W1 Urologic Procedures 101

Question 1

Foley placement
Straight cath for?
Coudes for?

Answer 1

Straight catheter for urinary retention, or if you’re trying to get a sample. Mainly for females and younger patients. Clean intermittant catheterisation (patients performing it themselves)

Coudes are caths with curved distal tips that may allow for easier passage around the curved prostatic urethra (esp when prostate is enlarged like in older pts), so most oten used for natal male anatomy

Question 2

Hematuria catheters , aka?
What bore?
To help with passage of ______

Answer 2

They are also usually of large bore (meaning higher French), often at least 18 - 20 Fr if not larger, so help with passage of clots (< obstruction) and to make irrigation easier

Hematuria catheters (aka 3 way catheters) are catheters that have 2 outside ports, and 1 inside port, goal to help promote flow of urine out thru one of the outside ports, leaving the other for intermittent / PRN irrigation

Question 3

Suprapubic tubes
Contraindicated

Answer 3

Some neurological patients — hyperspastic pelvic floor muscles

Question 4

Urethral stents
Common symptom warranting placement of stent?

Answer 4

Ureteral Stents are “internal” tubes typically placed either cystoscopically, endoscopically, or via IR to help promote drainage of urine f/ the upper tracts into the bladder (stents are typically most helpful in diverting urine when there is some sort of upper tract obstruction occurring and you are confident pt will still be able to void said diverted urine out through the bladder)

Common symptoms associated w/ stents are URGENCY, flank pain, hematuria, dysuria

Question 5

Percutaneous nephrostomy tubes
When would this be warranted?

Answer 5

Percutaneous Nephrostomy Tubes (PCNs) are externalized tubes placed percutaneously by IR (or uro) through the skin around the flanks, through the renal parenchyma, and into renal pelvis (or sometimes ureter / bladder), typically leaving one end of the tube inside an area where urine is building up, w/ the other end of the tube let in the outside world to promote drainage of the urine 2/2 an UT obstruction (PCNs are typically more helpful when you need to divert urine directly away f/ kidney urgently and you are concerned that the pt would not be able to void said diverted urine out through their bladder alone, like when there is also a concomitant LUT obstruction / BOO as well)