Apicectomy bladder: features, tips and advice
In diseases that disrupt the function of rochevilaine, a patient has an artificial emptying of the bladder. In urology to do this, use the catheters are introduced directly into the cavity of the body and discharge urine. Often used suprapubic catheter, in order to install the surgically created apicectomy — through hole in the lower part of the abdomen. The fistula is inserted a flexible rubber tube through which the urine is diverted into a bag, fixed on the outside of the leg or the waist of the patient.
Indications for the installation of a suprapubic catheter
Artificial drainage of urine through apicectomy necessary for patients experiencing difficulty with emptying the bladder naturally, for various reasons:
- acute urological infection;
- obstruction (obstruction) of the urethra due to injury, after surgical interventions;
- disorders of the nervous regulation of the process of urination, pathology of the spinal cord, atony of the muscular walls;
- diabetes mellitus;
- the action of certain medicines;
- hyperplasia of the prostate in men, cystocele;
- time weakening the function of the bladder, for example, after surgery.
The catheter is mounted on a long term or temporary, as long as the natural function of urination is restored.
Installing the catheter
A surgical procedure for the imposition of suprapubic fistula of the bladder is called epiziotomija. The name is formed from the words «EPI» is «high», «cyst» — «bladder», «tomiya» — «dissection». There are two methods of performing this operation:
- Puncture of abdominal wall and bladder with a trocar (a thin hollow tube) through the hole which then set the catheter.
- Open epicystostomy is carried out mainly before the main surgical intervention for temporary drainage of urine. The operation is performed strictly on a full bladder. If the body is not filled with urine, it is filled with air.
The urine is diverted through a special catheter that does not require fixing. Its end is connected with a urine bag attached to the leg of the patient or his bed. In order to avoid blockage of the tube urinary salts must be changed regularly. Fixation of the catheter is done using sutures or a container of liquid. If the volume of the bladder allows the bag to disconnect for a while, closing the outer end of the catheter.
Artificial mocheotdelenie through apicectomy is a good alternative to permanent urethral catheter, the bladder.
- The tube is secured in the abdominal wall and does not create patient serious discomfort. There remains the possibility of free movement, sports, even intimate life.
- The urethra is not exposed to the rubbing and injury.
Installation apicectomy allows to observe the possible restoration of the natural function of urination, as well as to train the bladder with a special gymnastics, blocking the catheter.
Disadvantages and side effects
In some cases, when you install a suprapubic catheter the patient may experience unpleasant painful feelings. Sometimes there is a hypersensitivity of the skin around apicectomy, especially the first time after the surgery. Over time, these symptoms disappear.
- There may be a leakage of fluid in the area episistomy. In this case, around the tube you should wrap it.
- Hampered the installation of a suprapubic catheter bladder in patients with excessive body mass.
- Over time, the tube of the catheter becomes clogged and must be cleaned or changed.
- In rare cases, there are spasms of the bladder and urethra.
Apicectomy is an open gate into the bladder, it is not surprising that patients with a catheter is more likely to have urogenital infections and inflammation.
The area of the stoma (fistula) should be regularly treated. If this is not done, with the big share of probability will be infection and inflammation. In the worst case the infection gets into the bladder itself, causing serious complications.
- Before the manipulations you need to thoroughly wash hands with soap and water and wear sterile gloves. Gently remove the old bandage holding the skin. Remove patch, which is attached to the catheter. During visual inspection note possible swelling, redness, spots, skin lesions. About these symptoms you must inform your doctor. Should then wash hands and change gloves.
- The catheter is slightly withdrawn to the side and hold, not pull it. Warm soapy water is washed up the outside and the surface of the skin in the direction from apicectomy to the periphery and remove the pus. The area of the fistula promatyvaya a clean cloth. Again changing gloves. Compliance with hygiene helps protect against infections.
- If necessary, place a new bandage, gently and carefully secure the catheter tubing, avoiding kinks. After the procedure, you must wash your hands.
- Hands should be washed as often as possible before and after any manipulation of the tube of the catheter, emptying the bladder.
Patients are encouraged to regularly take showers (instead of baths) and to consume less of drinks that irritate the bladder. Water should drink at least 1.5 liters a day to ensure the constant formation and movement of urine.
Change catheter and drainage bag
After the installation of the catheter in the first time change after 1.5-2 months, then every 1-2 months, depending on the practitioner. This procedure can conduct a nurse or even the patient himself and his relatives. In some cases after a tube change in the urine found blood, but most often this symptom passes quickly.
Urinals are of 2 types: night and day. Night have a larger volume, attached to bed, should be equipped with a drain valve. Daily less attached to the thigh or lower leg of a patient (below the bladder) with the help of straps.
Urine bag change every week, if necessary (corruption, pollution) more often. Bag drainage bag must be emptied on time.
Apicectomy and bladder training
Established in apicectomy the catheter does not block the emptying of the bladder. Moreover, in some cases, the patient is recommended to train on, closing the end of the tube stopper. If you are able to commit an act of urination, measure the volume remaining in the bladder urine, releasing it through the catheter. Reducing this amount over time may indicate a normalization of the urinary functions of the body.