Catheter induced hypospadias, urethral trauma and penile abscess in completely recoverable neurological afflictions: preventable entities

Background: Catheter associated complications are very common in the emergency departments of medicine, general surgery, orthopaedics and in community. They mostly occur in patients with neurological afflictions because of inexperience of the first handlers as they lack the insight of altered physiology and anatomy in the lower urinary tract because of neurological lesions and also because of an inadequate advice at the time of discharge regarding the catheter care. Objectives of this study were to find the prevalence of per-urethral catheter associated injuries in patients with neurological lesions in a tertiary care centre of south-eastern Punjab and their prevention in completely recoverable neurological afflictions.Methods: This is a cross-sectional observational study conducted in urology department from 1st August 2017-31st August 2018. The data was taken from medicine, general surgery and orthopedic emergency departments. A total of 82 patients were taken from 19-78 years and 49 patients had per-urethral catheter placement. Analysis was done using Statistical Program of Special Sciences, version 20.Results: It was observed that overall neurological lesions are more common in males (80.48%) as compared to females (19.51%) and distributed over an age range of 19-84 years in both sexes. Out of total patients, 59.75% required per urethral catheterization. The prevalence of per-urethral catheter associated complications was 20.40%.Conclusions: Insertion of per-urethral catheter is a simple procedure but an error of omission on the part of health professionals’ results in a serious complication in a neurological patient. Proper insertion technique and catheter care are to be followed to prevent avoidable complications in this subset of patients.

Vesicostomy button: how is it placed, in whom, and how is quality of life affected?

ABSTRACT Purpose The vesicostomy button has been shown to be a safe and effective bladder management strategy for short- or medium-term use when CIC cannot be instituted. This study reports our use with the vesicostomy button, highlighting the pros and cons of its use and complications. We then compared the quality or life in patients with vesicostomy button to those performing clean intermittent catheterization. Materials and Methods Retrospective chart review was conducted on children who had a vesicostomy button placed between 2011 and 2015. Placement was through existing vesicostomy, open or endoscopically. We then evaluated placement procedure and complications. A validated quality of life questionnaire was given to patients with vesicostomy button and to a matched cohort of patients performing clean intermittent catheterization. Results Thirteen children have had a vesicostomy button placed at our institution in the 4 year period, ages 7 months to 18 years. Indications for placement included neurogenic bladder (5), non-neurogenic neurogenic bladder (3), and valve bladders (5). Five out of 7 placed via existing vesicostomy had leakage around button. None of the endoscopically placed buttons had leakage. Complications were minor including UTI (3), wound infection (1), and button malfunction/leakage (3). QOL was equal and preserved in patients living with vesicostomy buttons when compared to CIC. Conclusion The vesicostomy button is an acceptable alternative to traditional vesicostomy and CIC. The morbidity of the button is quite low. Endoscopic insertion is the optimal technique. QOL is equivalent in patients with vesicostomy button and those who perform CIC.

Development and evaluation of a training model for paracentetic suprapubic cystostomy and catheterization

OBJECTIVES: Minimally invasive paracentetic suprapubic cystostomy is a technique that should be learned by all surgical trainees and residents. This study aimed to develop a self-made training model for paracentetic suprapubic cystostomy and placement of the suprapubic catheter and then to evaluate its effectiveness in training fourth-year medical students. METHODS: Medical students were divided into an experimental group receiving comprehensive training involving literature, video, and model use and a control group receiving all the same training protocols as the experimental group except without hands-on practice using the model. Each student's performance was video-recorded, followed by subjective and objective evaluations by urology experts and statistical analysis. RESULTS: All students completed the surgical procedures successfully. The experimental group's performance scores were significantly higher than those of the control group (median final performance scores of 91.0 vs. 86.8, respectively). Excellent scores were achieved by more students in the experimental group than in the control group (55% vs. 20%), and fewer poor scores were observed in the experimental group than in the control group (5% vs. 30%). CONCLUSIONS: Based on its cost-effectiveness, reusability, and training effectiveness, this paracentetic suprapubic cystostomy training model is able to achieve goals in teaching practice quickly and easily. Use of the model should be encouraged for training senior medical students and resident physicians who may be expected to perform emergent suprapubic catheter insertion at some time.

Clinical value of suprapubic Trocar puncture lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones / 中国基层医药

Objective@#To evaluate the clinical value of suprapubic Trocar puncture lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones.@*Methods@#From February 2016 to August 2018, 60 patients with benign prostatic hyperplasia and bladder stones in the Second Hospital of Pujiang County were randomly selected.The patients were divided into transurethral prostatic bipolarplasma electrotomy group(control group, 30 cases) and transurethral prostatic bipolar excision procedure combined with suprapubic Trocar puncture cystinolithotomy group(study group, 30 cases) according to the operation methods.The operation time, stone extraction time, removal of bladder fistula time, catheter extraction time, success of one stone extraction, postoperative complications of the two groups were statistically analyzed.@*Results@#The operation time, stone removal time, bladder fistula removal time and catheter removal time of the study group were significantly shorter than those of the control group(t=6.965, 4.541, 3.365, 3.306, all P<0.05). The success rate of the first stone extraction in the study group was 100.0%(30/30), which was significantly higher than 86.7%(26/30) in the control group (χ2=12.83, P<0.05). The incidence rate of postoperative complications in the study group was 10.0%(3/30), which was significantly lower than 23.3%(7/30) in the control group(χ2=13.34, P<0.05).@*Conclusion@#Suprapubic Trocar puncture lithotripsy has high value in the treatment of benign prostatic hyperplasia and bladder stones.

Clinical value of suprapubic Trocar puncture lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones / 中国基层医药

Objective To evaluate the clinical value of suprapubic Trocar puncture lithotripsy in the treatment of benign prostatic hyperplasia and bladder stones.Methods From February 2016 to August 2018,60 patients with benign prostatic hyperplasia and bladder stones in the Second Hospital of Pujiang County were randomly selected.The patients were divided into transurethral prostatic bipolarplasma electrotomy group (control group,30 cases) and transurethral prostatic bipolar excision procedure combined with suprapubic Trocar puncture cystinolithotomy group (study group,30 cases) according to the operation methods.The operation time,stone extraction time,removal of bladder fistula time,catheter extraction time,success of one stone extraction,postoperative complications of the two groups were statistically analyzed.Results The operation time,stone removal time,bladder fistula removal time and catheter removal time of the study group were significantly shorter than those of the control group(t =6.965,4.541,3.365,3.306,all P ＜0.05).The success rate of the first stone extraction in the study group was 100.0％ (30/30),which was significantly higher than 86.7％ (26/30) in the control group (x2 =12.83,P ＜0.05).The incidence rate of postoperative complications in the study group was 10.0％ (3/30),which was significantly lower than 23.3％ (7/30) in the control group(x2 =13.34,P ＜ 0.05).Conclusion Suprapubic Trocar puncture lithotripsy has high value in the treatment of benign prostatic hyperplasia and bladder stones.

Reporte de caso clínico: taquicardia supraventricular secundaria a irrigación con glicina / Case report: Supraventricular tachycardia secondaryto glicine irrigation

Supraventricular tachycardia is one of the tachyarrhythmias that do not have its origin in one organic cardiomyopathy. Generally, they have a good prognosis, and its clinical spectrum varies from asymptomatic patients to those with low cardiac output. Treatment will depend on the hemodynamic stability of the pa- tient. The objective of this case report is to make a review on existent literature about adverse cardiac effects with the use of Glycine in patients after urologic surgery.

La taquicardia supraventricular hace parte del grupo de taquiarritmias que no se originan de una cardiopatía orgánica existente y por lo general son de buen pronóstico. Su espectro clínico abarca desde pacientes asintomáticos hasta aquellos con signos de bajo gasto cardíaco que requerirán tratamiento según su estabilidad hemodinámica. El objetivo del presente reporte de caso es realizar una revisión de la literatura sobre los efectos adversos asociados a la irrigación vesical continúa con glicina en un paciente a quien se le realizó prostatectomía.

Correlation between disability acceptance and post traumatic growth in patients with bladder cancer with urinary transestration / 中国实用护理杂志

Objective To investigate the status of disability acceptance and post traumatic growth in patients with urinary diversion of bladder cancer and to analyze the correlation between them. Methods One hundred and fourteen cases with urinary diversion of bladder cancer were investigated with Acceptance Disability Scale and Post Traumatic Growth Inventory. Results The score of total score of disability acceptance and post traumatic growth of bladder cancer patients with urinary diversion and abdominal wall ostomy were (177.49 ± 38.28) and (56.13 ± 14.56) points respectively. There was a positive correlation between the total score and each dimension (r=0.274-0.413, P <0.05). Conclusions There is a clear correlation between disability acceptance and post traumatic growth in patients with urinary diversion of bladder cancer. Targeted measures should be taken to improve patients'disability acceptance so as to enhance their post traumatic growth and promote their quality of life.

The effect of self-care agency on self-perceived burden of patients with permanent bladder fistula / 中国实用护理杂志

Objective To explore the effect of self-care agency on the self-perceived burden of patients with permanent bladder fistula. Methods From January 2016 to January 2017,the general data questionnaire,the Self-Perceived Burden Scale(SPBS),the Exercise of Self-Care Agency Scale(ESCA)was used to investigate 388 cases of permanent bladder fistula in 2 hospitals in Lanzhou, Baiyin and Dingxi city, and the results were statistically analyzed. Results The total score of SPBS was (36.01 ± 1.34) points,which was in the middle level.The total score of ESCA was(51.05±10.23)points,which was in low level.The total score of SPBS was negatively correlated with the total score of ESCA and each dimension (r =-0.496--0.168, P<0.01 or 0.05). Stratified regression analysis showed that self-care skills, self-responsibility, self-concept and health knowledge level in self-care ability were important influencing factors (P<0.05). Conclusions Nursing staff can improve the self-care ability, reduce the self-perceived burden,and improve the quality of life of patients.

Suprapubic cystostomy versus nonsuprapubic cystostomy during monopolar transurethral resection of prostate: A propensity score-matched analysis / 亚洲男科学杂志(英文版)

We aim to reassess the safety of the monopolar transurethral resection of the prostate (M-TURP) without suprapubic cystostomy at our institution over the past decade. This retrospective study was conducted in patients who underwent M-TURP at Peking University First Hospital between 2003 and 2013. A total of 1680 patients who had undergone M-TURP were identified, including 539 patients in the noncystostomy group and 1141 patients in the cystostomy group. After propensity score matching, the number of patients in each group was 456. Smaller reductions in hemoglobin and hematocrit (10.9 g vs 17.6 g and 3.6% vs 4.7%, respectively) were found in the noncystostomy group. In addition, patients undergoing surgery without cystostomy had their catheters removed earlier (4.6 days vs 5.2 days), required shorter postoperative stays in the hospital (5.1 days vs 6.0 days), and were at lower risk of operative complications (5.7% vs 9.2%), especially bleeding requiring blood transfusion (2.9% vs 6.1%). Similar findings were observed in cohorts of prostates of 30-80 ml and prostates >80 ml. Furthermore, among patients with a resection weight >42.5 g or surgical time >90 min, or even propensity-matched patients based on surgical time, those with cystostomy seemed to be at a higher risk of operative complications. These results suggest that M-TURP without suprapubic cystostomy is a safe and effective method, even among patients with larger prostates, heavier estimated resection weights, and longer surgical times.

Simulation of human urethral catheterization to implement urodynamic testing in mice / 中国病理生理杂志

AIM: Cystostomy is the traditionary method for detecting urodynamic indexes in mice, which de-stroys the continuity of the bladder, and there are significant differences between this method and the clinically used trans-urethral method.This study aims to develop an appropriate urethral catheter to investigate the advantages and application val-ue of transurethral method for urodynamic test.METHODS:A pediatric intravenous catheter was used for urethral catheter-ization on 8 female mice, and linked to connect the catheter to baroreceptor and micropump.The epidural catheter was also used as manometry tube.RESULTS:Using this method, the following urodynamic indicators has been successfully cap-tured:basal bladder pressure (BBP), bladder leak point pressure (BLPP), maximum voiding pressure (MVP), maxi-mum bladder capacity ( MBC ) , post-void residual urine volume ( PVR ) , voiding volume ( VV ) , efficiency of voiding ( EV) and bladder compliance ( BC) .CONCLUSION:This is the first successful simulation used in human body to a-chieve mouse urodynamic testing through the urethra catheter, which avoids the impact of cystostomy on urodynamics in mice, and the mice are able to keep long-term survival after tests for the follow-up molecular and genetic experiments.

Bedside ultrasound-guided percutaneous cystostomy in an infant in the neonatal intensive care unit

We describe a case of an infant born at 39 weeks of gestation who was in the neonatal intensive care unit for postoperative management of congenital heart disease and underwent bedside ultrasound-guided percutaneous cystostomy to treat an iatrogenic urethral injury. The procedure was uneventful, successful, and no complications were noted. This case demonstrates that this procedure is safe and minimally invasive. Indications, contraindications, techniques, potential complications, and the safety of performing this procedure in a bedside setting are discussed.

Easily Removable Ureteral Catheters for Internal Drainage in Children: A Preliminary Report

PURPOSE: We review our experience using a new and easily removable ureteral catheter in patients who underwent complicated ureteral reimplantation. Our goal was to shorten hospital stay and lower anxiety during catheter removal without fear of postoperative ureteral obstruction. MATERIALS AND METHODS: Between April 2009 and September 2010, nine patients who underwent our new method of catheter removal after ureteral reimplantation were enrolled. Patients who underwent simple ureteral reimplantation were excluded from the study. Following ureteral reimplantation, a combined drainage system consisting of a suprapubic cystostomy catheter and a ureteral catheter was installed. Proximal external tubing was clamped with a Hem-o-lok clamp and the rest of the external tubing was eliminated. Data concerning the age and sex of each patient, reason for operation, method of ureteral reimplantation, and postoperative parameters such as length of hospital stay and complications were recorded. RESULTS: Of the nine patients, four had refluxing megaureter, four had a solitary or non-functional contralateral kidney and one had ureteral stricture due to a previous anti-reflux operation. The catheter was removed at postoperative week one. The mean postoperative hospital stay was 2.4 days (range 1-4 days), and the mean follow-up was 9.8 months. None of the patients had postoperative ureteral obstructions, and there were no cases of migration or dislodgement of the catheter. CONCLUSION: Our new method for removing the ureteral catheter would shorten hospital stays and lower levels of anxiety when removing ureteral catheters in patients with a high risk of postoperative ureteral obstruction.

Squamous Cell Carcinoma of the Suprapubic Cystostomy Tract With Bladder Involvement

Herein we report a case of a squamous cell carcinoma of a well-healed suprapubic cystostomy tract scar involving the bladder mucosa in a 56-year-old man. He presented with a spontaneous suprapubic urinary leak from a suprapubic cystostomy tract scar. He had a history of urethral stricture and failed urethroplasty. Preoperative cystoscopy suggested a bladder mass. Transurethral biopsy of the bladder mass revealed a squamous cell carcinoma confined to the suprapubic cystostomy tract involving the bladder mucosa. The patient died 6 months after the start of radiation therapy after lung metastasis and pneumonia.

Quince años de experiencia clínica con hidatidosis / Clinical presentation of hydatid disease during 15 years: a case series from Santiago, Chile

Introduction: Hydatidosis is a neglected parasitic disease that is endemic in Chile. We present the clinical experience of a single center in Santiago from 1996 to 2010. Methods: Cases were identified using hospital's database. Clinical and pathological features, treatment and outcomes were retrospectively analyzed. Results: In total, 23 patients were identified requiring 30 surgical interventions. Median age was 40 years old (range 5 to 73), and 76.5% visited or resided in regions of known endemicity in Chile. Abdominal cysts were predominant (78.3%), and most patients were symptomatic (73.9%). Elimination of cyst material by cough was reported in 42.9% of patients with symptomatic thoracic cysts. Eosinophilia was present in 41.2% of patients, and 57.1% had positive serology for hydatidosis. Aill patients underwent surgical treatment, in 60.9% in combination with albendazole treatment. While the majority of liver cysts (88.9%) were treated by complete cyst resection, lung cysts (83.3%) were predominantly treated by cyst resection plus capitonnage. Pathological examination revealed fertile cysts in 24%. Postsurgical morbidity was frequent (37.9%), and 13.3% of the series required readmission for this cause. Near 25% of patients remained in hospital > 14 days, a feature associated with fever during admission (p < 0.05). No recurrence was reported in the fraction of patients that were followed-up for 2 years or more. Conclusions: Our analysis of 23 cases demonstrates that patients were mainly adults suffering from abdominal cysts. Most patients were successfully treated by surgery with or without antiparasitic drugs but complications leading to prolonged hospital stays and readmissions were not infrequent.

Introducción: La hidatidosis es una enfermedad endémica en Chile. Se presenta la experiencia clínica de un hospital en Santiago, desde 1996 al 2010. Métodos: Los casos fueron identificados usando las bases de datos institucionales y se analizaron las características clínicas y patológicas, el tratamiento y la evolución en forma retrospectiva. Resultados: Se identificaron 23 pacientes intervenidos en 30 oportunidades. La mediana de edad fue de 40 años (rango 5 a 73) y 76,5% visitó o residía en zonas endémicas en Chile. Los quistes abdominales fueron predominantes (78,3%) y la mayor parte de los pacientes eran sintomáticos (73,9%). Un 42,9% de aquellos con quistes sintomáticos torácicos reportó eliminación de vesículas con la tos. Un 41,2% presentó eosinofilia y 57,1% tuvo serología positiva para hidatidosis. Todos los pacientes fueron tratados quirúrgicamente, en 60,9% en combinación con albendazol. La mayoría de los quistes hepáticos fueron tratados con cirugía radical (88,9%) y los pulmonares predominantemente con quistostomía y capitonaje (83,3%). Un 24% de los quistes eran fértiles. La morbilidad post-quirúrgica fue frecuente (37,9%) y 13,3% de la serie requirió reingresos por esta causa. Cerca de 25% de los pacientes estuvo hospitalizado por más de 14 días, un fenómeno asociado con la presencia de fiebre por complicación séptica al ingreso (p < 0,05). No se registraron recurrencias en la fracción de pacientes seguidos por más de dos años. Conclusiones: La hidatidosis afecta principalmente a adultos en su cavidad abdominal. Aunque los pacientes fueron tratados exitosamente con cirugía, las complicaciones, estadías prolongadas y reingresos por esta causa no fueron infrecuentes.

Unusual Foreign Body in Urinary Bladder: A Case Report.

In the urinary tract, foreign body is most commonly found in the urinary bladder. It is commonly self-inflicted but can rarely be introduced by other person. Various types of foreign bodies have been reported, which includes infusion set, aluminum rod, gold chain, pearl, fish, pencil etc. Here we report a case of a 28-year young man who gave the history of forceful introduction of a long wire of mobile charger into the bladder by another person. It could not be removed by himself and by the local doctors. Then he was referred to Enam Medical College & Hospital and subsequently was removed by suprapubic cystostomy.

Suprapubic cystostomy combined with transurethral vapor resection of the prostate in treatment of large benign prostatic hyperplasia / 中国医师进修杂志

Objective To explore the efficacy and feasibility of suprapubic cystostomy combined with transurethral vapor resection of the prostate(TUVRP)for large benign prostatic hyperplasia(BPH).Method Twenty-eight cases with large BPH were treated with suprapubic cystostomy combined with TUVRP and the clinical data was analyzed retrospectively.Results After operation,all patients had normal urination,followed up for 6 months,the international prostatic symptom score was decreased from(24.2 ±4.8)scores to(9.8 ±2.6)scores,the maximal uroflow rate was increased from(6.2 ±2.1)ml/s to(14.8 ±2.9)ml/s,the residual urine was decreased from(108.0 ± 37.1)ml to(20.2 ± 7.6)ml,there was significant difference(P ＜ 0.05).Complications were found in 3 cases,2 cases were transurethral resection of prostate syndrome,I case was secondary bleeding.Conclusion Suprapubic cystostomy combined with TUVRP is a safe,less complication,effective and feasible method for large BPH with proficient skill.

Application of central venous catheter for refractory urinary retention in children: A report of 7 cases / 第二军医大学学报

Objective: To assess the value of central venous catheter in treatment of refractory urinary retention in children. Methods: Seven boys with acute urinary retention, who underwent failed routine drainage from Aug. 2007 to Jun. 2008, received paracentric suprapubic cystostomy via disposable central venous catheter. The patients were followed up for 2-11 months and the outcomes and complications were observed. Results: The catheterization processes were successful at the first try, with the mean operation time being (3.2 ± 0.4) min, ranging 2-5 min. The drainage outcomes were satisfactory and there were no complications. Conclusion: Suprapubic puncture and drainage with central venous catheter is safe and effective for children with urinary retention and is worth popularizing.

Suprapubic Cystostomy: Risk Analysis of Possible Bowel Interposition Through the Percutaneous Tract by Computed Tomography

PURPOSE: The most serious complication of suprapubic cystostomy is bowel injury. By computed tomography (CT), we investigated the risk factors of possible bowel interposition through the percutaneous suprapubic cystostomy tract. MATERIALS AND METHODS: From September to October 2009, we consecutively reviewed 795 abdominopelvic CT scans of adult patients performed for various reasons in our hospital. From these scans, we selected the films wherein the urinary bladder was distended more than 6 cm above the symphysis pubis. We then determined whether the bowel was interposed between the bladder and the skin at the routine puncture site of suprapubic cystostomy (the midline of the abdomen 3 cm above the upper margin of the symphysis pubis). We analyzed which factors influenced the possibility of the bowel being interposed between the bladder and the skin at the suprapubic puncture site. RESULTS: A total of 226 CT (148 males, 78 females) scans were selected. The mean patient age was 63 years (range, 26-84 years). The mean distance between the upper margin of the symphysis pubis and the umbilicus was 14.4 cm (range, 7.2-21.0 cm). In the multivariate analysis, obesity, a positive history of radical pelvic surgery, and a short distance (< or =11 cm) between the symphysis pubis and the umbilicus had significant correlations with bowel interposition in the assumed tract. CONCLUSIONS: When performing a suprapubic cystostomy, extreme caution is needed to avoid possible bowel injury in patients who are obese, had a previous radical pelvic operation, or have a short distance between the upper margin of the symphysis pubis and the umbilicus.

Rethinking Suprapubic Cystostomy in Voiding Dysfunction: New Trial with Timed Drainage

PURPOSE: Today, many patients with voiding dysfunction select suprapubic cystostomy (SPC) instead of clean intermittent catheterization (CIC) for practical reasons. There is thus a need to reconsider SPC as a management for voiding dysfunction. We designed SPC with timed drainage (TSPCD) and evaluated its effectiveness compared with continuous drainage with a urine bag (CSPCD). MATERIALS AND METHODS: Between January 2006 and January 2010, a total of 82 patients underwent SPC. Patients undergoing SPC were randomly assigned to CSPCD or TSPCD. Patient characteristics, complications, and the results of urine cultures were compared between the two groups through retrospective chart reviews. Also, preferences for CSPCD and TSPCD in another 15 patients who had experienced both CSPCD and TSPCD were investigated. RESULTS: The CSPCD and TSPCD groups comprised 46 and 36 patients, respectively. In a comparison of complications between the two groups, the incidence of acute symptomatic cystitis was significantly lower in the TSPCD group than in the CSPCD group (43% vs. 20%, p=0.032). The incidence of symptomatic urinary tract infection (UTI) was lower in the TSPCD group. Positive urine culture rates were 89.7% and 72.4% in groups 1 and 2, respectively. There was a significant difference between the two groups (p=0.004). In another 15 patients who experienced both CSPCD and TSPCD, 14 patients (93%) stated a preference for TSPCD after converting from CSPCD to TSPCD, and one patient (7%) returned to CSPCD only at night. CONCLUSIONS: In this study, TSPCD had the advantages of less morbidity as UTI and being more preferable by patients with relatively good daily activity compared with CSPCD. TSPCD is an alternative to CSPCD for the treatment of voiding dysfunction.

Comparison of two experimental models of urodynamic evaluation in female rats / Comparação de dois modelos experimentais para avaliação urodinâmica em ratas

PURPOSE: Urodynamic studies in small animals can be performed through urethral sounding or cystostomy. OBJECTIVE: To compare the two methods of urodynamic evaluation in female rats. METHODS: Ten female rats weighing on average 250g, under anesthesia with urethane (1,25 mg/kg) were submitted in three repeats to an urethal catheter of 0,64 mm in external diameter for cystometric measurements of vesicle pressure(VP1) and contraction time (CT1). The catheter was extracted at a constant velocity of 0.05 cm/minute until complete exteriorization and determinations of maximal urethral pressure (UP1) and functional urethral length (FUL1). This was followed by a cystostomy with catheter PE50 and a new determination of the vesical pressure (VP2). After bladder denervation, a new cystometric record indirectly infered the maximum urethral closure pressure (UP2). The peak urethal pressure (UP3) and the functional urethral length (FUL2) were determined in another urethral sounding. The pressure registration system consisted of a continuous infusion pump regulated to a flow of 0.1 ml/minute connected both to the cystostomy catheter (PE-50) or the urethal catheter (0.64mm) and the polygraph Narco-Biosystem. Statistical analysis employed the Wilcoxon non-parametric test RESULTS: Mean VP1= 48,2 mmHg (11,8 SD); Mean VP2 = 38,2 mmHg (9,0 SD) "p" (VP1 X VP2) = 0,0039. Mean CT1=30,2 s (21,5 SD); Mean CT2=20,0 s(7 SD) p (CT1 X CT2) = 1,28. Mean UP1 = 47,2 mmHg (6,5 SD); Mean UP2 = 21,3 mmHg (6,6 SD), mean UP3 = 40,7 mmHg(13,3 SD) p (UP1 X UP2) = 0,002; "p" (UP1 X UP3) = 0,084; p (UP2 X UP3) = 0,002. Mean FUL1=14,2 mm (1,9 SD); Mean FUL2= 14,1mm (1,9 SD); p (FUL1 X FUL2) = 0,64. CONCLUSIONS: The methods employed to evaluate vesical and urethral pressures are different. The presence of the urethral catheter may be an obstructive factor. Surgical denervation up to the bladder neck level does not compromise urethral function.

INTRODUÇÃO: O estudo urodinâmico em ratas pode ser realizado através de sondagem vesical por via uretral ou por cistostomia. O objetivo deste estudo foi comparar estes dois métodos. MÉTODOS: Foram utilizadas 10 ratas da raça Wistar, peso médio de 250 gramas, anestesiadas com uretana (1,25 mg/kg). Inicialmente foi realizado estudo por sonda uretral (0,64 mm de diâmetro externo) para determinação da pressão vesical (PV1) e tempo de contração (TC1), após isto a sonda foi tracionada a velocidade constante (0,05 cm/m) até sua exteriorização pelo meato uretral, avaliando-se a pressão uretral máxima (PU1) e o comprimento funcional uretral (CFU1). Fez-se, então, a cistostomia (sonda PE50) para determinação da pressão vesical (PV2). A seguir, realizou-se desnervação cirúrgica da bexiga e realizou-se novo registro cistométrico para se inferir a pressão uretral indireta (PU2). Logo após, foi passada sonda uretral para determinação da pressão uretral máxima (PU3) e do comprimento funcional uretral (CFU2). O sistema de registro das pressões foi constituído de uma bomba de infusão contínua regulada para 0,1 ml/minuto conectada em Y com o cateter de cistostomia (PE-50) ou cateter uretral (0,64mm) a um polígrafo Narco-Bioystem. A análise estatística foi realizada através do método não paramétrico de Wilcoxon. RESULTADOS: Média PV1= 48,2 mmHg (11,8 SD); Média PV2 = 38,2 mmHg (9,0 SD). "p" (PV1 X PV2) = 0,0039. Média TC1=30,2 s (21,5 SD); Média TC2=20,0 (7 SD) p (TC1 X TC2) = 1,28. Média PU1 = 47,2 (6,5 SD); Média PU2 = 21,3 mmHg (6,6 SD), média PU3 = 40,7(13,3 SD) p (PU1 X PU2) = 0,002; "p" (PU1 X PU3) = 0,084; p (PU2 X PU3) = 0,002. Média CFU1=14,2 (1,9 SD); Média CFU2= 14,1 (1,9 SD); p (CFU1 X CFU2) = 0,64. CONCLUSÃO: Os métodos de avaliação urodinâmica são diferentes. A presença do cateter na uretra pode ser um fator obstrutivo. A desnervação cirúrgica, até o nível do colo vesical, não compromete a função uretral.