Catheters Flashcards
Disadvnatages of latex catheters
Forms encrustations should not stay for more than a week, causes urethral irritability, risk of allergy
Advantages of silicone catheter
Inert
Can remain indwelling for 3 months
Catheter associated UTI
Indweling catheters get colonized by organisms
Reach bladder by sheath of exudate that surrounds cath. in urethra or via lumen
Prophylaxis encourages emergence or resistant strains. Considered in high risk cases like prosthetic valves
However if perosn with indwelling catheter develops symtpmatic UTI (pyrexia, rigors, loin pain)
do ab course for 10-14 days
Indications of catheterisation
Procedures
- catheter urine specimen for culture
- urodynamics
- cystography
- cystological instillation( BCG, chemotherapy for bladder
Post surgery (prostatetomy)
For monitoring during surgery (open heart)
Relief of urinary retention
Long term treatment of any caus of urinary incontinence
Complications of transurethral catheterisation
Urethral injury- stricture
Urethritis
UTI
Acute epididymitis
Periurththral abscess
Bladder stones
Urethral stones
Leakage of catheter- small capacity irritable bladder
SCC of bladder
Chronic renal failure
Indications for suprapubic cystotomy
Urinary retention- failed tranurethral
Suspected traumatic urethral injury
Necrotizing fasciitis of perinuem
temporary urinary diversion after urological surgery
Neuropathic blader-those not suitable for CISC
When pt. with transurthral ather develop acute epidydimitis
Contraindications to percutanous suprapubic cystotomy
Empty or small capacity bladder
Previous lower abdominal surgery
Macroscopic haematuria (patient may have bladder tumour)
Skin disease in suprapubic area
Gross obesity
Complications of suprapubic cystotomy
Haematuria
Migration (dislodgement extraveddically)
Bowel injury and
injury to rectal injury and to iliac vessels
