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Urologic Involvement
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Jörg Keckstein, Gernot Hudelist, Simon Keckstein
A drain is placed in the space of Retzius or pouch of Douglas for approximately 2–3 days. A methylene blue test can be performed to exclude anastomotic leakage. After 7–10 days, cystography is performed to check bladder and anastomotic integrity and then the bladder catheter is removed if the findings are normal.
Urinary system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Cystography is the radiographic examination of the urinary bladder following the introduction of a suitable contrast agent into the bladder. This is a non-dynamic procedure. The procedure normally involves bladder catheterisation, withdrawal of any urine, and the removal of the catheter from the urethra after the bladder has been filled with contrast. Alternatively, suprapubic puncture may be required when catheterisation is impossible.
Management of Locally Advanced and Recurrent Rectal Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Where only a partial cystectomy was required, a double-layered suture repair over an indwelling catheter will usually suffice, which is left in situ for a minimum of seven days, will usually suffice. It is not uncommon to perform a check cystography prior to catheter removal to ensure that the cystostomy has healed prior to catheter removal.
Lower urinary tract injuries in patients with pelvic fractures at a level 1 trauma center – an 11-year experience
Published in Scandinavian Journal of Urology, 2023
Lasse Rehné Jensen, Andreas Røder, Emma Possfelt-Møller, Upender Martin Singh, Mikael Aagaard, Allan Evald Nielsen, Lars Bo Svendsen, Luit Penninga
Of 20 patients, 12 (60%) were classified as resolved and sustained no long-term complications. For evaluation of bladder injuries related to pelvic fractures, AUA and EAU recommends cystography (standard AP projection or CT). In case of visible hematuria, cystography is absolute indicated. AUA and EAU guidelines both recommend conservative treatment with CAD in uncomplicated extraperitoneal bladder injuries based on expert opinion [16,19]. Extraperitoneal lesions can be managed with continuous bladder drainage to prevent rise in intravesical pressure which thereby promotes the disruption to heal [30]. Most ruptures heal by 3 weeks, and AUA guidelines recommend surgical repair if healing is not achieved by 4 weeks [19]. As observed in this cohort, patient who are scheduled for open pelvic surgery, any bladder rupture should be surgically repaired to reduce the risk of infection according to guidelines. Surgical repair in intraperitoneal ruptures is always recommended to prevent urine extravasation and consequently peritonitis and abdominal sepsis. In case of complex extraperitoneal bladder injuries, follow-up cystography should be performed to confirm healing, according to AUA and EAU [16,19]. In our cohort, primary treatment of bladder injuries adhered to guidelines. Nevertheless, we observed that no formalized urological follow-up program was scheduled, and 11 (55%) patients had cystography done at different times and indications. Despite inconsistent follow-up strategies, overall severe long-term urinary complications were rare.
Is excision necessary in the management of adult urachal remnants?: a 12-year experience at a single institution
Published in Scandinavian Journal of Urology, 2018
Daanesh H. Hassanbhai, Foo Cheong Ng, Li-Tsa Koh
Much of the current literature advocates ultrasound as a first line investigation when urachal anomalies are suspected, with C.T. to be used only when U.S. findings are negative or questionable, due to the increased lifetime radiation-related cancer risk and limited additional information gained [12,13]. However, it is worthy to note that these are made in reference to primarily paediatric populations. In accordance to international guidelines, C.T. is more commonly employed in our institution as part of a work-up for haematuria [14]. Ultrasound is adequately informative for surveillance of urachal lesions due to their extraperitoneal location and relation to the bladder. Cystography magnetic resonance urography and sino/fistulography are also useful in specific cases. In a review by Nogueras-Ocana et al. [15], cystography was performed in all symptomatic cases, yet Little et al. [16] reported little additional information was gained from voiding cystourethrograms and computed tomography. While we propose ultrasonography as a reasonable method to follow-up urachal anomalies deemed benign, we lack evidence of cases where malignant transformation was noted on follow-up. Thus, further long-term follow-up with a larger cohort is needed to demonstrate the superiority of ultrasound in this respect.
The narrow vesicourethral angle measured on postoperative cystography can predict urinary incontinence after robot-assisted laparoscopic radical prostatectomy
Published in Scandinavian Journal of Urology, 2018
Motohiko Sugi, Hidefumi Kinoshita, Takashi Yoshida, Hisanori Taniguchi, Takao Mishima, Kenji Yoshida, Masaaki Yanishi, Yoshihiro Komai, Masato Watanabe, Tadashi Matsuda
Perioperative images may facilitate prediction of urinary incontinence after robot-assisted laparoscopic radical prostatectomy (RALP). Coakley et al. reported that membranous urethral length determined on magnetic resonance imaging (MRI) was related to the time taken to achieve stable postoperative urinary continence [8]. However, MRI is excessively expensive for use as a routine follow-up survey. In contrast, cystography is a convenient method for evaluating anastomotic leakage in daily practice. Parameters measured on postoperative cystography that are reportedly significantly associated with urinary incontinence after laparoscopic radical prostatectomy or RALP include postoperative shorter membranous urethral length, a more downward-directed bladder neck and a sharper bladder neck angle, a more downward-directed position of the urethrovesical junction (UVJ), hypourethral movement, the narrow posterior vesicourethral angle (PVUA), and the higher ratio between the longitudinal and horizontal length of the bladder (L/H ratio) [9–14].