The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consec...The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.展开更多
Non-deflated balloon of a transurethral inserted bladder catheter is a problem that could be difficult to manage, especially in males. A variety of methods have been described to puncture the balloon and remove the ca...Non-deflated balloon of a transurethral inserted bladder catheter is a problem that could be difficult to manage, especially in males. A variety of methods have been described to puncture the balloon and remove the catheter, though these can be associated with complications. We illustrate a simple and a safe method to overcome this problem using a flexible cystoscope under local anaesthesia.展开更多
BACKGROUND Insertion of a catheter into the bladder is a rare complication of peritoneal dialysis(PD),and is mainly related to surgical injury.This paper reports a case of bladder perforation that was caused by percut...BACKGROUND Insertion of a catheter into the bladder is a rare complication of peritoneal dialysis(PD),and is mainly related to surgical injury.This paper reports a case of bladder perforation that was caused by percutaneous PD catheterization.CASE SUMMARY A 64-year-old man underwent percutaneous PD catheterization for end-stage renal disease.On the second day after the operation,urgent urination and gross hematuria occurred.Urinalysis showed the presence of red and white blood cells.Empirical anti-infective treatment was given.On the third day after the operation,urgent urination occurred during PD perfusion.Ultrasound showed that the PD catheter was located in the bladder,and subsequent computed tomography(CT)showed that the PD catheter moved through the anterior wall into the bladder.The PD catheter was withdrawn from the bladder and catheterization was retained.Repeat CT on the fourth day after the operation showed that the PD catheter was removed from the bladder,but there was poor catheter function.The PD catheter was removed and the patient was changed to hemodialysis.CT cystography showed that the bladder healed well and the patient was discharged 14 d after the operation.CONCLUSION Bladder perforation injury should be considered and treated timeously in case of bladder irritation during and after percutaneous PD catheterization.The use of Doppler ultrasound and other related technologies may reduce the incidence of such complications.展开更多
Dear Editor,Persistent hematuria could trigger urinary retention,leading the patient to the emergency department for abdominal pain,decreased urinary output,anemia,and azotemia[1,2].Conventional bladder clot evacuatio...Dear Editor,Persistent hematuria could trigger urinary retention,leading the patient to the emergency department for abdominal pain,decreased urinary output,anemia,and azotemia[1,2].Conventional bladder clot evacuation requires a three-way catheter with continuous irrigation and aspiration with a syringe or Ellik evacuator[3].Sometimes a large and well-organized hematoma requires an open cystostomy[1,4].We want to introduce a combined method using hydrogen peroxide as well as suction technique with an endotracheal catheter to evacuate intravesical clots.展开更多
文摘The aim of this study was to figure out the predictors of early postoperative catheter-related bladder discomfort（CRBD） after urological surgery. We designed a prospective observational study in our hospital. Consecutive adult patients undergoing surgery under general anaesthesia or epidural anaesthesia necessitating urinary catheterization were included during a 3-month period. severity of bladder discomfort was assessed on a 4-point scale：（1） no pain,（2） mild pain（revealed only by interviewing the patient）,（3） moderate（a spontaneous complaint by the patient of a burning sensation in the urethra and/or an urge to urinate and/or sensation of urethral foreign body without any emotional agitation） and（4） severe discomfort（agitation, loud complaints and attempt to remove the bladder catheter associated with a burning sensation in the urethra）. Predictors of CRBD were identified by univariate and multivariate analysis. Totally, 116 patients were included, of which 84.5% had CRBD（mild CRBD： 40.5%; moderate or severe CRBD： 44.0%） at day 1, while 31.9% developed CRBD（mild CRBD： 29.3%; moderate or severe CRBD： 2.6%） at day 3. We evaluated 9 potential forecast factors of CRBD, and univariate Chi-square test showed male gender [OR=2.4, 95%CI（1.1–5.6）, P〈0.05], abdominal open surgery compared with transurethral surgery [OR=0.3, 95%CI（0.1–0.6）, P〈0.05], abdominal surgery compared with laparoscopic surgery [OR=3.3, 95%CI（1.2–8.9）, P〈0.05] and history of catheterization [OR=0.5, 95%CI（0.2–0.9）, P〈0.05] were independent predictors of moderate or severe CRBD in the patients after surgery. While multivariate logistic regression analysis showed that the abdominal open surgery [EXP（B）=3.074, 95%CI（1.3–7.4）, P〈0.05] and the history of catheterization [EXP（B）=2.458, 95%CI（1.1–5.9）, P〈0.05] might contribute more to the occurrence of moderate or severe CRBD. In conclusion, this observational study identified that the type of surgery and the history of catheterization might be predictive factors of moderate and severe CRBD after urological surgery.
文摘Non-deflated balloon of a transurethral inserted bladder catheter is a problem that could be difficult to manage, especially in males. A variety of methods have been described to puncture the balloon and remove the catheter, though these can be associated with complications. We illustrate a simple and a safe method to overcome this problem using a flexible cystoscope under local anaesthesia.
文摘BACKGROUND Insertion of a catheter into the bladder is a rare complication of peritoneal dialysis(PD),and is mainly related to surgical injury.This paper reports a case of bladder perforation that was caused by percutaneous PD catheterization.CASE SUMMARY A 64-year-old man underwent percutaneous PD catheterization for end-stage renal disease.On the second day after the operation,urgent urination and gross hematuria occurred.Urinalysis showed the presence of red and white blood cells.Empirical anti-infective treatment was given.On the third day after the operation,urgent urination occurred during PD perfusion.Ultrasound showed that the PD catheter was located in the bladder,and subsequent computed tomography(CT)showed that the PD catheter moved through the anterior wall into the bladder.The PD catheter was withdrawn from the bladder and catheterization was retained.Repeat CT on the fourth day after the operation showed that the PD catheter was removed from the bladder,but there was poor catheter function.The PD catheter was removed and the patient was changed to hemodialysis.CT cystography showed that the bladder healed well and the patient was discharged 14 d after the operation.CONCLUSION Bladder perforation injury should be considered and treated timeously in case of bladder irritation during and after percutaneous PD catheterization.The use of Doppler ultrasound and other related technologies may reduce the incidence of such complications.
文摘Dear Editor,Persistent hematuria could trigger urinary retention,leading the patient to the emergency department for abdominal pain,decreased urinary output,anemia,and azotemia[1,2].Conventional bladder clot evacuation requires a three-way catheter with continuous irrigation and aspiration with a syringe or Ellik evacuator[3].Sometimes a large and well-organized hematoma requires an open cystostomy[1,4].We want to introduce a combined method using hydrogen peroxide as well as suction technique with an endotracheal catheter to evacuate intravesical clots.
