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At least 19 recordsLinked to original sources
PubMed2006

Short term urinary catheter policies following urogenital surgery in adults.

BACKGROUND: Urinary catheterisation (by the urethral or suprapubic routes) is common following urogenital surgery. There is no consensus on how to minimize complications and practice varies. OBJECTIVES: To establish the optimal way to manage urinary catheters following urogenital surgery in adults. SEARCH STRATEGY: We searched the Cochrane Incontinence Group specialised trials register (searched 30 May 2005) and the reference lists of relevant articles. SELECTION CRITERIA: Randomised and quasi-randomised trials were identified. Studies were excluded if they were not randomised or quasi-randomised trials of adults being catheterised following urogenital surgery. DATA COLLECTION AND ANALYSIS: Data collection was performed independently by two of the review authors and cross-checked. Where data might have been collected but not reported, clarification was sought from the trialists. MAIN RESULTS: Thirty nine randomised trials were identified for inclusion in the review. They were generally small and of poor or moderate quality reporting data on only few outcomes. Confidence intervals were all wide. USING A URINARY CATHETER VERSUS NOT USING ONE: The data from five trials were heterogeneous but tended to indicate a higher risk of (re)catheterisation if a catheter was not used postoperatively. The data gave only an imprecise estimate of any difference in urinary tract infection. URETHRAL CATHETERISATION VERSUS SUPRAPUBIC CATHETERISATION: In six trials, a greater number of people needed to be recatheterised if a urethral catheter rather than a suprapubic one was used following surgery (RR 3.66, 95% CI 1.41 to 9.49). SHORTER POSTOPERATIVE DURATION OF CATHETER USE VERSUS LONGER DURATION: In 11 trials, the seven trials with data suggested fewer urinary tract infections when a catheter was removed earlier (for example 1 versus 3 days, RR 0.50, 95% CI 0.29 to 0.87) with no pattern in respect of catheterisation. CLAMP AND RELEASE POLICIES BEFORE CATHETER REMOVAL VERSUS IMMEDIATE CATHETER REMOVAL: In a single small trial, the clamp-and-release group showed a significantly greater incidence of urinary tract infections (RR 4.00, 95% 1.55 to 10.29) and a delay in return to normal voiding (RR 2.50, 95% CI 1.16 to 5.39). AUTHORS' CONCLUSIONS: Despite reviewing 39 eligible trials, few firm conclusions could be reached because of the multiple comparisons considered, the small size of individual trials, and their low quality. Whether or not to use a particular policy is usually a trade-off between the risks of morbidity (especially infection) and risks of recatheterisation.

Adult↗
PubMed1998

Caudal morphine in paediatric patients: a comparison of two different doses in children after major urogenital surgery.

We compared the duration of postoperative analgesia and the occurrence of side-effects of two different doses of caudal morphine in children undergoing major urogenital surgery. Fifty-two children aged between 1 and 12 years were randomly selected to receive caudal morphine, either 25 micrograms.kg-1 (Group A) or 50 micrograms.kg-1 (Group B) with 0.5 ml kg-1 of 0.25% plain bupivacaine immediately before surgery. They were monitored for 24 hours in a high dependency area for known complications of epidural morphine. There was no significant difference in postoperative analgesia between the two doses of caudal morphine. Clinically significant respiratory depression or sedation was not detected in either group. The occurrence of vomiting and pruritus was similar in both groups. Urinary retention was not recorded as all children had an indwelling catheter as required by the surgical procedure. We concluded that 25 micrograms.kg-1 of caudal morphine is as effective as 50 micrograms.kg-1 for providing postoperative analgesia in children undergoing urogenital surgery.

Analgesics, Opioid↗
PubMed1993

Female urogenital surgery in cattle.

Surgical manipulation of the female reproductive tract is part of routine bovine clinical practice. Most indications for urogenital surgery in cattle are for alleviation of dystocia or correction of injuries sustained during parturition. Less frequently, surgery is indicated for ovarian tumor removal, embryo transfer, or spaying of feeding heifers. This article discusses clinical assessment for selection of various surgical procedures of the bovine female genital tract.

Animals↗
PubMed2005

Urogenital surgery of the 15th century in Anatolia.

PURPOSE: We examined the urological procedures of the 15th century covered in the surgery textbook, Cerrahiyyetu'l Haniyye. MATERIALS AND METHODS: Three copies of the surgery textbook, Cerrahiyyetu'l Haniyye (Sultan's Surgery), by Serefeddin Sabuncuoglu, who lived in Turkey between 1385 and 1470, were evaluated. The colorfully miniaturized and illustrated textbook, written 536 years ago, covers a number of surgical disciplines, including urology. We evaluated urological sections with regard to the type of procedures, definitions and approaches for certain diseases and surgical tools used for urological operations. RESULTS: The textbook reviews the surgical treatment of urological conditions such as varicocele, hydrocele, hermaphroditism, imperforated urinary meatus, meatal stenosis, hypospadias, penile and scrotal lesions, and circumcision techniques. It includes definitions of diseases, etiologies and surgical therapies, and describes surgical instruments. The author also illustrated surgical approaches and instruments. CONCLUSIONS: A treasure trove of surgical knowledge, Cerrahiyyetu'l Haniyye has enlightened urologists from the 15th century to the present day.

Female↗
PubMed1991

Standing urogenital surgery.

Caslick's, episioplasty, urethroplasty, cervical, and rectovestibular laceration repair are, by preference, performed in the standing patient. Normal castration is performed routinely uneventfully in the standing patient. The duration of the procedures and the ease with which they are accomplished in a standing horse of normal temperament make general anesthesia unnecessary. More invasive procedures, such as removal of urinary bladder calculi in male horses or removal of a neoplastic ovary in a mare, can be accomplished in a standing patient but serious consideration should be given to the use of general anesthesia. For these procedures, the potential complications are increased while the ability to effectively deal with those complications is diminished in a standing patient. For instance, imagine a mare that lays down in the stocks during a standing flank removal of an ovary or a stallion that defecates during a Gokel's approach to the bladder. Only extenuating circumstances justify these risks when general anesthesia is available.

Animals↗
PubMed2005

[Small intestinal submucosa (SIS): prospects in urogenital surgery].

SIS (Small Intestinal Submucosa) is an extracellular matrix isolated from pig intestine. Since its discovery in 1987, many studies have defined its structure and have demonstrated its useful biointegration and tissue regeneration properties. It also appears to be a resistant substrate associated with a low risk of infection. The role of this matrix is still under investigation in many fields of surgery, but its value has been clearly established in urological and gynaecological surgery. Several experimental and clinical studies have reported interesting results in cystoplasties, repair of stress urinary incontinence by suburethral support, urethroplasties or even chordee of the penis. Applications of this material are still to be evaluated in pelvic floor disorders, particularly in prolapse surgery.

Animals↗
PubMed2000

Standing female equine urogenital endoscopic surgery.

Standing female urogenital endoscopic surgery is facilitated by the more dorsal location of the organs of the female reproduction tract. The most common reason for laparoscopic surgery on the female urogenital system is ovariectomy; however, the technique has been used to diagnose periparturient or reproductive diseases and to perform surgical embryo transfer. Standing surgical approaches avoid the risk and expense of general anesthesia, but these techniques are limited by the temperament and size of the patient and the availability of facilities for restraint. Owner acceptance of laparoscopic procedures is excellent. It is anticipated that standing endoscopic surgery may become the preferred technique for applicable procedures.

Animals↗