Category: Urology

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How to do Self Clean Intermittent Catheterization (Men)

Clean Intermittent Catheterization (Men) : Clean Intermittent catheterisation (CIC) is a medical technique used by patients where they need either short term catheter-based management of the urinary bladder or as a daily habit for life. CIC is considered the ‘gold-standard’ for medical bladder emptying. Intermittent catheterization can be done by the patient or a caregiver in home environment. CIC can be performed in both male and female patients.

Intermittent catheterization techniques are often used when you have the ability to use a catheter by yourself or someone can do it for you. In this process, you insert the catheter -a thin, flexible, hollow tube-through the urethra into the bladder and allow the urine to drain out. It is done at scheduled times, and the catheter is not permanent. There are many types of catheters available in the market based on the material used to manufacture them for example from red rubber/Latex (cheapest and may cause allergic reactions) to Silicone (Moderate to High priced but is very comfortable and are not known to cause reactions).

In general, an ICP requires that you limit your fluids. You and your doctor will figure out how much fluid you can consume each day and what times are best to use the catheter.

Advantages of Clean Intermittent catheterisation (CIC) Technique:

People with neurogenic bladder disorders like spina bifida or multiple sclerosis, spinal cord injury, and non-neurogenic bladder disorders like obstruction due to prostate enlargement, urethral strictures or post-operative urinary retention, need to be continuously catheterised to empty their urinary bladders. But such continuous catheterisation can often lead to problems like urinary tract infections (UTI), urethral strictures or male infertility. Intermittent catheterisation at regular intervals avoids such negative effects of continuous long term catheterisation, but maintaining a low bladder pressure throughout the day.

How to use the catheter :

Following is a general outline of the procedure. Your Doctor, most likely a Urologist will show you and/or a loved one how to perform a catheterization at home.

Preparation:

  1. Be sure you have everything you need. This typically includes a catheter, a water-based lubricant, a container to collect the urine, latex or medical gloves, and cleansing material, such as cotton balls, paper towels, soap, and antiseptics.
  2. Wash your hands thoroughly with soap and water, and put on the gloves. Gloves are optional.
  3. Wash the tip of your penis with soap and water, or use an antiseptic.
  4. Position the end of the catheter so that urine can flow out into a collection container.

Catheterization Instructions for Patients(Men):

intermittent self catheterisation for males
  1. Wash hands thoroughly with soap and water.
  2. Find a comfortable position. Some men prefer to stand for the procedure but it can be done just as easily in the sitting position.
  3. Hold the penis perpendicular to the body (pointing towards the umbilicus) and wash the urethral opening (meatus) with soap and a clean washcloth. For uncircumcised men, retract the foreskin first and clean the meatus in the same way.
  4. Lubricate about 2 in. (5.1 cm) of the tip of the catheter.
  5. Slowly and gently insert the catheter into the meatus, approximately 6-8 inches or until urine begins to flow. Often the entire length of the catheter must be inserted (to the hub, or end of the catheter) for urine flow to occur.
  6. There may be some resistance to the passage of the catheter at the prostatic urethra, the portion of the urethra where the prostate lies. If this occurs, hold firm, gentle, steady pressure and the external sphincter will fatigue. Muscle relaxation will be felt and the catheter will advance through this part of the urethra. If you cannot insert the catheter, do not force it. Stop, and call your doctor.
  7. There may also be resistance at the bladder neck, the internal sphincter (the opening from the urethra to the bladder). Using firm, gentle, steady pressure should cause the muscles to fatigue and allow the catheter to pass into the bladder. If you cannot insert the catheter, do not force it. Stop, and call your doctor.
  8. Keep the catheter in place until the flow of urine stops. Slowly and gently withdraw the catheter allowing for any pockets of urine at the base of the bladder to drain. When there is no further flow of urine, remove the catheter.
  9. If requested by the physician, record the amount of urine.
  10. Clean and store the catheter.

Catheter Maintenance:

One-time-use catheters can be thrown away after each use. If you have a reusable catheter, you will need to wash and dry it after each use.

To clean your catheter:

  1. Wash the catheter with soap and water, or put it in an antiseptic solution.
  2. Rinse the catheter, inside and out, with clean water. Some people use a syringe to push soapy water through the catheter.
  3. Dry the catheter. Place it on a clean towel, fold the towel over, and hang the towel on a rack.
  4. When the catheter is dry, place it in a plastic bag.

In case of any doubt or concern please feel free to contact us.

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Kidney stones – Treatments

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extracorporeal shock wave lithotripsy (ESWL)

Shock waves break up kidney stones (ESWL)

ureteroscopy

Stones being removed via Ureteroscopy

Treatment for kidney stones varies, depending on the type of stone and the cause.

Small stones with minimal symptoms

Most kidney stones won't require invasive treatment. You may be able to pass a small stone by:

  • Drinking water. Drinking as much as 2 to 3 quarts (1.9 to 2.8 liters) a day may help flush out your urinary system. Unless your doctor tells you otherwise, drink enough fluid — mostly water — to produce clear or nearly clear urine.
  • Pain relievers. Passing a small stone can cause some discomfort. To relieve mild pain, your doctor may recommend pain relievers such as ibuprofen (Advil, Motrin IB, others), acetaminophen (Tylenol, others) or naproxen sodium (Aleve).
  • Medical therapy. Your doctor may give you a medication to help pass your kidney stone. This type of medication, known as an alpha blocker, relaxes the muscles in your ureter, helping you pass the kidney stone more quickly and with less pain.

Large stones and those that cause symptoms

  • Kidney stones that can't be treated with conservative measures - either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections - may require more extensive treatment. Procedures may include:
  • Using sound waves to break up stones. For certain kidney stones — depending on size and location — your doctor may recommend a procedure called extracorporeal shock wave lithotripsy (ESWL).
  • ESWL uses sound waves to create strong vibrations (shock waves) that break the stones into tiny pieces that can be passed in your urine. The procedure lasts about 45 to 60 minutes and can cause moderate pain, so you may be under sedation or light anesthesia to make you comfortable.
  • ESWL can cause blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract.
  • Surgery to remove very large stones in the kidney. A procedure called percutaneous nephrolithotomy (nef-row-lih-THOT-uh-me) involves surgically removing a kidney stone using small telescopes and instruments inserted through a small incision in your back.
  • You will receive general anesthesia during the surgery and be in the hospital for one to two days while you recover. Your doctor may recommend this surgery if ESWL was unsuccessful.
  • Using a scope to remove stones. To remove a smaller stone in your ureter or kidney, your doctor may pass a thin lighted tube (ureteroscope) equipped with a camera through your urethra and bladder to your ureter.
  • Once the stone is located, special tools can snare the stone or break it into pieces that will pass in your urine. Your doctor may then place a small tube (stent) in the ureter to relieve swelling and promote healing. You may need general or local anesthesia during this procedure.
  • Parathyroid gland surgery. Some calcium phosphate stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone (hyperparathyroidism), your calcium levels can become too high and kidney stones may form as a result.

    Hyperparathyroidism sometimes occurs when a small, benign tumor forms in one of your parathyroid glands or you develop another condition that leads these glands to produce more parathyroid hormone. Removing the growth from the gland stops the formation of kidney stones. Or your doctor may recommend treatment of the condition that's causing your parathyroid gland to overproduce the hormone.

Note : This information is not intended to replace the advice of a doctor. Surgimedex and Global Medi Innovations disclaims any liability for the decisions you make based on this information.

 

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What is a Double J Stent ?

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What is it?

A thin, hollow tube placed inside the ureter during surgery to ensure drainage of urine from the kidney into the bladder. J shaped curls are present at both ends to hold the tube in place and prevent migration, hence the description "Double J stent".

Purpose?

It allows the kidney(s) to drain urine by temporarily relieving any blockage, or to assist the kidney(s) in draining stone fragments freely into the bladder if definitive kidney stone surgery is carried out.

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Kidney Stones – What Increases Your Risk ?

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Several risk factors (things that put you at risk) for kidney stones make it more likely that you will get them. Some of these things you can control, and others you simply cannot.

Risk factors that you can control

Factors you can control include:

  1. How much fluid you drink. The most common cause of kidney stones is not drinking enough water. Try to drink enough water to keep your urine light yellow or clear like water (about 8 to 10 glasses of water a day).
  2. Your diet. Diets high in protein, sodium, and oxalate-rich foods, such as dark green vegetables, increase your risk for kidney stones. If you think that your diet may be a problem, schedule an appointment with a dietician and review your food choices.
  3. Being overweight. This can cause both insulin resistance and increased calcium in the urine, which can result in a greater risk for kidney stones.
  4. Medicine. Some medicines, such as acetazolamide (Diamox) and indinavir (Crixivan), can cause kidney stones to form.

Risk factors you cannot control

Things you can't control include:

  1. Age and gender.
  2. Men between the ages of 30 and 50 are most likely to get kidney stones.
  3. Postmenopausal women with low estrogen levels have an increased risk for kidney stones. Women who have had their ovaries removed are also at increased risk.
  4. A family history of kidney stones.
  5. A personal history of frequent urinary tract infections.
  6. Other diseases or conditions, such as Crohn's disease, hyperparathyroidism, or gout.
  7. Intestinal surgery or gastric bypass surgery.
  8. Insulin resistance, which can occur because of diabetes or obesity.