Whether indwelling urethral catheter should be removed after urethroplasty or visual internal urethrotomy in patients with posterior urethral injured is still controversial. From May 1990 to February 1995, 28 patients with posterior urethral injury underwent retrograde pericatheter urethrography for the purpose of the evaluation of urethral continuity in the timing of the removal of indwelling urethral catheter. The indwelling catheter was removed in 24 patients whose urethra did not have any extravasation, and 4 patients had detectable extravasation. We conclude that retrograde pericatheter urethrogram is the most useful radiologically diagnostic method to evaluate in the timing of the removal of indwelling urethral catheter and to obtain the objective parameter of urethral patency in posterior urethral injured patients, postoperatively.
Catheters* ; Catheters, Indwelling ; Humans ; Urethra ; Urinary Catheters

No abstract available.
Rupture ; Urinary Bladder ; Urinary Catheters

Herein, we describe a perineum-based pediculated scrotal flap procedure for urethral reconstruction. A scrotal tubular flap was used as a substitute to correct a proximal penile urethral stricture in case 1. In case 2, a scrotal island patch was performed to treat an iatrogenic penile urethral injury. In both cases, the urethral catheter was removed on postoperative day 14 with simultaneous normal voiding cystourethrography. The excellent axial vascularization of this perineum-based pediculated scrotal flap procedure allows successful urethral reconstruction, regardless of extension, location, and etiology.
Urethral Stricture ; Urinary Catheters

Fifteen stress urinary incontinence patients were treated using the modified endoscopic suspension of the bladder neck that eliminates all incisions during the period from January 1990 to December 1990. The average operation time was 26 minutes and the mean days of urethral Foley catheter removal were 3.9 days operation. Two point three days were required to restore the normal voiding pattern. Of 15 patients treated. 1 failure occurred, for an overall success rate of 93%. There had been no significant complications. Therefore, no-incision pubovaginal suspension was simple and effective means treating stress urinary incontinence.
Catheters ; Humans ; Neck ; Urinary Bladder ; Urinary Incontinence*

Aims: Biofilm formation of bacteria inside the surface of urinary catheters triggers severe urinary tract infections (UTIs). This study aims to determine the biofilm forming capacity of bacteria isolated from urinary catheters of patients diagnosed with UTIs as well as comparison of antibiotic sensitivity patterns between biofilm and non-biofilm forming isolates. Methodology and results: A total of 40 urinary catheters were collected from 96 h catheterized patients. The isolated uropathogenic bacteria were identified and examined for biofilm formation using the microtiter plate method. Later, the isolates were subjected to antimicrobial susceptibility towards 12 antibiotics that commonly used for treating UTIs using the disk diffusion method. All the catheters were found colonized with two to five different bacterial species individually. Out of the 131 isolates from 40 catheters, Pseudomonas aeruginosa (38/131, 29%) was the predominant isolated bacteria followed by Escherichia coli (31/131, 24%), Proteus vulgaris (24/131, 18%), Klebsiella pneumoniae (21/131, 16%) and Staphylococcus aureus (17/131, 13%). Among these, the highest biofilm forming capacity was observed in P. aeruginosa (26%), followed by P. vulgaris (16%) and K. pneumoniae (13%). Regarding antibiotic resistance, biofilm forming bacteria showed resistance to multiple drugs except for carbapenems. Moreover, biofilm formers exhibited higher resistance than non-biofilm formers against antibiotics such as trimethoprim/sulfamethoxazole (100% vs 82%), amoxicillin-clavulanic acid (81% vs 55%), cefixime (85% vs 55%), ceftriaxone (81% vs 45%), cefalexin (93% vs 55%), amikacin (70% vs 45%), ampicillin (89% vs 73%), ciprofloxacin (70% vs. 36%) and ceftriaxone (81 vs 45%), (p-value<0.05). Conclusion, significance and impact of study Most of the isolated uropathogenic bacteria from catheters were biofilm formers and multiple antibiotic resistant. Appropriate selection of antibiotics, meticulous hygiene practices in hospital settings and limiting the duration of catheterization can reduce biofilm formation and the emergence of antibiotic resistance.
Biofilms ; Urinary Catheters ; Urinary Tract Infections

During last two year and seven month, We have seen 38 patients bladder rupture due to 34 blunt trauma, 2 penetrating injuries and 2 iatrogenic causes. There were 13(34.2%) intraperitoneal and 25(65.8%) extraperitoneal injuries. Nonoperative( catheter ) management was used in 21 patients with extraperitoneal rupture of the bladder with extravasation of dye found by retrograde cystogram and successfully treated by urethral catheter drainage only. We excluded 4 patients coexisting urethral rupture and significant intraabdominal injury. Complication occurred in 8 of the 2l patients but all were treated spontaneously during catheter drainage. It seemed obvious that nonoperative management will give a satisfactory result and would not be necessarily benefit from an operation to closing the bladder.
Catheters ; Drainage ; Humans ; Rupture* ; Urinary Bladder* ; Urinary Catheters

A clinical evaluation was performed on 7 patients of neurogenic bladder who underwent T.U.R. or T.U.R. with external sphincterotomy. All patients were indwelling Foley catheter from 7 months (minimal) to 2 and 1/2 years(maximal), were unable to self-voiding and their residual urine was over 100cc. The following conclusions were obtained: 1) 3 patients underwent T.U.R. but T,U.R. and external sphincterotomy was performed in 4 patients. 2) Of 7 patients, satisfactory result was obtained in 5 patients, but 2 patients obtained unsatisfactory result.
Catheters ; Humans ; Urinary Bladder, Neurogenic*

PURPOSE: The effect of a urethral catheter on pressure-flow study has important implications for the practice and interpretation of pressure flow studies. We wonder which catheter would be adequate for pressure flow study. We report 3 different size of catheters(4Fr, 10Fr, 12Fr) effects on urinary flow rate, voiding pressures and pressure flow plot. MATERIALS AND METHOD: Pressure flow studies were carried out on 141 patients(male;88, female;53), whose diseases were BPH in 22, prostatodynia in 37,urethral syndrome in 36, Hinman syndrome in 2, neurogenic bladder in 28, unstable bladder in 10, urethral stricture in 2 and bladder stone in 2. RESULTS: There was no significant difference between pre- and postcatheterization maximum flow rate in 4Fr group. But there were significant difference between pre- and post-catheterization maximum flow rate in 10Fr and 12Fr group. The detrusor pressure was significantly higher in 10Fr and 12Fr group than in 4Fr group. The larger size of catheter groups had more obstructive patterns in pressure flow plot. CONCLUSIONS: These results showed 4Fr catheter had less effect on pressure flow study than 10Fr, 12Fr catheter.
Catheters ; Urethral Stricture ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Bladder, Neurogenic ; Urinary Catheters*

PURPOSE: To compare the estimated degree of urine leakage during straining on standing cystourethrography(CUG) under fluoroscopy with subjective degree and Valsalva leak point pressure(VLPP), and to determine it's clinical significance. MATERIALS AND METHODS: 157 consecutive women who presented with stress urinary incontinence with a mean age of 47 years were included in this study. Standing CUG was performed in the state of urethral catheter insertion and removal. Degree of urine leakage was determined on the fluoroscopy during standing CUG by one urologist, and VLPP was determined by another observer. Each of subjective degree, leakage amount and VLPP was classified into 3 grade and compared it's results to each other. RESULTS: High correlation was present between the leakage amount and VLPP(p<0.05), and the subjective degree and VLPP(p<0.001), but subjective degree was not highly correlated with leakage amount. Among the clinical parameters, urge syndrome and urge incontinence only had the positive effect to urine leakage. CONCLUSIONS: Estimation of leakage amount during standing CUG on fluoroscopy seems to be a simple and useful method in the objective evaluation of urine leakage, but it should be considered to be the possibility of over-estimation in the cases of associated urge syndrome and urge incontinence.
Female ; Fluoroscopy ; Humans ; Urinary Catheters ; Urinary Incontinence* ; Urinary Incontinence, Urge

PURPOSE: The incidence and severity of catheter associated bacteriuria might be dependent on the catheterized duration and route, although this has not been clearly established yet. We evaluated the severity of urinary tract infection according to the duration of the indwelling urethral catheter and the effect of antibiotic therapy in rabbits. MATERIALS AND METHODS: A total of 54 rabbits were divided into one control group and two experimental groups; antibiotic and no antibiotic group, which were subdivided according to catheterized period(1, 4, 7 and 14-day). We examined the urinalysis, urine culture, qualitative biofilm culture and scanning electro-microscopy of the urethral catheter. RESULTS: 1. In the urinalysis, pyuria developed significantly both in 4, 7, 14-day group of no-antibiotic and in 14-day of antibiotic group compared to the control group(p<0.05). In the no antibiotic 7-day group, pyuria developed significantly as compared to that of the antibiotic group(p<0.05). 2. In the urine culture, positive urine culture was increased significantly in 7, 14-day of no-antibiotic group and 14-day of antibiotic group compared to the control group(p<0.05). In the no antibiotic 7-day group, positive urine culture developed significantly as compared to the antibiotic group(p<0.05). 3. In the qualitative biofilm culture of the urethral catheter, positive culture developed significantly in the no antibiotic 7, 14-day group and the antibiotic 14-day group as compared to the control group(p<0.05). Positive biofilm culture was developed significantly in the no antibiotic 7, 14-day group as compared to the antibiotic group(p<0.05). 4. In scanning electro-microscopy, bacterial biofilm of the urethral catheter was similar to the qualitative biofilm culture, and increased with increasing duration of the catheterization. CONCLUSIONS: It is suggested that the early removal of the urethral catheter is important for the reduction of chance of urethral catheter associated urinary tract infection. In case of a long-term indwelling urethral catheter(more than 2 weeks), prevention of urinary tract infection was very difficult despite antibiotic administration.
Bacteriuria ; Biofilms ; Catheterization ; Catheters ; Incidence ; Pyuria ; Rabbits ; Urinalysis ; Urinary Catheters* ; Urinary Tract Infections* ; Urinary Tract*