The epicistoma of the bladder is a fistula at the bottom of the abdomen. As a rule, this hole has an artificial origin. A bubble catheter is inserted into it for artificial emptying of the bladder. This device is used in cases where the patient cannot independently carry out urination.

Epicistoma is a fistula that is located at the bottom of the abdomen.

Indications for the installation of the catheter

Installing this device is performed quite often with violations of urine outflow. Such a need usually occurs for the following reasons:

• acute urological infections;
• diabetes;
• obstruction of the urethra due to mechanical damage or after surgery;
• uncontrolled use of medication drugs;
• an increase in prostate sizes in men;
• temporary disorders of the bladder. Meet after operations or due to any diseases.

Epicistoma can be in the human body for a long time. Sometimes such devices are installed only for a while - until the function of natural urination is restored.

Mechanism of procedure

The operation at which an epicistoma is made to enter the catheter in the human body, is called epicistomy. If the device is located in the body for a long time, the abdominal wall and bladder are pierced using a troacar - a thin tube, empty inside.

Sometimes the hole is made before other operations to ensure the temporary outflow of urin. So that such intervention is normal, the bladder must be complete. To do this, the patient is allowed to drink a small amount of fluid. If there is no such possibility, the bladder is filled with air.

The urine outflow occurs through a catheter that does not require additional fixation other than seams or a cylinder with liquid. The outer end of the catheter is connected to the urinary. This container can be fixed on the bed of a person or on his leg.

In some cases, temporary disconnection of the urinary student is allowed. About such a possibility should be consulted with a doctor. After disconnecting the container, it is necessary to close the outer end of the catheter.

Advantages and disadvantages of epicistomes

Compared to conventional urethral catheters, epitistoma has the following advantages:

• the device does not rub and does not injure urethra;
• the minimum probability of disconnecting the catheter;
• lack of significant discomfort for humans.

Physiotherapy.

After installing the device, physicians have the ability to check the condition of the human bladder. The patient itself has the ability to use therapeutic gym for training urethra. In front of any exercise It is necessary to close the catheter.

Despite these advantages, the installation of a suplocked catheter has negative sides. Sometimes the patient has pain after surgery. In some cases, irritation of the skin is observed around the artificial fistula. Such symptoms disappears in a few days.

In medicine, cases are recorded when a liquid flows around the opening. The problem is solved by imposing a dressing. It is quite difficult for people with overweight.

The disadvantages include the need to care for the catheter tube. Sometimes more serious complications arise - spasmodation of the bladder and urethra. There are also cases of the development of secondary infection through epitistus. To minimize such a probability, it is necessary to care for the catheter.

Subsequent patient care

The skin around the artificial hole must be treated with antiseptics. This must be done in order to avoid infection in the urinary bubble cavity.

Before any actions with the device should wash your hands with soap. It is best to use sterile gloves. It is necessary to care for the epitistoloma as follows:

1. You should carefully remove the old bandage, remove the plaster for fastening the catheter. If on the skin under the bandage there is redness, irritation and damage, you need to report this to the doctor. Then the hands should be reversed and swap gloves.
2. The catheter is a bit left aside, and without removing, wash the tube with warm water with soap. Wash and wash the skin, removing Sukrovitsa. The skin area around the hole flinches a clean napkin. Before the next action, it is necessary to change gloves again.
3. If the old bandage was worn out, it is necessary to replace it with a new one. After that, it should be carefully and firmly fix the catheter tube so that it does not go bend. Then re-wash your hands.

Compliance with hygiene rules plays a very important role in the prevention of complications.

People with epitistoloma are recommended to take a shower and drink less fluid that can irritate the mucous membrane of the bladder. During the day you need to drink at least 1.5 liters of pure water to avoid stagnant processes.

Depending on the type of catheter, it needs to be changed every 1-2 months. In the first times, it is best to use the help of a nurse, but in the future the procedure for changing the device can be performed without the participation of honey. personnel.

Cystostomoma is a special device for removing urine, which is installed in the urinary bubble cavity, not through the urethra, but by means of the end at the bottom of the abdominal cavity.

Bladder

Cystostomom is introduced into the bladder to remove urine from it if it is impossible to make physiological way.

Cystostomom

In addition, this method of removal of urin is necessary in the case when the installation of a standard catheter through the urethra is not possible for a number of reasons.

So, the main indications for the introduction of cystostomas in the bladder are:

• violation of the urethra's passability when squeezing its walls by increased prostate gland in men;
• various violations of the patency of the bladder cervix;
• urethra injuries, which cause serious damage to its inner surface up to a complete break of the urethra;
• treatment of serious bacterial diseases of genital organs, such as bacterial prostatitis or gangrene Fourier;
• avoiding too frequent administration of the catheter through urethra, since catheterization in any case causes damage to the epithelium of the urethra, which can lead to infectious complications;
• the inability of a person to control the act of urination due to various mental illness;
• the impossibility of normal urination in the innervation of the urinary tract in the injury with damage to the spinal or brain, stroke;
• complications after severe childbirth in women.

The formation of urine occurs continuously, after filtering in the kidney, it flows into the urinary bubble after filtering.

Its maximum volume can reach 700 - 800ml. Its critical overflow is very dangerous. Therefore, the introduction of cystostomas is often the only option to ensure urine outflow from the bladder.

Installation precautions

However, not all patients are possible in the bladder to establish a cystthomatome.

Contraindications

Contraindications to this manipulation are the incorrect physiological location of the bladder as a result of anatomical pathology and its cancer defeats.

With extreme caution, cystomatom must be installed in the following cases:

• blood coagulation disorders;
• previously made operations on the lower departments of the urinary or sexual system;
• various prostheses at a nearby bone system departments;
• overweight with large accumulation of fatty sediments in the abdomen.

Technique of manipulation

Cystostoma consists of such departments:

• tip;
• the sleeve, with which the replacement of the urinary researcher is carried out;
• side opening with special constipation, through it is taken to analyze the portion of urine;
  A shut-off system that allows you to overlap the stream of urin.

In the cavity of the urinary bubble cystostoma is installed under local anesthesia. Before manipulating the patient, it is recommended to drink some liquid to form urine.

First define the place of the puncture. Then processed by its special antiseptic. Cystostomom is installed using a special device - a trochar.

It is introduced with this catheter to the urinary bubble cavity, and then removed, while the tip of the catheter remains inside.

Urination

After that, a transparent urination with graduation is joined, which can be judged by the volume of urine allocated.

Cystostomom can be fixed in several ways. Some catheters have special extensions on the tip that are tightly held inside the bladder. Others are attached outside with a patch.

There are also catheters that need to be fixed with suture material.

With the help of a shut-off mechanism, you can open a permanent stroke of urine into the urinal tube, or empty the bladder periodically, once a few hours as it fills it.

In this case, the tube of cystostomas can be directed directly to the toilet.

Care

Departure care

In order to avoid the development of a bacterial bladder infection or at the site of introducing cystostomas, appropriate care for it is necessary.

Departure care is its regular devastation and replacement. If the cystostomtoma allows you to pour into the urine directly in the toilet, then in no case cannot contact the cutter tube with a toilet.

And after the drain, it must be thoroughly wipe.

The skin around the place of installation of cystostomas in the bladder is also needed. It needs to be switched to warm water with soap twice a day, or, if it is difficult, use antibacterial wet wipes.

Cystostoma is usually changing once a month.

But 2 - 3 times a week it is necessary to rinse the bladder with warm physician through the catheter tube. The procedure is considered completed after the appearance of a transparent fluid.

First, care for the catheter can be carried out with the help of medical personnel, and then do it yourself or with the help of loved ones.

When you need to go to the doctor

Sometimes, despite the proper care, symptoms appear, in which you need to seem to see. First of all, you need to contact the hospital within an hour if the cystostom fell.

It is necessary to contact the doctor as soon as possible if the urine does not go into the urinary or its color changed, blood or unpleasant smell appeared.

It is also dangerous bleeding, inflammation or strong redness at the site of the plantation of custostomas.

The reason for the consultation is also an increase in temperature, the pain at the bottom of the abdomen, the deterioration of the overall state.

If in your life I came at the time when you need a cystostomtoma, it's time to learn important information on the very procedure for installing cystostomas, as well as care for it, but also learn to change the epicistine yourself at home. Let's start.

What is a cystostom

The cystostomy is called a urological device in the form of a tube, a fole catheter is quite often in the role of the tube, which is installed (introduced) directly to the MP (bladder) to remove urine into the urinary. Figure 1. - Cystostomom, Foley Folee Catheter

In people who do not have urological problems with urination, there are no questions about what kind of cystostom is and why it is needed, but among people experiencing problems with the diverse of urine, this concept (cystostomy) is not new. As an example, I can give a real case from life.

As an example:

As a result of an accident, a person was injured by the spine, as a consequence of violation of the functions of pelvic organs and paralysis lower extremities. As a result, the patient began problems with urination, a urolithiasis appeared. The bladder stopped functioning normally, the urine began to be in the MP (bladder), as a result of which the ascending pyelonephritis developed.

The urologist was forced to establish a cystomy to eliminate any urine delay. At the moments when the urine outflow is impossible due to the stone or other pathology, the installation of cystostomomas is the only salvation.

Benefits and disadvantages of cystostomy

Benefits include the following:

• Unlike the conventional catheter installed through the urethra, the cystostomom does not injure or the urethra itself, nor the bladder neck, as it is installed above the pubic.
• In the case when the cystostomom is somehow clogged (most often mucus and sand), you have a so-called spare option for removal of urine across the urethra.
• Replacing the catheter is independently more complicated than the replacement of cystostomas.
• In cases of removal of cystostomomas, the place where it was installed heals in days, and therefore the procedure is reversible.
• The size of the cystostoma can be greater than the catheter, which reduces the likelihood of clogging.
• An ordinary catheter is installed on short termWhile cystostomom can stand for a long time, the replacement that is approximately 4-6 weeks.

Basic Disadvantages

• With the excess mass of the patient's body, the installation and care of the cystostomom can be very problematic.
• The emergence of bladder spasms
• Frequent occurrence of inflammatory processes
• After a cystostomtom time is clogged and should be replaced
• In the place where the cystostomtoma is installed can leak urine

When it is worth installing cysto

1. In cases of partial or complete absence of urination:
2. Disabled with violation of the functions of pelvic organs;
3. In case, when the patient has a benign prostatic hyperplasia;
4. Acute prostatitis;
5. Stagnation of urine as a result of inconspicuous operation of muscles and sphincter MP;

How to replace cystomatom at home video

Below we provide you with video about how to quickly replace the cystost without the help of the doctor.
Description of video. The disabled person of the first group shows how fast, and most importantly make a replacement of the dried cystostomomas at home.

Castty and bladder care rules

Wash your hands before and after the installation of cystostomas, at the time of changing the dressings and any other manipulations with the stoma.

• Place around the cystostoma wash warm water with soap at least once a day.
• Do not wait until the urine collection bag is complete. When filled with a bag to collect urine to half, it is time to empty it without touching the toilet bag valve.
• Drink at least two liters of fluid per day, so you will naturally wash the bladder and the cition itself.
• Rinse with chloromexed solution 1 time per day and stoma and bladder, thereby disinfection of the stoma and bladder (although some urologists do not advise this)
• Always have a spare catheter Foley at your hand, in case of obstruction of the old cystostomy, you can replace in the nearest cysto-time hour yourself, the channel in which is installed Stoma will not have time to delay during this time.

In practice, a doctor of a urological profile is quite often encountered with such a device like a catheter for urine. It is a rubber tube or a system consisting of several tubes necessary to introduce into the lumen of the bladder, if the patient does not undergo or for other diagnostic purposes.

Most often in catheterization, men in whose diseases such as prostate adenoma or her malignant rebirth (prostate cancer) are needed. On their background there is a violation of the urine channel, which leads to urine delay.

What is the bladder catheterization?

The main goal of catheterization is the restoration of normal urine outflow from the bubble lumen, which normalizes all the processes of urodynamics, and prevents a number of dangerous complications for the patient's life.

The catheter is introduced into the outer hole of the urethra, after which it is gradually moving along the urethra and reaches the lumen of the bladder. The appearance of urine in the catheter is evidence that the procedure is performed correctly and successfully.

Catheterization should be carried out only by a specialist who have a medical education (by a physician or emergency medical care).

Despite the fact that the catheterization technique is pretty simple in performance, a certain skill is required for its correct implementation.

When performing the catheterization of the bladder, it is important to comply with a number of the following basic conditions:

• the introduction of a catheter in the urinary channel (urethra) should be carried out carefully, without the use of rudeness and violence;
• the procedure begins with the use of elastic devices (Timan or Mercier type catheter);
• in order to minimize possible damage to the walls of the urethra, it is necessary to use a large-diameter catheter;
• the patient is inserted with a metal catheter only if the doctor who conducts manipulation is perfectly with this skill;
• when any pain in the process of catheterization appears, it must be discontinued, and the patient will immediately hospitalize in the hospital;
• if the patient has acute urine delay, but the introduction of a catheter in the bladder is impossible (there are contraindications), then resort to percutaneous cystostomy.

Varieties of catheters and their classification

Earlier, only metallic (hard) catheters, which led to frequent complications (injuries of mucous, gaps, etc.) were used to carry out catheterization. Currently, the prevalence was obtained silicone (soft) and rubber (elastic) devices of different diameters.

There are catheters for men (their length is about 30 cm) and for women (its length is 15-17 cm).

Apply the following types of devices:

• neltonon catheter (used for catheterization for a short period of time, with the goal of a one-time drainage);
• foley catheter (introduced for a long period of time, has several moves through which introduction is performed at the same time medicines and urine removal);
• timan's stent (a device used by urologists in prostate diseases is well taken by the bends of the urethra).

The catheter is chosen depending on the purpose of using it

Procedure implementation technique

In order to conduct a catheterization procedure, in accordance with all the rules of asepsis and antiseptics, it is necessary to conduct it in a specialized hospital, using modern antiseptic tools, sterile devices, medical disposable gloves, etc.

Woman's bladder catheterization

The following manipulation algorithm:

1. A woman is placed on his back, ask her to bend legs in the knees and dilute their side.
2. Careful treatment of female genital organs using antiseptic solutions, after which the inlet of the vagina is placed with sterile napkins.
3. The right hand introduces a well-lubricated catheter for urine to appear (approximately 4-5 cm).
4. If the urine suddenly ceased to flow, it may indicate that the device rested into the wall of the bubble, so it is necessary to pull the catheter back a little.
5. After the end of the manipulation, and the complete outflow of urin, it is necessary to gently remove the catheter outward, and the absurd of the urethra is again treated with an antiseptic solution.
6. The patient is required within an hour to be in a horizontal position.

The procedure is carried out only by qualified specialists.

During pregnancy, there are situations when a woman is required catheterization, for example, when promoting the concrete, and the blockage of the lumen of the urinary tract, which leads to an acute urine delay, and also before the upcoming cesarean cross section.

Condition requires immediate hospitalization and observation of a woman only in a specialized hospital.

In men, catheterization complicates the anatomical structure of the urethra, namely its small diameter, considerable length, convulsion and the presence of physiological narrowings.

The algorithm of the procedure is as follows:

1. The man is placed on the back (the legs are not necessary to bend in the knees).
2. The sexual dick and the groin area are placed sterile napkins around the perimeter.
3. An left-handed doctor pulls back the extreme flesh, exposing at the same time the absurd of the urethra, and at the same time pulls the penpendicular surface of the patient's body. The penis head and other men's genitals are carefully treated with antiseptic solutions.
4. The pre-lubricated catheter is introduced with the right hand, all movements must be smooth and uniform, while the doctor must apply only a small force in the places of anatomical narrowings (the patient is asked to relax as much as possible).
5. Recommended periodic palpation of the tip of the catheter is recommended, especially if there are obstacles on its paths, until the urine does not go through it (evidence that he achieved the bubble lumen).
6. When the procedure is completed, the catheter is removed, and the lumen of the urethra is re-treated with an antiseptic solution. The patient is required within an hour to be in a horizontal position.

Perpendicular to the male body perpendicular to the male body allows you to mostly straighten the front diver of the urethra

The catheterization of the bladder in a child

In general, the technique of catheterization in children does not have significant differences from the procedure performed in adults. It is carried out in order to restore the normal outflow of urine, and the elimination of all signs of acute delay of Urin.

The introduction of a catheter to a child requires special care and accuracy, as they have a high risk of damage to the mucous membranes, up to a complete break of the wall of the urethra or bladder. That is why the device of smaller diameter is used for the catheterization of children, and if there is such an opportunity, the procedure is carried out under ultrasonic or radiographic control.

Indications and Contraindications for the procedure

Basic readings for bladder catheterization:

• development of acute urine delay under different pathological conditions;
• chronic urin delay in the wake of the bladder;
• the shock state of the patient, in which there is no possibility of independent death of urine;
• the need to determine the exact amount of daily urine in patients in the intensive care unit or intensive therapy;
• determination of the volume of urine, which remains in a patient after an act of urination;
• the introduction of contrast substances (required in a cysture technographic study);
• washing the lumen of the bladder solutions of antiseptics or antibiotics;
• in order to remove blood bubbles from the bubble;
• a number of diagnostic procedures (for example, the take of urine analysis to further sowing it to nutritional environments, when the delivery is impossible or difficult).

Samoa frequent cause urine delay in men is prostatic adenoma

Contraindication for catheterization in men and women can serve as the following pathological processes:

• inflammatory process in the tissues of the prostate gland (acute prostatitis or exacerbation of its chronic form);
• inflammatory process in testicles or their appendages;
• prostate abscesses or other volumetric formations in it, resulting in a sharp narrowing of the enlightenment of the urethra, when the introduction of the catheter is impossible;
• the infection of the urethra (acute urethritis or aggravation of the chronic process, when the edema is sharply expressed);
• traumatic damage to the urethra or its sharp deformation on the background of strictures (the introduction of the catheter may entail a break of the vetra wall);
• pronounced spasm of the external sphincter bubble (for example, against the background of impaired innervation during damage to the lumbar spine);
• contracture of the cervical part of the bladder.

Complications after manipulation

As a rule, if the catheterization is performed by an experimental specialist, and the patient has any pathological processes that make it difficult to promote the catheter in the urethra, then complications are quite rare.

The most common are the following adverse outcomes from the procedure:

• damage to the walls of the urethra or bladder, which leads to the appearance in the urine of blood (hematuria);
• random breaking the wall of the urethra or perforation of the bubble (this happens with the coarse introduction of the catheter);
• infection of the urethra or bladder (cystitis or urethritis develops);
• a sharp decline in numbers arterial pressure (hypotension against the background of manipulation).

Urethra men have several anatomical bends, so rough and improper manipulation can cause a number of complications

Replacing a catheter or its removal

If the bladder catheterization is performed for a long period of time, it is often necessary to replace the device. This happens at the following situations:

• initially incorrectly selected catheter size, as a result of which the gradual "leakage" of urine is observed;
• block lumen of the device;
• the emergence of pronounced spasms in patient or other unpleasant sensations requiring temporary removal of the catheter.

Only a specialist with medical education should deal with the removal of the device, as well as its introduction to prevent any complications. The doctor disconnects the reservoir with the urine from the main tube. With the help of a large syringe attached to the outer opening of the tube, the residual volume of urine is displayed, then the catheter is completely removed. All movements must be smooth and insensitive, you need to avoid any "jerks".

After removing the catheter, you need to leave the patient in a horizontal position for 20-30 minutes. It is important to question its presence of unpleasant sensations, pain, etc.

If after catheterization in the patient, the abdomen is observed, blood from the urethra or other pathological symptoms appears, then it is necessary to find out their cause

Conclusion

The catheterization of the bladder is a manipulation that requires an intervention of only a specialist with medical education.

Each patient to which the catheter is installed requires constant surveillance. When any unpleasant symptoms appear, the diagnosis of this state is necessary, and the question of its removal is solved only by the doctor.