11: Bladder Flashcards
How can you locate a cryptorchid testicle?
Follow vas deferens
Why must you treat concurrent UTI before surgery?
Tissue more friable and leakage could cause sepsis
WHich uroliths are radiopaque?
Struvite and calcium
How can you get rid of ectopic ureter?
Laser ablation
When do you need peri-operative antibiotics?
Usually (because either UTI or contaminated)
What is often done before surgery in females?
Place catheter to flush urethra
Which equipment should you not use on the bladder?
Rat tooth or Allis tissue forceps
Where do you open the bladder?
Ventral, slightly off midline
Why do you do a ventral approach to the bladder?
Avoid nerve and trigone injury, avoid ureter damage, can extend incision to urethra
Where is the hardest place to remove stones?
Bladder neck
What should you do after urolith surgery?
Radiograph to check for any left behind
How long does it take the bladder to regain 100% strength?
2-3 weeks
Which suture material do you use for the bladder?
Monofilament, absorbable, synthetic
Why do you NOT use vicryl on the bladder?
Rapidly degrades in infected urine
Which suture pattern do you use for the bladder?
Simple continuous appositional
Why should you avoid penetrating the mucosa when suturing the bladder?
Can act as nidus for stones
What is the suture holding layer in the bladder?
Submucosa
What should you suture if you can’ identify the submucosa?
Full thickness, will probably be rapidly covered by urothelium
How long after surgery should you give IV fluids to flush?
12-24 hours to flush
How do you identify uroabdomen?
Potassium and creatinine more than twice that of blood
How can you reinforce a bladder repair?
Omentum or serosal patch
What minimally invasive technique is available for stones below 2cm?
PCCL
What are the indications for partial cystectomy?
Polyps, neoplasia, trauma, patent urachus
How much of the bladder can you remove?
75-80%
Which should you avoid removing the trigone?
Incontinence
How quickly will the bladder re-grow?
One month
How can you place a cystotomy tube in an emergency?
Percutaneously
What are some possible complications of a cystotomy tube?
Many, e.g. UTI
How do you manage urine leaking from a cystotomy tube?
Barrier cream
