basic instrumentation and cystoscopy
TRANSCRIPT
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Chapter 6: Basic
Instrumentation andCystoscopy
Peter Tran, D.O.Garden City Hospital
8/13/2008
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Objectives
• Urethral Catherization• Urethral Dilatation
• Cystourethroscopy• Retrograde pyelography
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Urethral Catherization
• For diagnosis and treatment – Collection of urine in females
– Relief of obstruction• BPH• Clot retention
– nstillation of chemo – Post!surgical
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Catheter Types and Size
• "ize – # Fr $ %&''mm& (utside diameter not
luminal&• )ypes
– "traight – Coude
– *alecot – Foley – '!+ay
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Catheter Insertion
• "terile )echni,ue• Use of Uro-et
• .ong!term use – "ilicone better than late/ or
polyurethane
• "ize – #0!#1 Fr for adults
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Di icult Catherization• Usually in males
– BPH• Use coude
– Urethral "trictures – B2C
• *ay re,uire the use of aglide!+ire or filiform andfollo+ers
• n Females – Rare
• (besity• Unable to locate urethral
meatus or difficult position – Use speculum
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Di icult Catherization
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Urethral Dilatation
• )ypically in male – Urethral "tricture – B2C
– *eatus fortransurethalsurgery
• "terile techni,ues – Filiforms and
follo+ers – Urethral dilators – 3mplatz dilators – balloon
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Cystourethroscopy• "ystematic nspection
– *eatus – Urethra
• *ucosal abnormalities• Diameter
– 6/ternal sphincter – 7eru – Prostate gland
• BPH8• *iddle lobe8• Prior turp8
– Bladder • U(• )rigone• Dome• Foreign Bodies• .esion92eoplasm• "tones• Cystitis
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!etro"rade #yelo"raphy• 7isualization of ureter and
collecting system +henother radiographic imagesare inade,uate or +hen thepatient is allergic to 7 dye&
– Hematuria – Filling defects – Positi4e cytology of 8
source – 8 (bstruction
• Delayed films