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Urethral prolapse: contemporary report on a modified ligation over a urethral catheter treatment approach.

Okorie CO - Nephrourol Mon (2013)

Bottom Line: None of the receiving medical personnel were aware of this condition.Maximum length of catheterization was for 4 days.Maintaining the inflated balloon of the Foley catheter with timed catheter removal especially adds predictability to this technique.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Banso Baptist Hospital, Kumbo, Cameroon ; Department of Surgery, Tenwek Hospital, Bomet, Kenya.

ABSTRACT

Background: Most contemporary series on urethral prolapse report either on the use of excisional or conservative treatment approaches.

Objectives: To introduce a modified ligation over a Foley catheter treatment method for urethral prolapse that addresses most of the previously reported complications.

Patients and methods: Five consecutive patients with urethral prolapse treated between 2003 and 2011, all using the ligation method on an outpatient basis were studied prospectively. Maintaining the inflated balloon of the Foley catheter with timed removal of the catheters among other modifications to the original technique is further described in the article. The main outcome measures were to evaluate for recurrence, post-operative appearance of the urethral orifice and satisfaction of parents. Secondarily the actions of the parents of the patients and those of the receiving physicians were also recorded.

Results: The mean age of the patients was 6 years old (ranging from 3 to 8 years). All parents suspected sexual molestation and in two cases, the suspected perpetrators were verbally threatened of dire consequences of their actions if proven. None of the receiving medical personnel were aware of this condition. Maximum length of catheterization was for 4 days. The post treatment urethral openings appeared normal and there were no complications.

Conclusions: The ligation method with attention to the modifications described further in the article is a simple, safe and cost effective option for the management of urethral prolapse. Maintaining the inflated balloon of the Foley catheter with timed catheter removal especially adds predictability to this technique.

No MeSH data available.


Related in: MedlinePlus

Urethral Prolapse
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fig4823: Urethral Prolapse

Mentions: Confirmation of the diagnosis of urethral prolapse was made by observing a circular hemorrhagic mass, anterior to the vaginal orifice, covering the normal location of the urethra but with a central opening (Figure 1). Patients were treated surgically by the method of ligation over a Foley catheter under sedation and analgesia (Figure 2); The inserted and inflated Foley catheter (size 14 for all patients except usage of size 16 for one 8 year old patient) should be placed on mild traction and maintained as such by an assistant during ligation of the mass to ensure that the base of the mass is completely exposed, facilitating placement of the knot of the ligature (size 0 polyglactin suture material in this series) at the base of the mass. During the ligature, the following modifications where incorporated specifically to address previously reported complications:


Urethral prolapse: contemporary report on a modified ligation over a urethral catheter treatment approach.

Okorie CO - Nephrourol Mon (2013)

Urethral Prolapse
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3842555&req=5

fig4823: Urethral Prolapse
Mentions: Confirmation of the diagnosis of urethral prolapse was made by observing a circular hemorrhagic mass, anterior to the vaginal orifice, covering the normal location of the urethra but with a central opening (Figure 1). Patients were treated surgically by the method of ligation over a Foley catheter under sedation and analgesia (Figure 2); The inserted and inflated Foley catheter (size 14 for all patients except usage of size 16 for one 8 year old patient) should be placed on mild traction and maintained as such by an assistant during ligation of the mass to ensure that the base of the mass is completely exposed, facilitating placement of the knot of the ligature (size 0 polyglactin suture material in this series) at the base of the mass. During the ligature, the following modifications where incorporated specifically to address previously reported complications:

Bottom Line: None of the receiving medical personnel were aware of this condition.Maximum length of catheterization was for 4 days.Maintaining the inflated balloon of the Foley catheter with timed catheter removal especially adds predictability to this technique.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Banso Baptist Hospital, Kumbo, Cameroon ; Department of Surgery, Tenwek Hospital, Bomet, Kenya.

ABSTRACT

Background: Most contemporary series on urethral prolapse report either on the use of excisional or conservative treatment approaches.

Objectives: To introduce a modified ligation over a Foley catheter treatment method for urethral prolapse that addresses most of the previously reported complications.

Patients and methods: Five consecutive patients with urethral prolapse treated between 2003 and 2011, all using the ligation method on an outpatient basis were studied prospectively. Maintaining the inflated balloon of the Foley catheter with timed removal of the catheters among other modifications to the original technique is further described in the article. The main outcome measures were to evaluate for recurrence, post-operative appearance of the urethral orifice and satisfaction of parents. Secondarily the actions of the parents of the patients and those of the receiving physicians were also recorded.

Results: The mean age of the patients was 6 years old (ranging from 3 to 8 years). All parents suspected sexual molestation and in two cases, the suspected perpetrators were verbally threatened of dire consequences of their actions if proven. None of the receiving medical personnel were aware of this condition. Maximum length of catheterization was for 4 days. The post treatment urethral openings appeared normal and there were no complications.

Conclusions: The ligation method with attention to the modifications described further in the article is a simple, safe and cost effective option for the management of urethral prolapse. Maintaining the inflated balloon of the Foley catheter with timed catheter removal especially adds predictability to this technique.

No MeSH data available.


Related in: MedlinePlus