Dr. Abdellatif Zayed INSTRUMENTS

Diagnostic: Diagnostic: 1. Cystourethrography 2. Urodynamic study 3. Measure Residual urine Therapeutics: Therapeutics: 1. Relief of urine retention (BPH,…) 2. Clot retention 3. Postoperative Indications of catheterizations

Catheter sizes refer to the outside circumference Catheter sizes refer to the outside circumference French (Fr) scale (circumference is in mm) French (Fr) scale (circumference is in mm) 1 Fr=0.33 mm in diameter. 1 Fr=0.33 mm in diameter. French scale

Strait catheter

Fixations of strait catheter by plaster strips

Foley’s catheters

Self retaining catheter

Catheter (18-16F) is usually satisfactory for adults. Catheter (18-16F) is usually satisfactory for adults. Inflating the balloon prematurely may result in urethral rupture Inflating the balloon prematurely may result in urethral rupture

Large-caliber catheters are used to evacuate blood clots Large-caliber catheters are used to evacuate blood clots Why Large balloons (30 mL)?? Why Large balloons (30 mL)?? To decrease the balloon migrating into the prostatic fossa after TUR_P. To decrease the balloon migrating into the prostatic fossa after TUR_P. Can be used as traction to control hemorrhage from the prostatic fossa Can be used as traction to control hemorrhage from the prostatic fossa

The standard latex catheter can result in severe reactions in patients with latex allergies The standard latex catheter can result in severe reactions in patients with latex allergies Silicone varieties are good alternatives even if it is to remain only for few days Silicone varieties are good alternatives even if it is to remain only for few days

Catheterizations

Catheter associated UTI Incidence: short term catheterization 10-20% short term catheterization 10-20% Long term catheterizations 100% Long term catheterizations 100% Guideline to prevent catheter associated UTI Only when necessary Only when necessary Condom catheter Condom catheter Aseptic catheterization technique Aseptic catheterization technique Using sterile lubricant Using sterile lubricant

Condom catheter Elastic adhesive band

The bag below the bladder level Should not touch the floor In males, the catheter should be secured above the thigh Guideline to prevent catheter associated UTI

The balloon may not deflate !!!!!!!

1.Deflating by using torsion

2.Shortening the defective length

3.Transluminal probing and perforation Probe

4.Percutaneous puncture U/S guided puncture

5.Transrectal or transvaginal puncture Transvaginal Transrectal

6.Harpoon technique

7.Rupture by overdistention

8.Chemically induced rupture Obsolete !!!

Ureteric stents

Bilateral JJ stents, Stienstrass

Ureteric stents

Facilitate internal drainage due to obstruction from internal or external ureteral compression Facilitate internal drainage due to obstruction from internal or external ureteral compression To decrease sepsis or obstruction in the presence of steinstrasse after ESWL To decrease sepsis or obstruction in the presence of steinstrasse after ESWL Double-J catheters

1. performing retrograde pyelography 2. collecting urine for cytology or cultures 3. performing brush biopsies 4. Draining an obstructed kidney Ureteral catheterization

Suprapubic catheter

Suprapubic Catheter insertion

Cystoscope

Flexible ureteroscope

Nephroscope

Thank you 