Essay On Urethral Stricture

Bernard, M.S., Hunter, K.F., & Moore, K.N. (2012). A review of strategies to decrease the duration of indwelling urethral catheters and potentially reduce the incidence of catheter-associated urinary tract infections. Urologic Nursing 32(1)

The three questions addressed were: Who should receive urinary catheters, what are the best practices for those who require urinary catheters and for preventing CAUTI’s acquired from urinary obstruction. This updated guideline offers recommendations for the appropriate use of indwelling catheters utilizing appropriate indications for usage, proper techniques for insertion of indwelling catheters, proper techniques for indwelling catheter maintenance, quality improvement programs, administrative infrastructure and surveillance including identifying those at risk for CAUTI (Gould et al, 2009). The strengths of this guideline are that many questions and scenarios are examined in this document and answered in explicit detail. Any healthcare professional can refer to the document to answer most practice based questions that are posed to them regarding indwelling urinary catheters. One weakness identified is the lack of an alternative explored for the external catheterization for female patients, for example the Purewick solution. However, the Purewick was not released until January 2016 and this guideline was last updated in 2009. Integrative Review

A catheter is used in an event of an individual that has either had trauma or surgery and as a result has temporary urinary retention (Patton & Thibodeau, 2013)

A Foley catheter is a thin, sterile tube inserted into the bladder to drain urine ( ). There are many types of catheters such as a straight, indwelling, and condom catheters. A straight catheter is one that does not stay inside the person. It is removed immediately after urine is drained. An indwelling catheter is one that stays inside of the bladder for a period of time. And last, a condom catheter is one that has an attachment that fits onto the penis. This catheter is changed daily or as needed. For the purpose of this document, the care that is going to be performed will need to be performed on a patient/resident with an indwelling catheter.

There are many successful options for control of urinary incontinence which include nursing interventions in the form of behavioral therapy, pharmacological agents, and surgical treatment.

Jones arrived at the operating room at 0745 hrs. Patient was transferred to OR table with arm boards at a 90-degree angle and shoulder braces. Anesthesia administered general anesthesia at 0800 hrs. Anesthesia intubated patient at 0810 hrs. Hair was removed from perineum prior to skin prep. A catheter is inserted into the urinary bladder, the bladder is irrigated. Skin was prepped with Chloraprep from nipple to mid-thigh, and allowed to dry for 5 minutes. He was draped with cuffed towel and an impervious sheet under the scrotum, folded towels, sheet with an aperture, laparotomy sheet and an individual drape sheet. First count with surgical technologist and circulator is accurate.

. The organization’s culture patients are found using indwelling catheterization for long periods of time, and no protocol for removal of the catheter post-operative patient’s, and also unnecessary Foley insertion on elderly inpatients for incontinence. Simultaneously, it is important to note that by avoiding indwelling cauterization and prolonged stay of catheter in patients may increase the infection and (CAUTIs (Bernard, Hunter, & Moore, (2012). The author made a survey and then analyzed it as a whole. However, the survey documented low and high score related to the case.

Surgery may be performed to correct an ectopic ureter, such as an artificial urethral valve may be implanted by a surgeon. According to the American Animal Hospital Association, Treatment options for USMI include medications, such as adrenergic agents and estrogen products, minimally-invasive urethral bulking procedures, surgical procedures, or combination therapy. For hormone-responsive incontinence, two different medication options can be given. Replacement hormone medication, such as Diethylstilbestrol (DES) for females and testosterone injections for males are used to control this incontinence problem. Also, certain medications may be given to increase the tone and strengthen the urethral sphincter. Phenylpropanolamine (PPA) is a common drug prescribed for aging dogs experiencing this issue. Although this is a treatable condition, it is not always possible to prevent urinary incontinence and it is generally only preventable to the extent that its causes are

Replace urinary catheter per hospital protocol making sure sterile technique is being followed, if still indicated.

As previously discussed, one of the major components that should guide the decision of bladder management devices is how it will affect the patient’s quality of life. A person’s perception of self, as well as their ability to bond with loved ones is a large factor in this. As mentioned previously Liu, Attar, Gall, Shah, and Craggs (2010) discuss that benefits of intermittent catheterization, when it is a realistic option, include an improved sense of independence. This higher level of functioning allows the patient to rely less on family or caregivers, while also giving the patient more of an ability to travel outside the home unassisted. Another benefit of the use of intermittent catheterization is that patients feel they are able to have closer interpersonal relationships than those with suprapubic or transurethral catheters in place (Sugimara, Arnold, English, and Moore, 2008). Since other bladder drainage methods require continuous drainage with an attached system, they may become cumbersome, and make it more difficult for patients to be physically closer to loved ones.

It is very important for the researcher to control the extraneous variable that could affect the study results. The extraneous variables that would affect the results in this study include, the catheter material, the catheter care, and the method of obtaining the urine sample. To control the catheter material, this study will be using the antimicrobial and antiseptic-impregnated catheters instead of the standard catheters as recommended by the Centers for Disease Control and Prevention (CDC) 2009 guidelines because they are effective in reducing the risk of CAUTIs. To control the catheter care, the study will follow the CDC guidelines for routine catheter care by ensuring that all the indwelling urinary catheters (IUC) maintain a sealed drainage system, and an unobstructed urine flow. In addition, the nursing staff will be cleansing the meatal area daily with warm soapy water instead of antiseptics, while maintaining the standard precautions including hand hygiene and wearing of gloves while performing peri-urethral care. To control the procedure for obtaining urine sample, the study will use the CDC recommendation for collecting the urine sample aseptically, by aspirating the urine from the sampling port with a sterile syringe after thoroughly cleansing the port with an antiseptic wipe (Gould et al., n.d.).

Until now, the only real treatment option for vaginal looseness was an invasive surgery followed by several days of uncomfortable and painful recovery time.

E: Initially, the nurse explained to us why the procedure was being completed. The patient was experiencing urinary retention which is a result of the bladder’s inability to empty fully (Wood, 2014, p. 1118). Additionally, there was a doctor’s order for a specimen collection. First, the nurse began the process by prepping for the procedure, this entails explaining the procedure to the patient, cleaning the perineal area and setting up all the materials required. Following, the nurse lubricated the tip of the catheter to decrease the friction while inserting the catheter through the urethral meatus. Then the nurse retracted the labia to expose the urethral

A widely acknowledged criterion for the technical quality of RP is the positive surgical margin (PSM) rate, and this rate has been shown to affect the risk of biochemical recurrence (BCR) after surgery. Although previous reports demonstrated predictors that may prolong operation time (OT) and raise the rate of positive surgical margin (PSM), there are no studies so far that evaluated the practical impact of adhesion of the Denonvilliers’ fascia due to prostatic bleeding by biopsy procedure on the PSM rate. Peri-prostatic and/or intra-prostatic bleeding is one of the most common complications seen in of the biopsies for prostatic gland. We reviewed patients’ operation record who had adhesion of the Denonvilliers’ fascia and found out most of

Occasionally, the proximal urinary tract—the bladder and prostatic urethra—is displaced anteriorly rather than posteriorly and stuck on to the back of the pubis. Occasionally there is bladder neck injury, or simultaneous rectal injury, or a false passage. These all require an adominoperineal approach rather than a pure