Safety and Effectiveness of Externalized Ureteral Catheter in Tubeless Percutaneous Nephrolithotomy.

PURPOSE: To review the safety and effectiveness of tubeless percutaneous nephrolithotomy (PCNL) with an externalized ureteral catheter (EUC) compared with standard PCNL with nephrostomy tube and tubeless PCNL with double-J (DJ) stent following uncomplicated PCNL and the absence of residual stones. MATERIALS AND METHODS: Patients with kidney stones who underwent uncomplicated PCNL between January 2000 to December 2017 and had no residual stones were retrospectively evaluated. The 766 patients were divided into standard PCNL with nephrostomy tube (group 1; 350 patients), tubeless PCNL with DJ stent (group 2; 189 patients), and tubeless PCNL with EUC (group 3; 227 patients). Demographic characteristics, stone-related factors, perioperative and postoperative parameters were analyzed. RESULTS: Demographic and stone-related characteristics were comparable. The differences in the mean operative time and complication rates were not significant. Postoperative hospitalization period was shorter in group 3 (3.19 ± 2.2 days) compared with group 1 (4.12 ± 2.4 days; p < .001) but not to that of group 2 (3.44 ± 2.8 days; p = .680). Postoperative pain score was lower in group 3 (3.24 ± 1.1) compared with both group 1 (6.36 ± 1.7; p < .001) and group 2 (4.85 ± 1.1; p < .001). Urine leakage complication was lower in group 3 (0.4%) compared with group 1 (2.9%, p = .038) but not to that of group 2 (0.5%; p = .897). CONCLUSIONS: Tubeless PCNL is effective and safe for uncomplicated PCNL in the absence of residual stones. Tubeless PCNL with EUC is associated with decreased pain, hospitalization time, and urine leakage compared with standard PCNL. However, it is only associated with decreased pain when compared with tubeless PCNL with DJ stent.

Urinary catheters PART 1.

Barry HIll, Senior Lecturer in Adult Nursing at Northumbria University ( barry.hill@northumbria.ac.uk ), and Michelle Mitchell, Graduate Tutor for Adult Nursing at Northumbria University, discuss the reasons for urinary catheterisation, the different types of catheter and the potential problems patients need to be aware of.

[Objective and subjective requirement of aids and appliances in patients with neurogenic lower urinary tract dysfunction : Multicenter study to determinate the daily necessity of urological aids and appliances]. / Objektiver und subjektiver Hilfsmittelbedarf bei Patienten mit neurogenen Harnblasenfunktionsstörungen : Multicenterstudie zur Ermittlung des täglichen Bedarfs an urologischen Hilfsmitteln.

BACKGROUND: The provision of urological appliances for patients with neurogenic lower urinary tract dysfunction (NLUTD) is essential. Hitherto existing standard guidelines for the estimation of monthly material requirements are based solely on estimates. OBJECTIVE: The goal of this work was to define the objective and subsequently subjective requirements for urological appliances on a scientifically validated basis. MATERIALS AND METHODS: Data concerning bladder management and daily consumption of urological appliances for patients with NLUTD were collected through a standardized survey at six different centers in Germany during the period of October to December 2014 and statistically evaluated. RESULTS: In all, 767 patient records were analyzed: 543 men and 221 woman (N/A = 3). The daily disposable catheter consumption of 577 patients who exclusively used intermittent catheterization was 5.13. Patients who used other means of bladder emptying (n = 31) in addition to catheterization consumed on average 3.17 catheters. The margin of deviation was larger for children. Of the 608 patients with intermittent catheterization, 94 (15.5 %) required additional paddings as absorbent aids (on average 2.29 paddings per day), 34 patients (5.6 %) additionally used pants (2.55 per day) and 46 patients (7.6 %) utilized condom catheters (3.81 per day) between catheterization. Among all surveyed patients, 126 (16.4 %) used paddings (5.03 per day) and 51 patients (6.6 %) pants (3.03 per day). Of all male respondents 82 (15.1 %) used condom catheters (2.80 urinary sheaths per day). CONCLUSION: Applying twice the standard deviation of the mean as a measure of assessing the objective requirement of urological appliances and aids for adult patients with NLUTD allows the following daily thresholds to be defined: 1-9 disposable catheters, 0-7 urinary sheaths, 1-9 paddings and 0-7 pants. These thresholds can serve as a basis for estimating the subjective need. They allow for a scientifically validated benchmark for an economically feasible and patient-tailored supply with urological aids and appliances. Individually required appliances and aids have to be recognized. Verifiable quality standards need to be developed.

Catéteres urinarios en la edad pediátrica / Pediatric urinary tract catheters

Los catéteres urinarios son sondas huecas y flexibles que se usan para facilitar la salida de orina del aparato urinario o para conseguir un tránsito de orina a través del mismo. Podemos encontrar distintos tipos de catéteres en función del fin para el que han sido diseñados: sondas uretrales, de cistostomía y catéteres ureterales entre otros. Repasamos las indicaciones de colocación de estos catéteres, sus diseños, composición, materiales de cobertura, la técnica de inserción y las complicaciones derivadas de los mismos. Los catéteres en los niños van por detrás de lo que se fabrica para el adulto, por ello hacemos una revisión de la literatura sobre los catéteres urinarios en general haciendo énfasis en el paciente pediátrico

Urinary tract catheters are hollow and flexible tubes used to facilitate urine output or to achieve urine transit through them. We can find different types of catheters depending on the purpose they have been designed for: urethral, cystostomy and ureteral catheters among others. We review the indications for insertion of these catheters, their designs, composition, covering materials, insertion techniques and associated complications. Pediatric catheters are behind what is produced for adults, so we perform a bibliographic review about urinary catheters in general with emphasis on the pediatric patient

Medical devices; gastroenterology-urology devices; classification of the urethral insert with pump for bladder drainage. Final order.

The Food and Drug Administration (FDA) is classifying the urethral insert with pump for bladder drainage into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the urethral insert with pump for bladder drainage's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

Versión española del cuestionario USSQ: evaluación de la tolerancia clínica al catéter ureteral doble jota / Spanish version of the USSQ questionnaire: evaluation of clinical tolerance to double J uretheral catheter

INTRODUCCIÓN: La evaluación de los síntomas debidos a catéter ureteral doble jota (CUJJ) precisa de una herramienta fiable como el cuestionario USSQ. Se presenta una versión traducida al español de este cuestionario (USSQ-E). MATERIAL Y MÉTODOS: La versión en inglés del USSQ ha sido traducida al español siguiendo una sofisticada sistemática lingüística. Una vez obtenido el USSQ-E ha sido probado en un grupo de 70 pacientes portadores de CUJJ. Como grupo control se han tomado 40 personas sin catéter. RESULTADOS: Se ha evaluado el USSQ-E con pruebas de consistencia interna, test-retest, validez convergente, sensibilidad al cambio y validez discriminatoria, siendo todas ellas satisfactorias. CONCLUSIÓN: El USSQ-E es una herramienta válida y fiable para evaluar la sintomatología derivada del CUJJ en población hispanoparlante (AU)

INTRODUCTION: The assessment of symptoms due to double J ureteral catheter (CUJJ) requires a reliable tool like USSQ questionnaire. A translation in Spanish of this questionnaire (USSQ-E) version is presented. MATERIAL AND METHODS: The English version of USSQ has been translated into Spanish language following a systematic sophisticated. After obtaining the USSQ-E has been tested in a group of 70 patients with CUJJ. A control group of 40 people have been taken without catheter. RESULTS: We evaluated the USSQ-E with evidence of internal consistency, test-retest reliability, convergent validity, sensitivity to change and discriminant validity, all of which are satisfactory. CONCLUSION: USSQ-E is a valid and reliable for assessing symptomatology derived CUJJ tool in speaking population (AU)