Aims:To introduce the concept that a urological Nurse Specialist can perform Suprapubic Catheter (SPC) insertions independently without significant complications, if systematic training is given.Settings and Design:Retrospective study.Materials and Methods:A retrospective audit of Suprapubic Catheter insertions performed by a Urological Nurse Specialist was conducted between April 2009 and April 2011.Results:Of the total 53 patients, in 49 (92.45%) the procedure was successful. Out of the remaining four, two (3.77%) were done by a urologist. One patient's (1.89 %) SPC did not drain after placement and ultrasonography reported that the Foley balloon was lying within the abdominal wall. The other patient's SPC drained well for a month and failed to drain after the first scheduled change in a month. Since the ultrasonography showed the Foley balloon to be anterior to the distended bladder, an exploration was performed and this revealed that the SPC tract had gone through a fold of peritoneum before reaching the bladder. None had bowel injury.Conclusions:If systematic training is given, a urological Nurse Specialist can perform SPC insertions independently without significant complications.
Adenine phosphoribosyltransferase (APRT) deficiency is a rare autosomal recessive error of purine metabolism resulting in the generation of 2,8-dihydroxyadenine (DHA), a highly insoluble metabolite of adenine, which can cause radiolucent urolithiasis. This is the second case of DHA stone being reported in India and the first case in India to document the mutation of the APRT gene on blood DNA analysis.
Objective:The urethral length has not been measured in the Indian population. Even the international literature in this arena is very sparse. This paper is an attempt to develop a simple anatomical database for urethral length.Materials and Methods:Between January 2010 and April 2011, the urethral lengths of 422 adult male patients who required catheterization as part of regular treatment at our hospital, were recorded after obtaining consent from the patients and from the scientific and ethics review boards of the institution. Patients with history of prostatic or urethral abnormalities were excluded. The balloon of a sterile Foley's catheter was inflated using 10 cc of saline. The length from the junction of the balloon to the ‘Y’ junction of the Foley was measured. The catheter was then passed into the bladder and re–inflated to same volume. The penis was gently straightened and the length of the catheter outside the penis was measured till the premarked point at the ‘Y’ junction. Subtracting this from the original length gave the length of the urethra.Results:The mean length of the urethra was 17.55 + 1.42 cm with a range between 14 and 22.5 cm.Conclusions:Literature in which the length of the normal adult male urethra is recorded for a significant sample size is very scarce. Our data adds to basic anatomic information of the male urethra specific to the Indian population.Statistical Methods:Descriptive statistical analysis was performed. The non-linear regression analysis was employed to find the normative values of urethral length according to age class.
Introduction and Objectives: Buccal mucosal graft (BMG) is frequently used for the reconstruction of urethral strictures with acceptable donor-site morbidity after graft harvest. There are only a few prospectively designed studies with a small number of patients reporting oral complications, particularly the mouth opening in the long terms. We did an objective assessment of mouth opening before and after 6 months of BMG urethroplasty as well as pain scores. Materials and Methods: Fifty-eight patients who underwent BMG urethroplasty were included in the study between May 2013 and December 2014. Preoperative mouth opening (reference point between two incisors with the highest of three readings taken as final) was measured using a Vernier caliper. Harvest site was left open to heal by secondary intentions. Postoperatively, mouth opening and pain scores using self-administered (Visual Analog Scale [VAS]) assessed on day 1 and day 3, and follow-up at 1 week, 1 month, and 6 months. Data were analyzed as mean (standard deviation [SD]), proportion, and median (inter-quartile range [IQR]) with two-tailedP < 0.05 as statistically significant. Results: The mean age was 39.6 years. The graft was harvested from a single cheek in 50% of patients. In remaining, it was taken from both cheeks, both cheeks with lip, and both cheeks with the tongue in 29.31%, 17.24%, and 3.5%, of patients, respectively. Preoperative mouth opening (5.13 cm [0.08]) was statistically significantly more than mouth opening on day 1 (4.34 cm [0.09]), day 3 (4.48 [0.09]), and day 7 (4.69 cm [0.09]). Mean difference became insignificant at the interval of 1 month (4.91 cm [0.09]) with 6 months’ values showing marginal improvement over preoperative values (5.14 cm [0.07]). Pain was tolerable and patients reported low median VAS 2 (2–4) on day 1 and day 3 each. Reported median VAS became 0 (0–0) on day 7. Conclusion: Mouth opening restriction after BMG urethroplasty is a definite entity in the initial postoperative period, which becomes nonsignificant by 6 months. The pain has no effect on mouth opening.
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