Application of pediatric ureteroscope-nested silicone catheter direct-vision catheterization in difficult urethral catheterization
10.12483/j.issn.1009-8291.2026.06.006
- VernacularTitle:儿童输尿管镜嵌套导尿管直视技术在男性困难导尿中的应用研究
- Author:
Xudong YANG
1
;
Xiaoyan WANG
1
;
Zhongbao ZHOU
1
;
Yong ZHANG
1
Author Information
1. Department of Urology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- Publication Type:Journal Article
- Keywords:
difficult catheterization;
pediatric ureteroscope;
direct-vision catheterization;
sheath effect;
urethral injury;
minimally invasive technique
- From:
Journal of Modern Urology
2026;31(6):536-541
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efficacy of direct-vision catheterization using pediatric ureteroscopenested silicone catheter in male patients with difficult urethral catheterization, so as to provide a novel minimally invasive solution for the clinical management of difficult catheterization. Methods A retrospective analysis was conducted on 33 adult male patients with failed conventional urethral catheterization admitted to our hospital during Jan.2019 and Dec.2024.Directvision catheterization technique using a pediatric ureteroscope (F4.5/6.5) nested within an F18 silicone catheter was employed. The ureteroscope was inserted into the catheter lumen reaching the tip, utilizing the “sheath effect” to provide rigid support and a direct pathway.Pressurized irrigation connected to the independent channel of the three-way catheter provided sufficient fluid flow to identify the urethral course and guide catheterization under direct vision.Catheterization success rate, operation time, complication rate, and postoperative recovery were observed. Results Among the 33 patients, there were 26 cases of iatrogenic/traumatic urethral injury and 7 cases of underlying pathological structural abnormalities.Successful catheter placement was achieved in 32 patients (97.0%), 3 (9.4%) of which required zebra guidewire assistance, and 4 (12.5%) of which were successfully catheterized after adult ureteroscope dilation.One case with long-segment urethral stricture (approximately 4 cm) underwent suprapubic cystostomy.The median operation time was 12 (8, 18) minutes, with intraoperative blood loss less than 10 mL.No serious complications occurred during the procedure.After 14 days of catheter indwelling, patients achieved smooth voiding, median maximum flow rate was 18.2 (16.5, 20.4) mL/s.During the median follow-up of 6 (4, 9) months, no complications such as urethral stricture or urinary incontinence occurred. Conclusion Direct-vision catheterization using pediatric ureteroscope-nested silicone catheter is a safe and effective method for managing difficult urethral catheterization in male patients.
