2. Dr. Abdellatif Zayed Amzayed_1919@yahoo.com INSTRUMENTS

3. 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

4. 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

5. Strait catheter

6. Fixations of strait catheter by plaster strips

7. Foley’s catheters

8. Self retaining catheter

9. 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

10. 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

11. 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

12. Catheterizations

13. 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

14. Condom catheter Elastic adhesive band

15. 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

16. The balloon may not deflate !!!!!!!

17. 1.Deflating by using torsion

18. 2.Shortening the defective length

19. 3.Transluminal probing and perforation Probe

20. 4.Percutaneous puncture U/S guided puncture

21. 5.Transrectal or transvaginal puncture Transvaginal Transrectal

22. 6.Harpoon technique

23. 7.Rupture by overdistention

24. 8.Chemically induced rupture Obsolete !!!

25. Ureteric stents

26. Bilateral JJ stents, Stienstrass

27. Ureteric stents

28. 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

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

30. Suprapubic catheter

31. Suprapubic Catheter insertion

32. Cystoscope

33. Flexible ureteroscope

34. Nephroscope

35. Thank you Amzayed_1919@yahoo.com  0101953318