Use Of Ureteral Catheters Research Articles

Use of ureteric catheters and indocyanine green in complex pelvic surgery: a must or a luxury in 2023?

Use of ureteric catheters and indocyanine green in complex pelvic surgery: a must or a luxury in 2023?

Use of ureteral catheter in uterine-sparing surgery for placenta accreta

Objective: The study aimed to investigate the effect of ureteral catheter use during surgery on the outcomes of obstetric and urinary complications in patients with placenta accreta spectrum (PAS) and placenta previa. Methods: The patients who were followed up at Meram Medical Faculty Hospital of Necmettin Erbakan University between January 2016 and November 2021 and diagnosed with PAS and placenta previa were included. Patients who underwent emergency and planned surgery were grouped as those with or without an intraoperative ureteral catheter. The primary outcome was determined as the rate of urinary system damage among these groups. The number of blood transfusions, preoperative and postoperative hemoglobin values and hemoglobin changes, length of hospitalization, patients who underwent uterine-sparing surgery or hysterectomy, urinary tract injury, and wound infection were compared regarding the use of catheters. Results: A total of 122 patients were included in the study. While an intraoperative ureteral catheter was placed in 56 (45.01%) patients, it was not used in 66 (54.09%) patients. Bladder injuries were determined in 31 (55.4%) patients with a catheter and 13 (19.7%) patients without a catheter, and no other urinary system injuries were found. The incidence of bladder injury was statistically significantly higher in the group with a catheter (p=0.001). The number of transfused erythrocyte suspensions, the hemoglobin change according to the preoperative hemoglobin level, and the mean duration of hospitalization in patients with a catheter were statistically significantly greater than the group without a catheter (p=0.001). Conclusion: Ureteral catheterization did not reduce urinary damage in patients with PAS and placenta previa who underwent uterine-sparing surgery and hysterectomy. However, we believe that the insertion of a catheter increases the possibility of diagnosing intraoperative damage.

Use of ureteral catheter for under vision suctioning in rigid therapeutic bronchoscopy in children: A novel approach

Background: Rigid bronchoscopy is a common procedure and treatment of choice for foreign body (FB) in respiratory tract. Blind suctioning using rigid suction cannula is associated with technical difficulties and complications. Under vision flexible cannula are expensive and not commonly available. This led us to discover the alternative of using Ureteral catheters flexible suction cannula for under vision suctioning. Patients and methods: A retrospective study was conducted in the department of Surgery at tertiary hospitals, from January 2015 to March 2020. Medical records and operative videos were analyzed. Forty two Paediatric patients with foreign body in respiratory tractwere subjected to rigid bronchoscopy and Ureteral catheterwas used as flexible suction cannula for under vision suctioning. Results: Forty two patients (12 infants, 30 between age 1to 8 year; 26 males and 16 females) with FB bronchus subjected to rigid bronchoscopy. N = 32 were having organic FB and n = 10 were having inorganic (Graph 1), duration of FB in Respiratory tract ranged from 6 hours to 8 months, 7 in main bronchus, 33 having unilateral and 2 having Bilateral FB. Operative time ranged from 15 minutes to 75 minutes. 4 patients had slight intraoperative bleed due to mucosal injury, postoperative stay ranged from 1 to 4 days. Conclusion: Use of Ureteral catheterfor under vision suctioning in rigid bronchoscopy in children quite feasible and effective technique. The main advantages in are simplicity, short operative time, Less traumatic, Good vision, with minimal complications. Type of study: Treatment Study. Level of evidence: LEVEL IV, Case series with no comparison group.

Urinary diversion for patients with inoperable obstetric vesicovaginal fistula: the Jos, Nigeria experience.

Repair of obstetric urinary fistula may result in successful fistula closure, but often incontinence persists. Our goal was to review our experience with continent urinary diversion in our patients with inoperable vesicovaginal fistula (VVF). The database of patients who underwent urinary diversion at ECWA Evangel VVF Centre in Jos, Nigeria, between 1996 and 2012, was reviewed. Complications and surgical outcomes were noted. The earlier patients (1996-2002) and the later patients (2003-2012) were compared. Urinary diversions were performed on 118 patients. Compared with the earlier patients, the later patients more often underwent modified Mainz II diversions, had similar complication rates, but had better outcomes. The use of ureteric catheters intraoperatively and the performance of modified Mainz II pouch were associated with a better outcome. Overall perioperative mortality was 2.5%. Urinary diversion is feasible in a low-resource setting. Use of modified Mainz II pouch diversion and intraoperative ureteric catheters were associated with a better outcome. Urinary diversion should be undertaken only after the careful counseling of each patient, and by an experienced surgeon.

E69 Use of ureteral catheter after URS. Our results

E69 Use of ureteral catheter after URS. Our results

Gestione Delle Lesioni Iatrogene Ginecologiche di Pertinenza Urologica. Cause e Prevenzione Delle Complicanze: Il Parere del Ginecologo

To detect and prevent urinary tract injuries in gynecological surgery. A brief review of the literature about recognition and prevention of ureteral and bladder injuries. It is well known that factors as intra-operative bleeding, pelvic adhesions and infections, pelvic masses, endometriosis and obesity can make surgery difficult. For these reasons the study of the urinary tract and the use of ureteral catheters may be helpful when alterations of the urinary tract anatomy is suspected. However the surgeon should always operate under direct vision of the ureters with a judicious use of diathermy and taking care when separating bladder from the uterus where the blunt dissection is blind and dangerous. When there are some doubts about the integrity of ureters, the control with i.v. infusion of indigo-carmine or with ureteral catheters should be performed. The same applies for the bladder: the cystoscopy should be in the armamentarium of gynecological surgeons to control the ureteral efflux and the bladder integrity. To fill the bladder with methylene blue at the end of the surgery is also helpful in revealing, under the pressure, even very small lesions as well as partial thickness of the bladder that can cause a delayed fistula. Surgeons' training is the most important factor in avoiding and detecting urinary tract injuries. This is important not only for the technique but also in the selection of patients, and then in planning the more appropriate pre-operative study and in recognizing the presence of injuries during surgery.

Prophylactic Ureteric Catheterization with Illuminated Ureteric Stent during Difficult Laparoscopic Colorectal Surgeries

Background: The close proximity of ureters to the colon and rectum, ureteric injury is a potential complication in colorectal surgery. Incidence of iatrogenic ureteric injury ranges from 1 to 10%.Aim: The aim of this study is to evaluate the operative time, the efficacy in preventing iatrogenic ureteric injuries and the complications associated with prophylactic illuminated ureteric catheterization in the difficult laparoscopic colorectal surgeries.Materials and methods: Twenty-two patients who underwent difficult laparoscopic colorectal surgery from 2009 to 2011 in Department of General Surgery in SCB Medical College Hospital, Cuttack, were included in the study. The ureteric catheterizations were cystoscopically performed by using number 5 French illuminated ureteric catheter.Results: The use of ureteric catheters added a mean of 20 minutes to the total surgical procedure time. Postoperative complications oliguria or anuria not seen. Urinary tract infection seen in one patient which makes the incidence of 4.5% in our study. There was no ureteric injury during surgery. Average hospital stay was 6 days. Overall cost did not alter. There were no cases of conversion to laparotomy in our study.Conclusion: With negligible morbidity, the use of illuminated ureteric stents ensure ureteric safety in complex cases by direct visualization of the ureteric position throughout the dissection, especially in laparoscopic surgeries. Iatrogenic ureteric injuries and conversion to laparotomies are minimized by using illuminated ureteric stent.

Fever After Shockwave Lithotripsy—Risk Factors and Indications for Prophylactic Antimicrobial Treatment

To identify risk factors for fever after shockwave lithotripsy (SWL) and suggest guidelines for prophylactic antimicrobial treatment. Between 1985 and 2007, a total of 15,324 SWL procedures were performed in our institution using the Dornier HM3 lithotripter. Because stone analyses were not available in the majority of patients, management of stones larger than 2 cm in diameter were excluded from this analysis to minimize the ratio of struvite stones as a possible cause for postprocedural fever. In this analysis, 11,500 SWL treatments were included. Clinical parameters before, during, and after treatments were prospectively registered using a computerized database. Potential risk factors for fever after SWL were evaluated. Fever >38.0 degrees C developed in 161 (1.4%) patients. The risk factors for fever after SWL were: A positive urine culture (P < 0.05), an indwelling nephrostomy tube or stent during the procedure (P < 0.001), lithotripsy of kidney or upper ureteral stones (P < 0.05) and preoperative symptomatic urinary tract infection (UTI) (P < 0.05) or sepsis (P < 0.05). Lithotripsy of mid and lower ureteral stones, stone size, and the use of ureteral catheters during the procedures were not associated with increased risk of fever after SWL. Fever (>38.0 degrees C) develops in only 1.4% of the patients undergoing SWL. Therefore, prophylactic antibiotic treatment is not indicated in all patients. Selective prophylactic treatment is recommended in patients who present with UTI, kidney or upper ureteral stones, and those for whom a nephrostomy tube or stent is necessary.

Laparoscopic Partial Nephrectomy: A Single-center Evolving Experience

To review our laparoscopic partial nephrectomy (LPN) experience, examine the evolution of technique, and compare the outcomes between the early and recent experience. The indications and surgical technique of LPN continuously evolve. Data for 184 patients who underwent LPN for a tumor between October 2002 and August 2008 was retrieved from a prospective database. Surgical and functional outcomes for the entire cohort were analyzed and the first 50 (group 1) and most recent 50 (group 2) cases were compared. The groups were similar in terms of baseline renal function, body mass index, and comorbidities. The mean tumor size and the proportion of central tumors in groups 1 and 2 were 2.4 vs 3 cm and 12% vs 52%, respectively (P <.003). In group 2 we stopped the use of ureteral catheters and bolster renorrhaphy, and routinely clamped the renal hilum. Mean warm ischemia time in groups 1 and 2 (30 and 27 minute, respectively, P = .3) and the complication rate were similar. Overall, patients with tumors >4 cm had more complications (P = .042). In group 2 the estimated blood loss and hospital stay decreased (243 vs 140 mL, P = .01, 1.4 vs 2.5 days, P <.001). Overall 78% of the tumors were malignant and the positive margin rate was 3%. With a median follow-up of 18 months, no local or distant tumor recurrences were observed. With growing experience and technical modifications, LPN is now performed for patients with larger and more central tumors. Longer follow-up is necessary to evaluate oncologic outcomes.

Removal of Retained Foley Catheter in Bladder with Novel Use of Ureteral Catheter: Lasso Technique

Numerous and varied foreign bodies have been described in the lower urinary tract. Techniques previously used to remove these objects have included open and endoscopic removal. We present a novel endoscopic technique using a ureteral catheter as a lasso to remove a retained foreign body, in this case a retained Foley catheter.

Effect of smooth muscle relaxant drugs on proximal human ureteric activity in vivo: a pilot study

Drugs are increasingly being used to promote stone passage in renal colic. Diclofenac, nifedipine and tamsulosin cause ureteric smooth muscle relaxation in vitro; however, in clinical trials nifedipine and tamsulosin promote stone passage whereas diclofenac has no apparent benefit. We adapted a ureteric pressure transducer catheter in an attempt to compare the human ureteric response to these drugs in vivo. The catheter was inserted into the contralateral ureter following ureteroscopy for stone disease. Contraction frequency, pressure and velocity measurements were recorded at 24 h. Each patient was randomly allocated to receive oral diclofenac, nifedipine or tamsulosin. Measurements were taken following drug administration. Eighteen patients (mean age 50 years) were recruited. Two patients were excluded intraoperatively and three required early removal of the catheter. Prior to drug administration, the mean number of contractions recorded was 0-4.1/min and the peak contraction pressure ranged from 11 to 35 mmHg. Conduction velocity ranged from 1.5 to 2.6 cm/s. Ureteric peristalsis persisted in all patients despite these drugs. Diclofenac and nifedipine produced inconsistent ureteric pressure responses but had little effect on contraction frequency. Tamsulosin significantly reduced ureteric pressure but had no effect on contraction frequency. There are many limitations associated with the use of ureteric catheters, however, they may provide some useful information when used to record the response to an intervention in the same patient. These preliminary results suggest a reduction in pressure generation may be the essential factor in the promotion of stone passage. More work is required but these drugs may work by preventing the increased, uncoordinated muscular activity seen in renal colic whilst maintaining peristalsis, thereby promoting stone passage.

Clinical value of prophylactic ureteral stent indwelling during laparoscopic colorectal surgery.

One of the hazards of colorectal surgery is ureteric injury. The aim of this study was to evaluate the results of ureteric catheterization regarding its safety and operative time. One-hundred sixty two patients underwent laparoscopic segmental left or right colectomy. The mean time for placement of ureteric catheters was 11.4 min for the right hemicolectomy and 11.3 min for the left hemicolectomy group. The mean preparation times for right hemicolectomy and left hemicolectomy (group 1 vs. group 2) were 54.7 vs. 39.1 min (p=0.00001) and 61.4 vs. 47.6 min (p=0.006), respectively. There were no significant differences in the laparoscopic operative time in either the right or left hemicolectomy groups (134.2 vs. 145.5 min and 198.4 vs. 170.1 min, respectively). There was no morbidity directly related to the ureteric catheters and in fact the incidence of postoperative urinary tract infection was lower in group 1 (1.5%) than in group 2 (5.3%) (p<0.05). Although the use of ureteric catheters added a mean of 11.3 min to the surgical procedure, the overall anesthetic time for right hemicolectomy was no longer than that for left hemicolectomy. The morbidity rate was quite acceptable. Thus, ureteric catheters may be useful in selected cases of laparoscopic left and right colorectal resections.

Prophylactic use of ureteric catheters in gynecologic surgery

Prophylactic use of ureteric catheters in gynecologic surgery

Routine use of ureteric catheters at laparoscopic hysterectomy may cause unnecessary complications

Study Objective: To test the use of ureteric catheters in preventing ureteric trauma during laparoscopic hysterectomy. Design. Prospective study of 492 consecutive women. Setting. Pelosi Women's Medical Center, New Jersey, and Cliveden Hill Private Hospital, Melbourne, Australia Patients. Four hundred ninety-two consective women. Interventions. Laparoscopic hysterectomy was performed in all women. Because of the reported increased risk of ureteric trauma during laparoscopic hysterectomy, we passed ureteric catheters in 92 such procedures and ceased the practice with the last 400 when further reports suggested lack of increased risk. Measurements and Main Results. Oliguria and anuria occurred in 7 of 92 patients having ureteric catheterization. No ureteric trauma occurred in 400 patients without ureteric catheterization. The injury rate in this series was significantly lower than in three other series of abdominal hysterectomy. Conclusions. As long as surgical techniques incorporate various procedures to avoid ureteric injury, routine ureteric catheterization during laparoscopic hysterectomy is not indicated and may result in unnecessary complications.

Are ureteral catheters in gynecologic surgery beneficial or hazardous?

Study Objective. To evaluate the use of ureteral catheters in gynecologic surgery. Design. A prospective study. Setting. A university-affiliated private hospital. Patients. A series of 317 women undergoing a variety of gynecologic surgeries who were at high risk for ureteral injury. Interventions. The procedures ranged from radical oncologic surgery to difficult operations for benign disease. In 273 patients the ureteral catheters were inserted prophylactically, and in 44 they were inserted postoperatively to confirm ureteral patency. Nineteen were lighted catheters used during laparoscopic surgery. Measurements and Main Results. Only 3 of 546 ureters could not be catheterized preoperatively. The average time to insert the catheters was 6 minutes (range 2–21 min). All ureters were easily identified, and their dissection was facilitated by the catheters. Two asymptomatic cases of transitional cell cancer of the bladder were diagnosed. One case of ureteral obstruction was identified at postoperative ureteral catheter insertion. No immediate or delayed problems were identified. The frequency of urinary tract infection was 3.2%. Conclusion. Ureteral catheters are safe and are simple to insert. They enhance identification of ureters and facilitate ureteral dissection.

Use of ureteral catheters in colonic and rectal surgery.

Injury to the ureters is a serious complication of colonic and rectal surgery. The experience of the authors with routine use of ureteral catheters to minimize this complication is reviewed. It was found that there are minimal complications associated with their use. Injuries to the ureters were not completely avoided. However, unrecognized injuries (except ischemia) did not occur.

Effect of ureteral stent on urinary tract infections in renal transplantation

A retrospective study was carried out to determine the effect of ureteral intubation during renal transplantation. We noted urinary tract infections in 76 per cent of those patients whose ureters were intubated during transplantation, as opposed to 45 per cent in those transplant recipients without ureteral stents. The incidence of recurrent urinary tract infections also increased from 18 to 34 per cent with the use of ureteral catheters. Ten separate episodes of bacteremia, indirectly related to indwelling catheters, are noted.

EXPERIMENTAL TRANSPLANTATION OF URETERS INTO THE INTESTINE.

Summary.1. A brief history of the operation is given up to the present date. 2. General surgical opinion judges that the principle of submucous transplantation described by Coffey offers best hope of success.3. A new technique is described which is truly aseptic. The sub‐mucous principle is employed, but the necessity of incision and resuture of the muscle and peritoneum of the bowel wall is obviated.4. Operations have been carried out on 77 dogs, with the implanta‐tion of 106 ureters. 15. Peritonitis as a complication is not serious; none occurred while using the completed technique; that is, 34 operations (one case originating from a gangrenous wound is not considered).6. Pyelonephritis is not frequent and is always accompanied by some evidence of ureteral obstruction.7. Hydronephrosis following on contracture of the cut end of the ureter still remains the greatest problem.8. The use of ureteral catheters, though particularly well suited to the technique, produced bad results in these experiments because they blocked so easily on account of the small bore. I n animals in which large catheters could be used, it is considered the objection to their use would be removed.