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Conservative Treatment
Published in Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg, Essentials of the Adult Neurogenic Bladder, 2020
Samer Shamout, Lysanne Campeau
There are two main techniques regarding sterility and IC: sterile approach19 (nontouch technique where sterility is maintained) and clean approach11 (where only general hygiene practices are followed). The sterile technique is associated with high cost and mostly used in a hospital setting. In the majority of cases, a clean catheterization technique is employed. This technique is found to be easily used and reduced urologic complications in patients with SCI.14 The ongoing debate on the optimal IC technique does not appear to change the practical outcome of IC given that general rules are applied: adequate patient education and training, clean and nontraumatic catheterization, adequate number of catheterizations, and long-term patient compliance.20 For patients with catheterization difficulty due to DSD, botulinum toxin injection in the striated sphincter can be useful.21
The Urinary System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
In patients who should not or are unable to void intentionally, the bladder may be manually drained through a urinary catheter. Catheterization is commonly performed pre- and postoperatively or in otherwise debilitated patients suffering from urinary incontinence. It is also used simply to void (or fill) the bladder to perform any number of procedures. Indwelling catheters, such as a Foley catheter, are held in place within the urethra by an inflatable tip placed in the bladder; others are specifically designed to open urethral strictures, dilate the ureter, instill antimicrobial irrigants and other fluids, bypass an enlarged prostate, or serve several other specialized purposes.
Anorectal malformation: Definitive repair and surgical protocol
Published in Alejandra Vilanova-Sánchez, Marc A. Levitt, Pediatric Colorectal and Pelvic Reconstructive Surgery, 2020
Belinda Dickie, Taiwo Lawal, Paola Midrio
The Foley catheter can be removed in girls with vestibular fistula, as well as in boys with perineal fistula, within 24 hours of surgery but can be left longer to keep the perineal incisions dry. A similar measure is done for patients with ARM without fistula. In boys with rectourethral fistula, the Foley catheter is left in place in the urethra for 5 to 7 days. The catheter is retained for longer in those who had rectovesical fistula or in whom urethral repair was done, in which case the Foley is kept for 10–14 days, or in patients with spinal anomalies who may need to do intermittent catheterization. Another option is to pass a suprapubic catheter or perform a vesicostomy in boys with rectovesical fistula or following urethral repair, especially with a laparotomy or laparoscopy-assisted anorectoplasty. A transurethral silicon stent can also be used. This stent exits the lower abdomen at one end and the urethral meatus at the other end. The two ends are tied together to prevent the stent from being dislodged (circle stent) and the stent is removed after cystoscopy confirms healing of the urethra at 6–8 weeks.
Wall shear stress indicators influence the regular hemodynamic conditions in coronary main arterial diseases: cardiovascular abnormalities
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
M. Ferdows, K. E. Hoque, M.Z.I. Bangalee, M. A. Xenos
This study focuses to build a framework for patient-based on 3 D model reconstruction and geometric analysis and describes CH properties, for instance, the velocity magnitude with streamlines, mean arterial pressure difference, WSS, TAWSS, OSI, RRT, and cFFR by exploiting open-source tools. The hemodynamic factors allow delineating the intrinsic blood flow in a non-invasive procedure. Our simulation results that show the WSS, TAWSS, and OSI are linearly correlated with the percentage of the AS and WSS magnitude distribution values. We have observed that the multiple sequential stenoses are more critical than the single one, and proximal stenoses are more severe than distal stenoses although the percentage of AS is the same. The cFFR results allow distinguishing the unstenosed and stenosed arterial models produced by the natural phenomena. The WSS values increase with an increase in the velocity magnitude in the stenosis regions. The simulation results are feasible for actual clinical applications, but there are also some limitations in the procedures, which require more studies to overcome them. This technique could be used as a non-invasive, low-risk, and complementary procedure for expensive and risky invasive catheterization.
Optimizing a MitraClip procedure with high frequency jet ventilation
Published in Baylor University Medical Center Proceedings, 2023
Manesh Kumar Gangwani, Fawad Haroon, Fnu Priyanka, Anthony Sonn
The procedure was performed in the catheterization laboratory with the patient under general anesthesia. Two- and three-dimensional TEE was used for guidance of the catheter during the MitraClip procedure. A 7 French sheath was placed in the right common femoral vein, followed by dilation up the vein. This was followed by transseptal puncture, and an optimal puncture site was located using TEE. This allowed advancement of the steerable guide catheter into the left atrium. Once the catheter was in the left atrium, maneuvering to the correct position for clip deployment was challenging due to the patient’s valve anatomy and cardiac movement artifact caused by respiratory variations. Three-dimensional echocardiographic imaging was used to determine the appropriate predeployment approach for direction, orientation, and trajectory. It was technically difficult to grasp the posterior leaflet for MitraClip deployment in two attempts. As a result, HFJV was utilized to stabilize the surgical field and reduce motion artifact. The clip was then moved to the correct position below the mitral valve. Once this was accomplished, the leaflet was successfully grasped, the result was assessed using TEE imaging, and the clip was successfully released (Figure 1h).
A Prospective Multi-Institutional Evaluation of Iatrogenic Urethral Catheterization Injuries
Published in Journal of Investigative Surgery, 2022
Stefanie M. Croghan, Leah Hayes, Eabhann M. O’Connor, Mark Rochester, William Finch, Anne Carrie, Shane W. Considine, Frank D’Arcy, Aisling Nic an Riogh, Wasim Mahmalji, Mohammed Elhadi, Helen Thursby, Ian Pearce, Vaibhav Modgil, Hosam Noweir, Eoin MacCraith, Aideen Madden, Rustom Manecksha, Eva Browne, Subhasis K. Giri, Connor V. Cunnane, John Mulvihill, Michael T. Walsh, Niall F. Davis, Hugh D. Flood
A multi-center, prospective, descriptive cross-sectional study was designed to identify the incidence of urethral catheterization injury occurring with standard catheterization practice, using the primary institution of three UK Hospital Trusts and four Irish Hospital Groups. Participating institutions were as follows: Manchester Royal Infirmary (Manchester University NHS Foundation Trust), Hereford County Hospital (Wye Valley NHS Trust), Norfolk and Norwich University Hospital (Norfolk and Norwich University Hospitals NHS Foundation Trust), Beaumont Hospital (Royal College of Surgeons Ireland Hospital Group), University Hospital Limerick (The University of Limerick Hospital Group), Tallaght University Hospital (Dublin Midlands Hospital Group) and Galway University Hospital (Saolta University Healthcare Group). An overall six-month study timeframe was designated (October – March inclusive), within which each participating institution was requested to identify and complete a consecutive 3-4 month period of data collection. This timeframe was selected based on previous work showing relative consistency of catheter injuries over a six-month period [5], with in-built flexibility to permit centers to select the period in which they could guarantee the highest quality of data collection based on local variables such as staffing. Data saturation was anticipated after this period given the multi-center design. Institutional ethics or audit committee approval was obtained at each site.