Background: Ultrasound (U/S) guided peripheral IV catheter (PIV) placement is often needed after unsuccessful traditional IV attempts. Commercial U/S PIV training phantoms are expensive and difficult to alter. Non-commercial phantoms have been described; however, there has been no comparison of these models. The primary objectives of this study were to compare the echogenic and haptic properties of various non-commercial phantoms. Secondary objectives were to characterize the cost and ease of making the phantoms. Methods: This prospective observational study trialed six unique phantom models: Amini Ballistics; Morrow Ballistics; University of California San Diego (UCSD) gelatin; Rippey Chicken; Nolting Spam; and Johnson Tofu. Total cost and creation time were noted. Emergency Ultrasound Fellowship trained physicians performed U/S guided PIV placement on each model to evaluate their resemblance to human tissue haptic and echogenicity properties, utility for training, and comparability to commercial phantoms (Likert scale 1–5; higher performance = 5). Results: The Rippey model scored highest for each primary objective with an aggregate score of 4.8/5. UCSD ranked second and Nolting last for all primary objectives, with aggregate scores 3.7/5 and 1.3/5 respectively. Cost of production ranged from $4.39 (Johnson) to $29.76 (UCSD). Creation times ranged from 10 min (Johnson) to 120 min (UCSD). Conclusion: In our study the Rippey model performed best and offered a mid-level cost and creation time. Non-commercial U/S phantoms may represent cost-effective and useful PIV practice tools. Future studies should investigate the utility of these phantoms in teaching U/S guided PIV to novices and compare non-commercial to commercial phantoms.

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From 1971-1979, 380 women with marked stress incontinence had urethro-vesical suspensions according to Pereyra. In the majority of the cases this urethrovesical suspension was done as an additional operation to vaginal hysterectomy and anterior and posterior colporrhaphy. The follow-up examination of 189 patients 6 to 60 months after the operation included as for the pre-operative examination the history, the gynaecological findings, the Bonney test, the residual urine determination, chromocystoscopy, urinalysis with culture and sensitivity and a lateral cysto-urethrogram. 86.2% of the patients were objectively and subjectively cured. In 13.8% no improvement of the stress incontinence was found. The Pereyra urethro-vesical suspension is a valuable addition to the operative treatment of urinary stress incontinence. The complication rate is as low as for other methods and the results are at least the same. The Pereyra urethro-vesical suspension is recommended.

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