Is continuous bladder irrigation after prostate surgery still needed?

Okorie, Chukwudi O.

doi:10.5410/wjcu.v4.i3.108

Cited by 13 publications

(15 citation statements)

References 58 publications

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“…Every clinical situation leads to a particular kind of hematuria, which can be managed with a greater or lesser irrigation flow in order to prevent complications. 2 Some patients presenting with lower urinary tract bleeding must undergo efficient and effective catheter irrigation. 3 In addition, clot retention is a serious situation encountered after transurethral procedures, and a significant challenge for the patient and urologist.…”

Section: Discussionmentioning

confidence: 99%

Same sized three-way indwelling urinary catheters from various manufacturers present different irrigation and drainage properties

Carneiro

Wroclawski

Peixoto

et al. 2020

Therapeutic Advances in Urology

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Background: The three-way indwelling urinary catheter (IUC) is used for continuous bladder irrigation and is considered the cornerstone for clinical treatment of patients with macroscopic hematuria. Although there seems to be a logical relationship between catheter size and efficacy of irrigation and drainage, we often observe relevant variations in these parameters between different brands of catheters available on the market. The aim of this study was to compare the mechanical properties of different models of latex and silicone three-way catheters in an in vitro setting that resembles clinical use. Methods: Three different three-way catheters were evaluated: Gold Silicone-Coated Rusch® (Model A), 100% Silicone Rusch® (Model B) and X-Flow Coloplast® (Model C). Irrigation channel, drainage channel, and overall cross-sectional areas were all digitally measured. Irrigation and drainage channel flow rates were measured and correlated with their corresponding catheter cross-sectional area values. Results: Different catheter models of the same caliber have different internal irrigation port diameters, internal drainage port diameters and internal cuff port diameters. The Model C IUC internal irrigation port diameter is significantly larger than models A and B. When flows were evaluated, we found that in the same model, the increase in caliber of the IUC was related to an increased drainage flow, but not to an increased irrigation flow. Conclusion: Precise measurements of the internal architecture of the three-way catheter, rather than relying on the caliber itself, could assist surgeons in choosing the best product for each specific patient, while minimizing complications.

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Section: Discussionmentioning

confidence: 99%

Same sized three-way indwelling urinary catheters from various manufacturers present different irrigation and drainage properties

Carneiro

Wroclawski

Peixoto

et al. 2020

Therapeutic Advances in Urology

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“…[4] Besides, CBI has been proposed to inhibit the hemorrhagic cystitis [5] and increase the survival rate following stem cell transplantation. [6] Although CBI is widely used for preventing the complications following TURP, it is not easy for nurses to take CBI for patients.…”

Section: Introductionmentioning

confidence: 99%

A novel automatic regulatory device for continuous bladder irrigation based on wireless sensor in patients after transurethral resection of the prostate

Ding

Cao²,

Wang³

et al. 2016

Medicine

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Background:Benign prostatic hyperplasia is a common progressive disease in aging men, which leads to a significant impact on daily lives of patients. Continuous bladder irrigation (CBI) is a supplementary option for preventing the adverse events following transurethral resection of the prostate (TURP). Regulation of the flow rate based on the color of drainage bag is significant to prevent the clot formation and retention, which is controlled manually at present. To achieve a better control of flow rate and reduce inappropriate flow rate–related adverse effects, we designed an automatic flow rate controller for CBI applied with wireless sensor and evaluated its clinical efficacy.Methods:The therapeutic efficacy was evaluated in patients receiving the novel automatic bladder irrigation post-TURP in the experimental group compared with controls receiving traditional bladder irrigation in the control group.Results:A total of 146 patients were randomly divided into 2 groups—the experimental group (n = 76) and the control group (n = 70). The mean irrigation volume of the experimental group (24.2 ± 3.8 L) was significantly lower than that of the controls (54.6 ± 5.4 L) (P < 0.05). Patients treated with automatic irrigation device had significantly decreased incidence of clot retention (8/76) and cystospasm (12/76) compared to controls (21/70; 39/70, P < 0.05). There was no significant difference between the 2 groups with regard to irrigation time (28.6 ± 2.7 vs 29.5 ± 3.4 hours, P = 0.077).Conclusion:The study suggests that the automatic regulating device applied with wireless sensor for CBI is safe and effective for patients after TURP. However, studies with a large population of patients and a long-term follow-up should be conducted to validate our findings.

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“…There was wound infection in four patients, whereas in three other patients, there was catheter blockage with clots that were easily flushed out. None of the authors' patients has received blood transfusion up to the time of this report with no mortality or significant morbidity 451551…”

Section: The Authors' Approach In Achieving Consecutive Bloodless Supmentioning

confidence: 98%

Evolution of bloodless surgery: A case for bloodless suprapubic prostatectomy

Okorie

Pisters

2019

Niger Med J

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Allogeneic blood transfusion is commonly prescribed to patients undergoing suprapubic prostatectomy for benign prostatic hyperplasia as a treatment option to replace blood loss. Historically, suprapubic prostatectomy has been perceived as an extremely high hemorrhagic surgery, and this has led to the association of suprapubic prostatectomy with a high rate of allogeneic blood transfusion. However, the outcome of suprapubic prostatectomy has significantly improved over the years and has become less hemorrhagic in many hands – creating the opportunity to consistently avoid allogeneic blood transfusion. On the other hand, the efficacy of blood transfusion has come under more stringent scrutiny as many clinical studies have reported inconsistent effects of blood transfusion on patient outcome. In contemporary practice, a more conservative/bloodless approach in the perioperative management of anemia in surgical patients is strongly being advocated with convincing evidence that many surgical patients can be routinely and safely managed without allogeneic blood transfusion. There is no large-scale discussion on bloodless surgery in urology in the contemporary literature, especially in the area of suprapubic prostatectomy that has been historically associated with a high rate of blood transfusion. This review article will discuss the evolution of bloodless surgery including the ongoing controversies surrounding blood transfusion in general, and then the relatively small but ongoing penetration of bloodless surgical approach in the field of suprapubic prostatectomy. Furthermore, the authors' approach to bloodless suprapubic prostatectomy will be highlighted, and in doing so, it can be emphasized that suprapubic prostatectomy is no more as hemorrhagic as was historically perceived, but rather a routine bloodless suprapubic prostatectomy is now possible in many hands.

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Is continuous bladder irrigation after prostate surgery still needed?

Cited by 13 publications

References 58 publications

Same sized three-way indwelling urinary catheters from various manufacturers present different irrigation and drainage properties

Same sized three-way indwelling urinary catheters from various manufacturers present different irrigation and drainage properties

A novel automatic regulatory device for continuous bladder irrigation based on wireless sensor in patients after transurethral resection of the prostate

Evolution of bloodless surgery: A case for bloodless suprapubic prostatectomy

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