Common Urological Devices Flashcards
What is the urinary catheter called?
How many ports can it have? State what each port is for
Foley catheter
It is a 2/3-way catheter
1) Irrigation fluid bag which is hung up
2) Syringe to inflate catheter balloon within bladder to keep in place
3) Urine collection bag
You attempt to insert a urinary catheter due to an acute presentation but this has failed. What other catheter can be used in this scenario?
Suprapubic catheter
How and Where is the suprapubic catheter inserted exactly?
Who inserts it?
What is the main indication?
The Urologist/surgeon Transcutaneously inserts above the pubic bone to treat acute urinary retention => must be a fully distended bladder
The Foley catheter may have 2 or 3 ports. What port is the differentiating one and what is the indication for its use?
The 3-way catheter has an irrigation channel for normal saline which is used to prevent clot formation in frank haematuria
The size of urinary catheters is measured via what measurement?
What is the most commonly used size on the wards?
Why might you use a smaller size and why might you use a larger size?
Catheters are measured in French
Most common = 16 French (14-18)
Smaller (6-12) for urethral strictures + paediatrics
Larger (18-22) for Large prostate with difficulty using thinner one, viscous urine, post-bladder surgery, large amounts of frank haematuria (=> more clots)
Give the top 2 contra-indications for using a urinary catheter?
Recent urological surgery
Pelvic fracture
When inserting a urinary catheter, the BP suddenly drops from 120/80 to 100/75. What do you do?
Nothing, this is a complication but it is transient
But for exam purposes you should say that you will continue monitoring patient to ensure BP returns to normal
Give 6/7 complications of using a urinary catheter
1) Urge sensation secondary to irritation
2) Leakage, blockage, kinking of catheter
3) Infection - UTI/Pyelonephritis/abscess
4) Haematuria
5) Fistula
6) Uretheal trauma
7) Transient hypotension
What is being shown in this image?
Bilateral percutaneous nephrostomy tubes
Nephrostomy tubes:
When is it indicated?
How is it inserted and by who?
Where is it inserted?
What is the name of the catheter used?
Nephrostomies are indicated in the setting of urinary tract obstruction proximal to the bladder causing !hydronephrosis!
It is inserted by IR via US-guided insertion of a !!Pigtail catheter!!
You will find this at the renal angle
What is special about a pigtail catheter
A pig’s tail is coiled, so this catheter is coiled at the end to prevent it from dislodging
What is being shown in this image
PFA showing right sided JJ-ureteric stent
JJ stent:
Describe the stent. What is it used for?
How is it inserted?
A JJ-stent is a ureteric stent, coiled on both ends (like a pigtail and also to prevent migration) placed within the ureter to bypass an obstruction such as stone, stricture, or mass (whether inside or outside lumen)
The urologist can insert it:
1) Anterograde via nephrostomy tube
2) Retrograde via Cystoscopy (much more common)
What urological device is shown in this image?
Give another name for it
Urostomy or Ileal Conduit
Urostomy:
How is it performed?
Is it spouted?
If a patient in your long case has this, what is the most likely reason?
Ureters are diverted into an isolated portion of the small bowel (ileum typically) that opens up to the abdominal surface via a stoma
Yes, it is spouted to prevent irritation of the skin
Most likely indication = post-radical cystectomy for bladder cancer
