UniPi
DIRIGENTE MEDICO UOC Urologia
Nuovo Ospedale S.Giuseppe - Empoli
Dottorato di Ricerca in Scienze Chirurgiche, Anestesiologiche e dell'Emergenza - Università di Pisa

Probe insertion through the urethra

Definition:
it consists in the introduction of a catheter or probe through the urethra.

Indications:
the goal is to drain (for once or for good) the bladder content.

Procedure:
after disinfection of the glans and possible introduction into the urethral channel a gel for lubrication often containing a local anesthetic, the probe or catheter is inserted into the urethra; there are various types, based on the shape of the distal end (with straight or angled, conical, fluted or rounded tip) on the caliber (expressed in French or in Charrière), on the number of channels (one, two or three “ways”) and for the mechanism that ensures their permanence in place (simple probes must be secured with appropriate adhesive mechanisms, while two- or three-way catheters are provided with an inflatable balloon that ensures its fixation in the bladder or in the prostatic lodge). The use of one type with respect to another is closely linked to the aims of the catheterization itself.

Preparation:
antibiotic prophylaxis is useful.

Duration of the intervention:
catheterization can be extremely easy (and therefore rapid) or difficult: in this second case it is the sensitivity and the experience of the urologist that can lead to a different solution of the problem to be addressed (possible positioning of an epicystostomic tube, especially in suspected urethral ruptures in the trauma of the pelvis).

Type and duration of hospitalization:
it depends on the reason of the procedure to catheterization: the solution of an acute urinary retention from cervico-prostatic obstruction is usually an outpatient procedure.

Results:
It should be understood as an extemporaneous maneuver, which does not resolve pathological conditions except in their acute manifestation (urinary retention). Intermittent catheterization may be the definitive solution for chronic urine retention in patients, for example, with neurological bladder.

Advantages:
minimally invasive solution to a problem that may require more aggressive and sometimes not achievable behavior for the patient’s condition.

Disadvantages:
except in certain particular conditions it can not be considered the ideal solution and forces slavery due to a foreign body constantly present in the urinary tract (fixed catheter) or to procedure whose realization can also condition close people (intermittent catheterization).

Complications:
urethrorrhagia and creation of “false roads”, for the possible lesion of the urethral wall: the immediate recognition of this allows to proceed without any further damage; it may be conservative, possibly by performing an external compression on the urethra to prevent bleeding, and / or, if necessary, deriving urine from the bladder by means of a “minimum” cystostomy.

Attention at discharge:
where the catheter is left permanently, its patency must be verified, thus avoiding over stretching of the bladder; in this case it must also be periodically replaced, which may vary in relation to the material it is made off (which also conditions its tolerability). In this case, antibiotic prophylaxis should be converted into a protracted treatment over time, even if at low dosage.

Contacts & appointments

Lucca:
Centro Medico San Luca
(presso Check up Medical Center)
via Romana Traversa II, 35
0583 495473
0583 080338

Livorno:
via del Mare, 83
347 6439874

Pisa:
Centro le Querciole
via di cisanello 1/A
Ghezzano
347 6439874

Empoli:
Centro Salus
via Chiara, 111
0571 711818

Cellulare privato:
347 6439874


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