PubMed · 533472
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R B Brown. 1979. Cystoscopy.. https://pubmed.ncbi.nlm.nih.gov/533472/
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Inserting a Foley catheter into a traumatized urethra with false channels or a post-transurethral resection of prostate (TURP) undermined bladder neck can be very difficult if not impossible at times. Likewise, replacing a Foley catheter that has fallen out in the early postoperative period after a radical prostatectomy can be difficult and can cause significant injury to the fresh anastomosis. We describe a technique using a Peel-Away sheath that fits over a cystoscope or a resectoscope, and facilitates accurate insertion of a Foley catheter without trauma to the urethra.
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As the general experience with extracorporeal shock wave lithotripsy (ESWL) for renal calculi broadens, it is increasingly evident that the clearance of stone fragments in lower pole calices needs to be improved. The stone-free rate after treatment for lower caliceal stones is consistently less than that for other upper tract locations. Use of a cystoscopically placed cobra catheter for directed irrigation during ESWL resulted in an increase of our lower caliceal stone-free rate at 1 and 3 months of followup to 71% (15 of 21) compared to 33% (8 of 24) of randomly selected controls at 1 month and 54% (13 of 24) at 3 months. We conclude that pre-ESWL placement of a cobra catheter into the lower pole calix and intermittent irrigation during the procedure are potentially useful adjuncts in the successful treatment of lower caliceal calculi.