Urine Collection System Research Articles

Urine Sample Handling in Laboratory—Process Reengineering is the Need of the Hour

Background and Aims: Monitoring and a continual improvement of turnaround time (TAT) in urine examination and reporting is essential for improved management of laboratory quality as well as ensuring patient satisfaction. TAT can be impacted by multiple factors, some of which appear to be beyond the control of laboratory, especially the preanalytical phase of urine examination such as specimen collection, transportation and sample preparation. The aim of the study was to compare the preanalytical variables like TAT for transportation and incidences of spill between our current urinalysis workflow process and the new urinalysis workflow process using a pneumatic chute-compatible closed urine collection system. Materials and Methods: This observational prospective study was conducted on 4/9/23 from 9 am to 4 pm at the laboratory of Apollo Main Hospital, Chennai. Pneumatic chute compatible closed urine collection cup was given to the patients in Group-A and normal screw cap containers which we are currently using were given to the patients in Group-B. Once the urine samples were collected in the respective containers, they were transported to the laboratory using pneumatic chutes for Group-A samples and manual carry for Group-B samples. Analysis of transportation time using the new collection method (Group-A) when compared with the current method of practice (Group-B) was done. The incidence of spillage was also monitored. Results: A significant improvement was noticed in the transportation process and spill incidence with closed collection devices through the pneumatic chute. Conclusion: To conclude, the implementation of pneumatic chute compatible closed collection tubes for urine improves the transportation and processing time, eliminates the manual carry of urine samples, eliminates the incidences of leakage and spillage, reduces errors and reduces the exposure of urine to healthcare workers, thereby leading to significant improvement in patient care, patient experience and staff satisfaction.

Influence of biomaterial tube bottom shape on urine sediment counts by digital flow morphology (Digital Flow Morphology). An example of local validation of urine collection systems

Influence of biomaterial tube bottom shape on urine sediment counts by digital flow morphology (Digital Flow Morphology). An example of local validation of urine collection systems

Magnetic resonance elastography resolving all gross anatomical segments of the kidney during controlled hydration.

Introduction: Magnetic resonance elastography (MRE) is a non-invasive method to quantify biomechanical properties of human tissues. It has potential in diagnosis and monitoring of kidney disease, if established in clinical practice. The interplay of flow and volume changes in renal vessels, tubule, urinary collection system and interstitium is complex, but physiological ranges of in vivo viscoelastic properties during fasting and hydration have never been investigated in all gross anatomical segments simultaneously. Method: Ten healthy volunteers underwent two imaging sessions, one following a 12-hour fasting period and the second after a drinking challenge of >10mL per kg body weight (60-75min before the second examination). High-resolution renal MRE was performed using a novel driver with rotating eccentric mass placed at the posterior-lateral wall to couple waves (50Hz) to the kidney. The biomechanical parameters, shear wave speed (cs in m/s), storage modulus (Gd in kPa), loss modulus (Gl in kPa), phase angle and attenuation (α in 1/mm) were derived. Accurate separation of gross anatomical segments was applied in post-processing (whole kidney, cortex, medulla, sinus, vessel). Results: High-quality shear waves coupled into all gross anatomical segments of the kidney (mean shear wave displacement: 163 ± 47μm, mean contamination of second upper harmonics <23%, curl/divergence: 4.3 ± 0.8). Regardless of the hydration state, median Gd of the cortex and medulla (0.68 ± 0.11kPa) was significantly higher than that of the sinus and vessels (0.48 ± 0.06kPa), and consistently, significant differences were found in cs, , and Gl (all p < 0.001). The viscoelastic parameters of cortex and medulla were not significantly different. After hydration sinus exhibited a small but significant reduction in median Gd by -0.02 ± 0.04kPa (p = 0.01), and, consequently, the cortico-sinusoidal-difference in Gd increased by 0.04 ± 0.07kPa (p = 0.05). Only upon hydration, the attenuation in vessels became lower (0.084 ± 0.013 1/mm) and differed significantly from the whole kidney (0.095 ± 0.007 1/mm, p = 0.01). Conclusion: High-resolution renal MRE with an innovative driver and well-defined 3D segmentation can resolve all renal segments, especially when including the sinus in the analysis. Even after a prolonged hydration period the approach is sensitive to small hydration-related changes in the sinus and in the cortico-sinusoidal-difference.

Fetal urinary tract dilation: What to tell the parents.

Urinary tract dilation (UTD), which refers to the abnormal dilation of the urinary collection system, is the most common finding on prenatal ultrasound and presents with varying severity, presentation, etiology, and prognosis. Prenatal classification and risk stratification aim to prevent postnatal complications, such as urinary tract infections and further kidney dysfunction. Parents expecting a child with UTD should be counseled by a multidisciplinary team consisting of maternal-fetal medicine specialists, and pediatric urology and nephrology providers. This review summarizes the key points in the diagnostic evaluation and management during the prenatal and initial postnatal period, focusing on the information that should be provided to future parents. We address frequently asked parental questions and concerns that our multidisciplinary clinical practice faces.

Understanding and Managing Anxiety Sensitivity During Critical Illness and Long-Term Recovery.

Anxiety sensitivity is a fear of symptoms associated with anxiety (eg, rapid respiration and heart rate, perspiration), also known as "fear of fear." This fear is a misinterpretation of nonthreatening symptoms as threatening across 3 domains: physical ("When my heart rate increases, I'm afraid I may have a heart attack"), social ("If people see me perspire, I fear they will negatively evaluate me"), and cognitive ("When I feel these symptoms, I fear it means I'm going crazy or will lose control and do something dangerous like disconnect my IV"). These thoughts stimulate the sympathetic nervous system, resulting in stronger sensations and further catastrophic misinterpretations, which may spiral into a panic attack. Strategies to address anxiety sensitivity include pharmacologic and nonpharmacologic interventions. In intensive care unit settings, anxiety sensitivity may be related to common monitoring and interventional procedures (eg, oxygen therapy, repositioning, use of urine collection systems). Anxiety sensitivity can be a barrier to weaning from mechanical ventilation when patients are uncomfortable following instructions to perform awakening or breathing trials. Fortunately, anxiety sensitivity is a malleable trait with evidence-based intervention options. However, few health care providers are aware of this psychological construct and available treatment. This article describes the nature of anxiety sensitivity, its potential impact on intensive care, how to assess and interpret scores from validated instruments such as the Anxiety Sensitivity Index, and treatment approaches across the critical care trajectory, including long-term recovery. Implications for critical care practice and future directions are also addressed.

An IoT-Based Automatic and Continuous Urine Measurement System

Urine output is an important indicator of renal function. In hospitals, urine is collected using a catheter connected to a urine collection bag that has volume gradation markings. This type of visual measurement has low levels of accuracy and is labor-intensive. This paper developed an Internet-of-Things enabled system that continuously monitors the urine volume collected via the urine collection system. The device is built utilizing a strain gauge load cell, an integrated circuit that contains an amplifier, analog-to-digital converter, and a WiFi-enabled microcontroller. The data is sent via wireless networking to a data collection and analysis server, which provides accurate analyses of urine output. A mobile application utilizing the Blynk.io system is used to display the data. This device and mobile application were built at a minimal cost of 26 USD. The device has been tested multiple times and reported urine output accurately, with minimal difference between actual versus measured volumes. In the future, further development of this device can provide hospitals and physicians worldwide with easy access to affordable, accurate, and real-time urine measurement, which would translate into better, life-saving medical care.

Nutrients in a circular economy: Role of urine separation and treatment

The increasing global population, over the last few decades, brought about the rise in synthetic fertiliser market prices along with explosive agricultural demand. Source separation of urine can be one of the most effective solutions for nutrient recovery as a fertiliser, transforming the conventional linear economy into a circular economy. The urine diversion from wastewater can improve conventional wastewater treatment plants to be energy-efficient and cost-effective, as a considerable quantity of nutrients in wastewater is derived from urine. The stabilisation and sanitisation of source separated urine have been studied earlier by applying physical, biological, chemical, and electrochemical treatment processes. Further processes such as evaporation, freeze-thawing, and membrane processes have been investigated to recover as well as concentrate nutrients as a urine-derived fertiliser. As such, this review discusses the urine diversion and collection systems as well as previous technologies for the urine treatment and nutrient recovery. In addition, the industrial research hub funded by Australian Research Council (ARC) which focuses on the Nutrients in a Circular Economy (NiCE) is introduced in this paper. The ARC NiCE hub aims to achieve four themes, including urine collection, processing, fertiliser optimisation, and fertiliser end-use, moving towards a closed circular nutrient economy.

Resolution of urethral obstruction using temporary urethral stents in two female cats.

The management of urethral obstructions is well documented in male cats but is less established for females. These cases describe two female cats that presented with non-dissolvable urocystoliths. Urocystoliths were removed by laser lithotripsy and basket retrieval. Following urolith removal, urethral obstruction occurred in both cats. Both cats were successfully managed using temporary urethral stents in lieu of indwelling urethral catheters permitting outpatient, spontaneous recovery of the urethra. Use of temporary urethral stents has not been described in cats. These novel stents are constructed from materials available in most veterinary facilities, placed without advanced imaging and reside entirely within the urethra and vestibule. Temporary stents are used to bypass urethral disease, facilitating outpatient recovery, and are easily removed when no longer needed. For these reasons, temporary stents are a cost-efficient alternative to permanent stents or indwelling urinary catheters attached to closed urine-collection systems.

Stabilization of Urea in Urine through the Electrochemical Generation of Hydrogen Peroxide

Urine represents a small fraction, usually 1-2%, of the total volume of a typical wastewater stream, but contributes over half of the nitrogen. This nitrogen, which is predominantly ammonium, must be removed prior to discharging the treated wastewater into the environment. Traditional nitrogen removal processes are often energy intensive and operationally sensitive. Source separation of urine presents an opportunity to divert most of the nitrogen received by a traditional wastewater treatment plant and allow direct treatment of this highly concentrated waste stream. Source separation of urine is not without its own operational difficulties though; flushless urinals often succumb to clogging and foul odors. This is in part due to the hydrolysis of urea by the urease enzyme which converts urea, the principal nitrogen compound in urine, to ammonia. This in turn produces odors and precipitates minerals which lead to mineral scaling. Source separated urine is also susceptible to biological growth, which along with scaling, are the primary causes of plumbing fixture failures in source separation installations. Source separated urine has been identified as a potential candidate for resource recovery, but the instability of fresh urine presents operational hurdles that must be overcome. The hydrolysis of urea by urease may be inhibited by dosing fresh urine with a sufficient volume of strong acid or base, or by strong oxidants such as hydrogen peroxide. These stabilizers are hazardous materials, and bulk storage of these chemicals presents inherent danger. We have investigated the use of electrochemical cells capable of producing hydrogen peroxide in-situ in fresh urine to determine the feasibility of this technology for urine stabilization. Urine is fed to the cathode chamber where a gas diffusion electrode reduces atmospheric oxygen to hydrogen peroxide, which deactivates any urease present in the urine. An added benefit to using hydrogen peroxide is its biocidal properties; urine samples treated with this approach displayed no biological growth after extended storage. Previous experiments have utilized exogenously added jack bean urease to simulate conditions present in source separated urine collection systems; control samples with no hydrogen peroxide present exhibited complete disappearance of urea, while samples with electrochemically synthesized hydrogen peroxide remained stable. Current experiments are exploring the long-term stability of treated urine after exposure to ureolytic bacteria to better simulate real world applications of this treatment approach.

Urea hydrolysis and long-term storage of source-separated urine for reuse as fertiliser is insufficient for the removal of anthropogenic micropollutants

Human and animal source-separated urine, stored and allowed to naturally hydrolyse (the bio-catalysed transformation of urea to ammonia and bicarbonate), has been used for millennia as a fertiliser in agriculture. In a context of growing water scarcity and climate uncertainty, source-separation of urine is facing a strong revival thanks to the emergence of cost-effective waterless collection systems. Concomitantly, urine source-separation can be used as a method for nutrient recovery and subsequent reuse. In its simplest form, such recovery consists of collection followed by urea hydrolysis and storage as sole treatment. Numerous guidelines, including by the World Health Organisation, consider that this is sufficient to stabilise the nutrients and inactivate any potential pathogens in the urine. However, it is still unclear whether said urine is effectively free from other compounds of concern, such as anthropogenic micropollutants with known toxicological effects. Moreover, it is also currently unknown if the metabolites produced by human consumption of these products behave in similar way during short- and long-term storage i.e. whether any changes in chemical structure mean that these could be sorbed and/or precipitated in a different way, or if they can potentially be degraded by the biomass inherently present in urine collection systems. Finally, there is currently no knowledge of whether the observed concentrations of micropollutants in stored hydrolysed urine could potentially have toxicological effects if/when applied to soils and edible crops. To fill these research gaps, 20 commonly consumed compounds were selected in this study and their concentrations in the liquid and solid phases studied in the short- and long-term (up to ≥ 2 years). During the initial process of urea hydrolysis (≤ 5 days), ethyl-glucuronide was the sole compound effectively removed (by deconjugation), while only two other compounds, erythromycin and its metabolite, saw a reduction in their concentration (likely due to biomass sorption). Subsequently, during early storage (≤ 15 days), only three additional compounds were removed: paracetamol (> 99%), acesulfame (11.5%) and carbamazepine-10,11 epoxide (40.7%). Finally, long-term storage of up to 24 months did not result in any further significant removal for any of the measured compounds, indicating that the procedure of hydrolysis + storage is not effective for the removal of anthropogenic micropollutants. The results of this investigation raise strong concerns about the direct reuse of hydrolysed/stored human source-separated urine, and evidence the need for post-processing before implementation as fertiliser into edible crops due to the inherent toxicological risk, particularly to infants.

Design of automatic urine collection system for medical system applications.

BACKGROUND: The results of urine tests are often affected by improper midstream urine collection time, urine spilling, and urine pollution, all of which can lead to an increase in the test error.OBJECTIVE: To solve this problem, aiming at improving the toilet environment at the hospitals and public physical examination centers, this paper designs an automatic urine collection system. It can automatically adjust the position of the urine cup with an infrared remote controller, or manually, adjust the position of the urine cup in special situations according to the needs of the user. It also has an alarm function.METHODS: The overall size and shape are designed based on the squatting pan, suitable for disposable plastic urine cups of different shapes and sizes. It can realize the automatic collection of midstream urine, manual collection in exceptional cases, emergency stops, and rescue calls.RESULTS: Through the trial survey, there was a significant difference between the statistical results of using the device and not using the device ( 13.937, 0.000). 96% of the subjects thought that the design of the system was reasonable, 22% thought that it was inconvenient to use, and 91.7% of the medical staff thought that the system met the sampling requirements.CONCLUSIONS: Therefore, the trial evaluation is satisfactory, and the proposed collection system is suitable for use in hospitals at all levels and public health examination centers with a large amount of inspection.

Fertiliser recovery from source-separated urine via membrane bioreactor and heat localized solar evaporation

Urine with its abundant macronutrients (N-P-K) is an ideal resource for the production of fertiliser. However, the odor and pathogens in the raw urine must be removed to meet the public acceptance of urine collection systems and to enable its safe reuse as a fertiliser. In this work, real urine was collected and treated through a pilot-scale gravity-driven membrane bioreactor (GDMBR) to remove the malodorous organics and to nitrify almost 50% of the ammonia into nitrate. The stablised urine was subsequently distilled via low-cost heat localized solar evaporation (HLSE) to produce a non-odorous solid fertiliser. The developed HLSE with a small footprint can attract bulk solution into a vertical insulated space and quickly heat it up to 68 °C within 1 h. The HLSE process had vapour flux at 1.3 kg m−2 h−1 as well as high solar to vapour conversion efficiency at 87%. Based on the EDX mapping and XRD analysis, the generated crystals are mainly NaNO3, NH4Cl, NaCl, NH4H2PO4 and K2HPO4, which are ideal nutrients for vegetation. In this study, the produced urine-derived fertilisers have a better performance on the growth of the leafy basil than the all-purpose commercial fertilisers. Generally, the GDMBR-HLSE is a promising cost-effective and green technology for nutrients recovery from urine.

Implementation of External Urine Collection Devices to Decrease the Standardized Utilization Ratio of Indwelling Urinary Catheters

<h3>Background</h3> Catheter associated urinary tract infections (CAUTIs) are one of the most common hospital acquired infections. CAUTIs are associated with numerous complications including increased length of stay. The most significant risk factor for developing a CAUTI is the prolonged use of an indwelling catheter. Our purpose is to determine if the introduction of external urine collection devices for both male and female patients would impact the utilization of indwelling urinary catheters and subsequently, reduce our CAUTI events in our 24-bed Intensive Care Unit (ICU). <h3>Methods</h3> We established our baseline by measuring our urinary catheter utilization rate in our ICU for all 12-months in 2017. In June 2018, a qualitative trial was performed for three weeks for a female external device and then followed by the male external device. Prior to our trial, all team members were educated on the use of the external urine collection systems. Unit based Intensivists were updated on the product trial and encouraged to participate. During the trial, a light duty nurse rounded on each patient with an indwelling catheter to discuss the need for catheter necessity. If the patient required a device, it was advocated to remove the indwelling device and use an external device. Standardized Likert scale evaluations were completed by bedside nursing and nursing assistants during the trial. <h3>Results</h3> Based on the positive trial results, both products were implemented in the ICU and subsequently expanded hospital wide. Our baseline SUR for 2017 was 1.067. In 2018, our SUR decreased by 9.7% to 0.964. To date, our SUR data for January 2019 to October 2019 is 0.736. This is an overall 31% reduction in urinary catheter utilization from our baseline data. <h3>Conclusions</h3> In conjunction with daily conversations regarding catheter necessity, the implementation of external urine collection devices has significantly decreased the SUR on indwelling catheters.

Impact of forced diuresis with furosemide and hydration on the halo artefact and intensity of tracer accumulation in the urinary bladder and kidneys on [68Ga]Ga-PSMA-11-PET/CT in the evaluation of prostate cancer patients.

to assess the influence of intravenous hydration and forced diuresis with furosemide in two different dosages (20 vs 40mg) on the intensity of tracer accumulation in the urinary collection system and on the occurrence of halo artefact surrounding the urinary bladder and kidneys in [68Ga]Ga-PSMA-11-PET/CT scans. Comparison of four groups with 50 patients each, receiving different preparation prior to [68Ga]Ga-PSMA-11-PET/CT. Group one, no preparation. Group two, 500ml sodium chloride administered immediately after tracer injection. Group three, 500ml sodium chloride and injection of 20mg furosemide immediately after tracer administration. Group four, 500ml sodium chloride and injection of 40mg furosemide immediately after tracer injection. Images were judged visually whether halo artefact was present; semiquantitative measurements were performed with standardised uptake value (SUV). Halo artefact of the urinary bladder was present in twelve patients without preparation, in eight patients receiving only sodium chloride, in one patient injected with 20mg furosemide/sodium chloride and in two patients receiving 40mg furosemide/sodium chloride, showing a median SUVmean in the bladder of 45.8, 14.4, 4.6 and 5.8, respectively. Differences between patient group without preparation and the two groups with furosemide/sodium chloride were statistically significant. Patient groups receiving 20mg furosemide and 40mg furosemide did not differ significantly. Renal halo artefacts were observed in 15 patients of group one, in ten patients of group two, in 14 patients of group three and in 14 patients of group four, with corresponding median SUVmean values of 33.9, 32.0, 37.8 and 30.4 (no statistically significant differences). Performing [68Ga]Ga-PSMA-11-PET/CT, intravenous injection of 20-mg furosemide and 500-ml sodium chloride significantly reduces the number of bladder halo artefacts and intensity of tracer accumulation in the urinary bladder. A total of 40mg furosemide does not further improve results.

Contamination in Adult Midstream Clean-Catch Urine Cultures in the Emergency Department: A Randomized Controlled Trial

IntroductionA midstream clean-catch urine sample is recommended to obtain a urine culture in symptomatic adults with suspected urinary tract infection. The aim of this randomized controlled trial was to determine whether a novel funnel urine-collection system combined with a silver-colloidal cleaning wipe would decrease mixed flora contamination in midstream clean-catch urine cultures from ambulatory adults in the emergency department. MethodsIn a 2x2 factorial trial, adult participants were randomized to 4 groups: (A) sterile screw-top urine collection container/cup paired with a castile-soap wipe (control group); (B) sterile screw-top urine collection container/cup paired with a colloidal silver-impregnated wipe; (C) sterile urine-collection funnel paired with a castile-soap wipe; (D) sterile urine-collection funnel paired with a colloidal silver-impregnated wipe. ResultsThe trial was stopped after interim analysis, as the contamination rate in the control group (30%) was markedly lower than the historical ED contamination rate (40%) at the study site. From 1,112 urinalysis results, 223 urine culture results were analyzed (190 female patients and 33 male patients). Urine contamination rates were as follows: Group A, n = 67 (29.9% contaminated); Group B, n = 69 (34.8% contaminated); Group C, n = 51 (23.5% contaminated); Group D, n = 36 (22.2% contaminated). The differences in contamination rates were not statistically different among any of the groups. DiscussionThe use of a funnel urine-collection system and silver-impregnated wipe did not reduce urine-culture contamination in adult midstream clean-catch urine cultures in the emergency department.

Health Risks for Sanitation Service Workers along a Container-Based Urine Collection System and Resource Recovery Value Chain.

Container-based sanitation (CBS) within a comprehensive service system value chain offers a low-cost sanitation option with potential for revenue generation but may increase microbial health risks to sanitation service workers. This study assessed occupational exposure to rotavirus and Shigella spp. during CBS urine collection and subsequent struvite fertilizer production in eThekwini, South Africa. Primary data included high resolution sequences of hand-object contacts from annotated video and measurement of fecal contamination from urine and surfaces likely to be contacted. A stochastic model incorporated chronological surface contacts, pathogen concentrations in urine, and literature data on transfer efficiencies of pathogens to model pathogen concentrations on hands and risk of infection from hand-to-mouth contacts. The probability of infection was highest from exposure to rotavirus during urine collection (∼10–1) and struvite production (∼10–2), though risks from Shigella spp. during urine collection (∼10–3) and struvite production (∼10–4) were non-negligible. Notably, risk of infection was higher during urine collection than during struvite production due to contact with contaminated urine transport containers. In the scale-up of CBS, disinfection of urine transport containers is expected to reduce pathogen transmission. Exposure data from this study can be used to evaluate the effectiveness of measures to protect sanitation service workers.

Quantified water intake in laboratory cats from still, free-falling and circulating water bowls, and its effects on selected urinary parameters.

The study objectives were to determine if the method of water presentation (still [S], circulating [C] or free-falling [FF] bowl systems) influences daily water consumption in cats in a controlled environment, and whether differences in water intake affect urine relative super saturation (RSS) for calcium oxalate and struvite, urine specific gravity (USG), urine osmolality (Uosmol) and urine volume. Sixteen healthy laboratory cats fed a dry diet were individually housed with urine collection systems. Each cat underwent a randomized 2 week crossover period with all bowl systems, allowing a 1 week acclimation period between each crossover. Water intake was measured daily by bowl weight, accounting for spillage and evaporation. USG and urine volume were measured daily, whereas other urinary parameters were measured at various time points throughout each 14 day crossover period. Fourteen cats completed the study. Average daily water intake (ml/kg/day), urine volume, USG and urine RSS for struvite and calcium oxalate were not significantly different between water bowls. Uosmol was significantly higher in C compared with S and FF bowl systems (P = 0.009 for both). Three individual cats demonstrated a significant water bowl preference (Cat 4: C >S, P = 0.039; Cat 10: FF >C, P = 0.005; Cat 11: S >C, P = 0.037). Overall, water bowl type had no appreciable effect on water intake. Uosmol was the only urinary parameter found to be significantly different, and was higher for the C bowl. The implication of this is unknown, considering water intake did not differ significantly between bowls. Alternative methods to increase water intake should be implemented beyond providing unique water bowls in patients where augmented water intake would be beneficial for disease management.

Comparison of vacuum and non-vacuum urine tubes for urinary sediment analysis

Urine collection systems with aspiration system for vacuum tubes are becoming increasingly common for urinalysis, especially for microscopic examination of the urine. In this study, we aimed to examine whether vacuum aspiration of the urine sample has any adverse effect on sediment analysis by comparing results from vacuum and non-vacuum urine tubes. The study included totally 213 urine samples obtained from inpatients and outpatients in our hospital. Urine samples were collected to containers with aspiration system for vacuum tubes. Each sample was aliquoted to both vacuum and non-vacuum urine tubes. Urinary sediment analysis was performed using manual microscope. Results were evaluated using chi-square test. Comparison of the sediment analysis results from vacuum and non-vacuum urine tubes showed that results were highly concordant for erythrocyte, leukocyte and epithelial cells (gamma values 1, 0.997, and 0.994, respectively; p < .001). Results were also concordant for urinary casts, crystals and yeast (kappa values 0.815, 0.945 and 1, respectively; p < .001). The results show that in urinary sediment analysis, vacuum aspiration has no adverse effect on the cellular components except on casts.

Meticulous nursing of indwelling urinary catheter between the children with hypospadias during perioperative

Objective To summarize the meticulous nursing experience of indwelling urinary catheter between the children with hypospadias during perioperative. Methods 317 cases of indwelling urethral only in the silicone Foley tube, and without other urinary diversion with hypospadias were retrospectively analyzed, summarized the fine points of nursing, including preoperative children with comprehensive risk assessment, standardized preoperative skin preparation and postoperative protective constraint, effective properly fixed catheter keep the urine drainage unobstructed, close observation of urine drainage characteristics, maintain urine collection system tightness, maintain perineal skin clean and improved extubation nursing method, and do a good job after extubation nursing. Results 266 cases were cured with a cure rate of 83.9%(266/317); the incidence of urine leakage in 42 cases, the incidence rate was 13.2% (42/317); 7 cases of urethral stenosis, the incidence rate was 2.2% (7/317); 2 cases of urethral closing, the incidence was 0.6% (2/317), none of the patients had accidental extubation. Conclusions The meticulous nursing has a better effect in hypospadias patients during the perioperative period and it can reduce the incidence of postoperative complications; shorten the time of hospitalization and alleviate the suffering of children; improve the quality of nursing service, which is worthy of clinical application. Key words: Hypospadias; Perioperative nursing; Indwelling urinary catheter; Meticulous nursing

Efficacy of intravesical pentosan polysulfate sodium in cats with obstructive feline idiopathic cystitis.

Obstructive feline idiopathic cystitis is a common emergency in small animal practice. There is evidence for a defective glycosaminoglycan layer in the urinary bladder of affected cats. The aim of this study was to investigate the effect of intravesical pentosan polysulfate sodium (PPS) in cats with obstructive feline idiopathic cystitis in a randomised, placebo-controlled, blinded clinical study. Thirty-five cats with obstructive feline idiopathic cystitis were enrolled into the study. On day 0, cats were randomised to receive either 30 mg PPS in saline (18 cats) or saline alone as placebo (17 cats) at the time of indwelling urinary catheter placement and then after 24 and 48 h. The catheter was clamped for 30 mins after administration before connecting it to a sterile urine collection system. The procedure was repeated after 24 and 48 h, and then the indwelling catheter was removed. Treatment success was assessed via the incidence of recurrent urethral obstruction, results of a scoring system for physical examination and daily urinalysis from day 0 to 5. Recurrent urethral obstruction occurred in 3/18 cats of the verum group and 3/17 of the placebo group (P = 1.000). The verum group showed a significantly lower degree of microscopic haematuria between day 5 and day 0 (P ⩽0.05). The placebo group showed a significantly lower degree of dipstick haematuria between day 5 and day 0 (P ⩽0.05). There was no difference in the clinical score between the groups in the investigated time period. Intravesical instillation of PPS three times within 48 h in the chosen dose had no influence on the incidence of recurrent urethral obstruction and clinical signs in cats with obstructive feline idiopathic cystitis.