Flexible Cystoscopy In The Management Of Difficult Urethral Catheterization

1. Flexible Cystoscopy In The Management Of Difficult Urethral Catheterization Dr Atif Mazhar ,Dr Shahab Javed Baqai Institute Of Nephro Urology , Baqai Medical University , Karachi , Pakistan . Introduction : Inability to place urethral catheter is a common cause of urologic consultation . Often other health care providers have unsuccessfully attempt catheter placement . Urethral false passages, perforations , accidental pull out of Foley and edema are common squeal. Bedside flexible cystoscopy was performed in this series not only to define the area and etiology of urethral obstruction but also to facilitate catheter placement. Material & Method: Inclusion criteria : Pull out foley’s,Patient with false passages, Known history of difficult catheterization. Exclusion criteria: Urethral Trauma,Urethral Stricture. Duration : two years Seventy five patients were studied prospectively. Initial endoscopic assessment was based on flexible cystoscopy done under topical lidocaine anesthesia. Under direct vision a 0.038 inch standard guide wire was directed through the area of obstruction /false passage. A well lubricated cut edge Foley's catheter was glided over the guide wire and pushed through the entire length of urethra till it reached the bladder. After inflation of the balloon, guide wire was pulled out. Conclusions: Flexible cystoscopy is a useful and time tested tool in the management of difficult catheterization. Results: In 70 patients the urethral drainage was established successfully Only five patients require further management.