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At least 55 records · Page 3Linked to original sources
PubMed1996

Postoperative catheterization, urinary retention, and permanent voiding dysfunction after polytetrafluroethylene suburethral sling placement.

OBJECTIVE: To determine the incidence of permanent voiding dysfunction after polytetrafluoroethylene suburethral sling placement, and to assess the effect of voiding mechanism and uroflowmetry on the duration of postoperative catheterization. METHODS: Between January 1986 and April 1991, 108 patients underwent suburethral sling procedures to treat genuine stress incontinence. Medical records were reviewed to collect urodynamic and catheterization data. One year or longer after surgery, 98 women completed a telephone interview evaluating incontinence, self-catheterization, and voiding symptoms. RESULTS: The mean duration of postoperative cathtrerization was 10.7 weeks. There was no significant relationship between preoperative uroflow indices and the duration of catheterization. The presence of a preoperative detrusor contraction was associated with a shorter mean duration of postoperative catheterization (6.1 versus 14.8 weeks, P = .07) and a lower risk of sling removal for retention (7 versus 33%, P = .04). Eight patients continued self-catheterization. Fourteen patients reported other micturition problems: three used the Credé maneuver or double voided to facilitate emptying and 11 were unable to urinate when seated upright. There was no correlation between the duration of catheterization and ongoing voiding dysfunction. Among nine women who underwent further surgery to treat postoperative urinary retention, three continue to catheterize, one performs Credé, and one urinates standing. CONCLUSIONS: Polytetrafluoroethylene suburethral sling placement commonly produces permanent voiding difficulty. Patients who void without a detrusor contraction are at increased risk for prolonged postoperative catheterization. Sling removal does not ensure resolution of urinary retention and may be no better than leaving the sling in place.

Adult↗
PubMed2003

Molecular epidemiology of Proteus mirabilis infections of the catheterized urinary tract.

Proteus mirabilis compromises the care of many patients undergoing long-term indwelling bladder catheterization. It forms crystalline bacterial biofilms in catheters which block the flow of urine, causing either incontinence due to leakage or painful distention of the bladder due to urinary retention. If it is not dealt with, catheter blockage can lead to pyelonephritis and septicemia. We have examined the epidemiology of catheter-associated P. mirabilis infections by use of pulsed-field gel electrophoresis (PFGE) of NotI restriction enzyme digests of bacterial DNA. This technique was shown to be more discriminatory than the classical phenotypic Dienes typing technique. We demonstrated that each of 42 isolates from diverse environmental sources and 10 of 12 isolates from blood, wound swabs, and mid-stream urine samples of hospitalized patients had distinct genotypes. Examination of a set of 55 isolates of P. mirabilis, each from a different clinical or environmental source, identified 49 distinct genotypes and 43 Dienes types. The index of discrimination was 0.993 for the PFGE method and 0.988 for the Dienes method. Applying the PFGE method to isolates from catheter-associated urinary tract infections confirmed that the strains present in the crystalline catheter biofilms were identical to those isolated from the same patient's urine. An analysis of samples taken during a prospective study of infections in catheterized nursing home patients revealed that a single genotype of P. mirabilis can persist in the urinary tract despite many changes of catheter, periods of noncatheterization, and antibiotic therapy.

Biofilms↗
PubMed2003

Medical management of urethral and colonic perforation associated with urinary catheterization in a kitten.

A 6-week-old male kitten was evaluated because of stranguria and possible urethral blockage; a urinary catheter placed during general anesthesia penetrated the urethral and colonic walls and entered the colon. Treatment was conservative, with fluids administered i.v., administration of piperacillin, and supportive care. The kitten never became febrile or clinically ill and continued to thrive. There was no development of clinical signs consistent with stricture, diverticulum, or fistula formation. Complications from urethral perforation include infection and urethral stricture. Reconstructive surgery is considered the treatment of choice for traumatic urethral-colonic perforation. However, surgery may not be feasible or may be cost-prohibitive in certain situations. In such instances, medical management may provide a reasonable alternative to euthanasia.

Animals↗