Pawłowska-Krajka Emilia, Dorobek Adam
Medical University of Warsaw, Department of General, Oncological and Functional Urology, Warsaw, Poland.
Cent European J Urol. 2017;70(4):405-411. doi: 10.5173/ceju.2017.1315. Epub 2017 Oct 19.
The most frequent reason for ureterorenoscopy is the necessity to remove calculi from the ureter and/or kidney. After completing this procedure the Foley catheter is inserted in the bladder. The aim of the study is to show whether catheterisation of the bladder after ureterorenoscopic stone removal in patients with a low-risk of complications is necessary and indicated.
This is a comparative, prospective and randomized study. 100 patients meeting the assumed criteria, subjected to the ureterorenoscopy due to ureter and/or kidney stones participated in the study. The patients were divided into the experimental (Group I) and control (Group II) groups. Group I did not have a catheter, Group II was catheterised. There were two subgroups: female and male in each group. Mean values of the following parameters were calculated: intensity of postoperative pain measured by Visual Analog Pain Scale, the number of additional doses of painkillers administered after the procedure, hospital stay, occurrence of fever, significant bacteriuria, acute urinary retention and post- void retention greater than 30 ml.
Intensity of pain measured by the Visual Analog Scale was higher in Group II. Catheterisation does not influence: the number of additional doses of ketoprofen and pethidine administered during the 1 day after the operation, the duration of hospitalization, the occurrence of fever, significant bacteriuria, the postoperative acute urinary retention and the post-void residual urine volume.
In patients with a low risk of postoperative complications who did not have any intraoperative complications, catheterisation of the urinary bladder increases discomfort without bringing any benefits.
输尿管肾镜检查最常见的原因是需要从输尿管和/或肾脏中取出结石。完成该手术后,将Foley导尿管插入膀胱。本研究的目的是表明,对于并发症风险较低的患者,输尿管肾镜取石术后进行膀胱插管是否必要且有指征。
这是一项比较性、前瞻性随机研究。100例符合既定标准、因输尿管和/或肾结石接受输尿管肾镜检查的患者参与了研究。患者被分为试验组(I组)和对照组(II组)。I组不插管,II组进行插管。每组又分为两个亚组:女性和男性。计算了以下参数的平均值:用视觉模拟疼痛量表测量的术后疼痛强度、术后给予的额外止痛剂剂量、住院时间、发热、显著菌尿、急性尿潴留和排尿后残余尿量大于30 ml的发生率。
II组用视觉模拟量表测量的疼痛强度较高。插管不影响:术后1天内给予酮洛芬和哌替啶的额外剂量、住院时间、发热、显著菌尿、术后急性尿潴留和排尿后残余尿量的发生率。
对于术后并发症风险较低且术中无任何并发症的患者,膀胱插管会增加不适且无任何益处。