients had abdominal aortic aneurysms and two had atherosclerotic occlusion of the aorta and iliac arteries. Twelve patients had colostomies, ileostomies, or both and one patient had permanent tube cystostomy. All had good renal function and the disease for which the diversion procedure was performed was either cured or under good control. All patients survived the vascular reconstructive procedures without significant complications and long-term follow-up revealed that late graft infection did not occur.

Graft reconstruction to treat disease of the abdominal aorta in patients with colostomies, ileostomies, and abdominal wall urinary stomata

Abdominal aortic reconstruction combined with colon or urinary tract operations is generally not acceptable because of a supposed greater incidence of graft infection. Similar fears exist regarding aortic reconstruction in the presence of colostomies, ileostomies, and permanent urinary diversion stomata. In fact, the presence of a colostomy has been reported to be a contraindication for abdominal aortic reconstruction. This report is concerned with vascular operations in 13 such patients with aortic disease referred to us for fear of these complications. Eleven patients had abdominal aortic aneurysms and two had atherosclerotic occlusion of the aorta and iliac arteries. Twelve patients had colostomies, ileostomies, or both and one patient had permanent tube cystostomy. All had good renal function and the disease for which the diversion procedure was performed was either cured or under good control. All patients survived the vascular reconstructive procedures without significant complications and long-term follow-up revealed that late graft infection did not occur.

Closure of the bladder Neck in Spinal Cord Injury Patients with Urethral Sphincteric Incompetence and Irreparable Urethral Pathological Conditions

Total urinary incontinence developed secondary to incompetence of the urethral closing mechanism in 8 spinal cord injury patients who were on Foley catheter drainage (5 patients) or suprapubic cystostomy (3 patients). All patients had irreparable urethrocutaneous fistulas and 4 had urethroperineal erosion. Closure of the bladder neck with drainage via a suprapubic cystostomy tube was used to divert the urinary stream. Bladder neck closure was successful in alleviating total urethral urinary incontinence in all patients. However, suprapubic abdominal leakage developed in 2 patients. This procedure should be recommended cautiously when a maximal bladder capacity greater than 125 cc cannot be maintained unless concomitant augmentation cystoplasty also is considered.

Penile Arteriography in Impotence After Pelvic Trauma

A patient who was impotent following pelvic trauma was evaluated by penile arteriography. The study revealed bilateral disruption of the internal pudendal artery at the level of the urogenital diaphragm. It is concluded that impotence in this case is vasculogenic, although it is not possible to eliminate conclusively the possibility of neurogenic factors. Evaluation of more patients with this new technique of penile arteriography is necessary to establish the frequency of vasculogenic impotence in pelvic trauma.A review of the current literature revealed that impotence is approximately 10 times more common after conventional retropubic urethral realignment for acute prostatomembranous disruption compared to treatment by cystostomy tube alone. Analysis of the pertinent neurovascular anatomy suggests that when impotence is caused by surgical dissection of the periprostatic region the pathogenesis probably is neurogenic because of injury to the prostatic plexus and/or cavernous nerves, and it may be irreversible.

The mutagenic activity of anti-cancer drugs and the urine of rats given these drugs

Twenty-one anti-cancer drugs have been tested for their ability to cause mutations in Salmonella typhimurium test strains in the Salmonella/microsome mutagenicity test. Nine of the 21 anticancer drugs showed this ability: cyclophosphmide, nitromin, thio-tepa, busulfan, 6-mercaptopurine, neocarzinostatin, daunomycin, adriamycin and estramustine phosphate. Seven of these 9 mutagenic drugs were injected continuously into the jugular veins of rats. Urine was collected through a cystostomy tube and tested for mutagenicity. The urine from rats treated with 6 of these 7 drugs was mutagenic. These were cyclophosphamide, nitromin, thio-tepa, neocarzinostatin, adriamycin and daunomycin.

Reconstruction of previously diverted urinary tracts in children

HE PAST DECADE has seen increased effort directed toward repair of the urinary tracts of children with severe obstructed uropathy. 1-7 Such repair has proved successful in most instances despite the complexity of these problems and the difficulty of the surgery. Many youngsters however, have had some type of urinary diversion in the past before current techniques were developed, or more recently in the belief that their renal function was too much reduced to prevent any approach except permanent diversion. Diversion methods have included ileal conduit, cutaneous vesicostomy, cutaneous ureterostomy, suprapubic tube cystostomy, and tube nephrostomy. Long-term follow-up of such children has been dismal in some cases. Although there may be initial improvement, all too often it is followed by gradual deterioration from continuing low-grade infection, s Improved results in various pediatric obstructive uropathies have prompted us to attempt reconstruction of certain children who had been previously diverted. This paper will describe an experience with undiversion of the urinary tract in ten children with the following types of drainage: ileal loop in three (for 6, 6, and 5 yr); suprapubic cystostomy in three (for 6, 3, and 2 yr); nephrostomy in two (for 10 and 9 yr); ureterostomy in one (for 9 yr); and both nephrostomy and cystostomy in one (for 16 yr).

Use of suprapubic cystostomy tube: Helpful adjunct to transurethral resection of prostate

The use of a suprapubic cystostomy tube is a helpful adjunct to transurethral resection of the prostate. After using the tube in more than 200 transurethral resections of the prostate, the authors believe that it is an easily performed and safe procedure. It promotes greater and uninterrupted visibility by keeping the bladder partially decompressed. The advantages and disadvantages of the suprapubic cystostomy tube are discussed.

Severe cyclophosphamide hemorrhagic cystitis controlled with phenol

Cyclophosphamide (cytoxan) is an alkylating agent used extensively in the chemotherapy of leukemia, lymphomas, and selected solid tumors. Experimentally, cyclophosphamide is currently used for the treatment of steroid-resistant nephrosis in children. The drug is inert as administered orally or systemically but is metabolized to form a potent cytotoxic agent that is excreted in the urine. Adverse reactions include leukopenia, anorexia, nausea, vomiting, alopecia, vesical fibrosis, and sterile hemorrhagic cystitis. It is this last complication that may reach such severe proportions that hemorrhage cannot be controlled by conventional means. The usual cyclophosphamide cystitis is characterized by dysuria, urgency, and gross or microscopic hematuria. Approximately 7% of patients undergoing cyclophosphamide therapy develop this complication. 1,2 Cystoscopically, the bladder appears edematous and hyperemic, with multiple punctate hemorrhagic areas. Histologically, telangiectasia of subepithelial blood vessels can be found. In the great majority of cases a spontaneous remission of the hemorrhage will result with cessation of the drug and forced hydration, 3–8 but occasionally more aggressive measures must be taken to control the bleeding. Local fulgeration with the resectoscope or ball-tip electrode is usually unsuccessful, probably due to the further local mucosal breakdown with the fulgerating current. Suprapubic placement of a cystostomy tube will make irrigations more effective. Bilateral ureteral catheterizations or nephrostomies may be used to divert the cytotoxic urine. Division of the hypogastric vessels is ineffective. Unfortunately, urinary diversion into an ileal conduit may be the only means of control for this severe complication. 9–11

A study on electro-stimulation of the bladder

The development of new therapeutic procedures has improved the prognosis for the paraplegic patients with spinal cord injuries, but in a number of cases the use of a urethral catheter remains necessary, Catheterisation increases the risk of recurrent infection, which provokes the development of vesicoureteral reflux, leading to an involvement of the upper urinary tract and renal function.In the last several years, studies on wireless stimulation of the detrusor muscle of neurogenic bladder in an attempt to evacuate its contents has been reported by Bradley, Boyce, Kantrowitz and others, but there are many discrepancies in the results among the investigators.Thus, the writer studied basic problems in an attempt to improve the application of this procedure to paraplegic patients.In the present study fifty mongrel dogs were used. Through a lower abdominal midline incision, the lateral vesical spaces and pelvic nerves were exposed transperitoneally and a pair of electrodes were implanted in the detrusor muscle or hooked to the nerves. In short-term experiments oval disk copper electrodes and in long-term experiments stainless steel wire electrodes were used. The electrodes were connected directly with wires to the output terminals of an electronic stimulator (Nihonkoden) and a train of monophasic square waves was applied. The stimulating current and tissue impedance were observed throughout the experiment by an oscillograph. The effect of stimulation was evaluated by a rise of intravesical pressure meassured through a cystostomy tube with a strain gauge type transducer and a carrier amplifier.To obtain a neurogenic bladder we transected the spinal cord of dog at various levels under deep ether anesthesia. For wireless stimulation an external oscillator and an internal receiver with a pair of stimulating electrodes were adopted. The external oscillator produces 200KC carrier waves which are modulated with LF square waves. The receiver buried in the subcutaneous tissue in the lower abdomen receives and rectifies the waves and sends the square waves to the electrodes sutured into the detrusor.I. Wired experimentsA. Preliminary experimentsParameters of the stimulating current to be adopted in the wireless stimulation were explored. Since deeper anesthesia showed poor response, the dogs were kept in constant light anesthesia by intravenous pentothal. In repeating the stimulation, intervals exceeding five minutes were maintained since too short intervals between each stimulation produced a gradual lowering in response. The volume of intravesical content widely influenced the height of response and it was found important to maintain the intravesical content constant throughout an experiment. A pair of electrodes were implanted at venous points in the detrusor muscle, and it was found that at points near the ureterovesical junction the highest intravesical pressure was obtained. Use of more than one pair of electrodes did not show any better effect.A higher voltage of stimulating current produced a larger contraction of the detrusor in a range of less than 32V. When the voltage and frequency of pulses was kept constant, the longer duration of one pulse produced a higher effect. When the voltage and product of frequency and duration of a pulse was fixed, the most effective frequency of pulses was 20-50cps.B. Experiments on dogs with spinal cord lesionIn experiments on dogs with upper motor neuron lesions (acute and chronic) the voltage required to produce a satisfactory rise of intravesical pressure was 5-15V (impedance ca. 300ohm) by detrusor stimulation and only 3V(impedance ca. 700ohm) by pelvic nerve stimulation.In experiments on the dogs with lower motor neuron lesions, the reactibility of the bladder at the acute stadium was nearly the same as that of the dog with upper motor lesion, but it became lower day by day. Several weeks later the lowest values were seen and intravesical pressure s

U-Tube Nephrostomy

No AccessJournal of Urology1 Feb 1967U-Tube Nephrostomy Henry M. Weyrauch and Stephen N. Rous Henry M. WeyrauchHenry M. Weyrauch More articles by this author and Stephen N. RousStephen N. Rous More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)63017-9AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1967 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byCrawford E and Borden T (2018) New Instrument for Placement of Circle Tube NephrostomyJournal of Urology, VOL. 124, NO. 3, (324-325), Online publication date: 1-Sep-1980.Lyon E (2018) Editorial CommentJournal of Urology, VOL. 124, NO. 3, (325-325), Online publication date: 1-Sep-1980.Redman J and Bissada N (2018) Circle Tube Cystostomy DrainageJournal of Urology, VOL. 118, NO. 3, (390-390), Online publication date: 1-Sep-1977.Finney R and Sharpe J (2018) Self-Retaining Loop NephrostomyJournal of Urology, VOL. 117, NO. 5, (638-640), Online publication date: 1-May-1977.Gillenwater J (2018) Loop Nephrostomy with the Cummings CatheterJournal of Urology, VOL. 117, NO. 5, (641-642), Online publication date: 1-May-1977.Hawtrey C, Boatman D, Brown R and Schmidt J (2018) Clinical Experience with Loop Nephrostomy for Urinary DiversionJournal of Urology, VOL. 112, NO. 1, (36-41), Online publication date: 1-Jul-1974.Levine R (2018) A Technique For Reinsertion of the Displaced Nephrostomy TubeJournal of Urology, VOL. 112, NO. 3, (393-393), Online publication date: 1-Sep-1974.Binder C, Gonick P and Ciavarra V (2018) Experience with Silastic U-Tube NephrostomyJournal of Urology, VOL. 106, NO. 4, (499-502), Online publication date: 1-Oct-1971.Lyon E, Ellis J, Borden T, Fried F, Gill W and Wong R (2018) Favorable Experience with Silicone Circle Ureterostomy Tube DiversionJournal of Urology, VOL. 104, NO. 6, (821-823), Online publication date: 1-Dec-1970. Volume 97Issue 2February 1967Page: 225-227 Advertisement Copyright & Permissions© 1967 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Henry M. Weyrauch More articles by this author Stephen N. Rous More articles by this author Expand All Advertisement PDF downloadLoading ...