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Richard S Foster - One of the best experts on this subject based on the ideXlab platform.
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urethral Catheter Removal prior to hospital discharge following radical prostatectomy
Urology, 1997Co-Authors: Christopher L Coogan, Samuel J Little, Richard Bihrle, Richard S FosterAbstract:Abstract Objectives To investigate the feasibility of early Catheter Removal following radical prostatectomy. Methods Fifty-eight consecutive patients underwent radical prostatectomy, with intent of early Catheter Removal. Catheter Removal was based on postoperative cystograms performed on postoperative day (POD) 3 or 4. Charts were retrospectively reviewed and patients were contacted by phone and specifically questioned regarding continence and bladder control. Results Fifty-one patients (87.9%) had a cystogram performed on POD 3 or 4. In 43 patients (74.1%), the Catheter was successfully removed prior to hospital discharge. Eight patients experienced either early or late complications (excluding incontinence); these included 3 patients with a superficial wound infection, 2 patients with hematuria requiring reinsertion of a urethral Catheter, 1 patient with a spontaneous pneumothorax, 1 patient who developed a deep vein thrombosis and lymphocele, and 1 patient with a bladder neck contracture. Urinary continence was reported as excellent to good in 86% of the patients at a mean followup of 17.4 months. Three patients (5%) underwent placement of an artificial urinary sphincter. Conclusions Catheter Removal prior to hospital discharge after radical prostatectomy is feasible without any increase in morbidity.
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early urethral Catheter Removal following radical prostatectomy a pilot study
Urology, 1995Co-Authors: Samuel J Little, Richard Bihrle, Richard S FosterAbstract:Abstract Objectives Postoperative urethral Catheter drainage after radical prostatectomy is bothersome to patients. A pilot study was initiated to determine if urethral Catheter Removal prior to hospital discharge is feasible. Methods Thirty-three consecutive men undergoing radical retropubic prostatectomy were prospectively studied and followed for a minimum of 6 months (mean, 8.5). Postoperative cystography was utilized to direct early Catheter Removal. Results Of 33 patients, 27 (82%) underwent successful Catheter Removal at a mean of 4.2 postoperative days. No patient experienced urinary retention, urinoma development, pelvic abscess, or anastomotic stricture. Urinary continence is excellent (no pads required) in 70% and good (stress incontinence requiring 1 to 2 pads/24 hours) in 18% of patients at last follow-up. Conclusions Following radical prostatectomy, early Catheter Removal prior to hospital discharge is feasible. Early results suggest no deleterious consequences. Prospective monitoring of more patients is needed to determine if this practice is widely applicable.
Hidefumi Kinoshita - One of the best experts on this subject based on the ideXlab platform.
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urethral mobility at Catheter Removal predicts early recovery of urinary continence after radical prostatectomy
International Journal of Urology, 2009Co-Authors: Sachiyo Nishida, Noriaki Utsunomiya, Hiroyuki Nishiyama, Toshiyuki Kamoto, Osamu Ogawa, Hidefumi KinoshitaAbstract:Objectives: To analyze the clinical parameters correlated with early recovery of urinary continence after radical prostatectomy, focusing especially on urethral mobility during voiding at Catheter Removal. Methods: At the time of Catheter Removal, a voiding cystourethrography was performed in 58 men (median age 69 years, range 55–76) who had undergone radical prostatectomy. The vertical length of urethral movement between voiding and standstill was measured. The correlation between continence status and various clinical parameters, including age, prostate volume, International Prostate Symptom Score, quality of life score and the length of urethral movement was analyzed. Results: An inverse correlation was observed between length of urethral movement and urinary incontinence volume rate (defined as [leakage volume/daily total urine volume] × 100%) on day 7 after Catheter Removal (r = −0.388, P < 0.05). Classifying patients into two groups according to the length of urethral movement of 2 mm gave the best accuracy for the prediction of postoperative recovery of urinary incontinence with receiver operating characteristic analysis. A statistically significant difference was observed between group 1 (length ≥ 2 mm) and group 2 (<2 mm) for the leakage rate until day 7 after the Catheter was removed (P < 0.01). Urethral movement at the time of Catheter Removal was significantly correlated with early recovery of continence in the two groups (P < 0.05). Conclusions: Urethral mobility after radical prostatectomy, which can be easily evaluated using voiding cystourethrography, may be a good predictor of early recovery of urinary continence.
Mark H Wilcox - One of the best experts on this subject based on the ideXlab platform.
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in situ diagnosis of intravascular Catheter related bloodstream infection a comparison of quantitative culture differential time to positivity and endoluminal brushing
Critical Care Medicine, 2005Co-Authors: J A Catton, B M Dobbins, Peter Kite, Jonathan M Wood, Kerrie Eastwood, Sarah Sugden, Jonathon A T Sandoe, Dermot Burke, M J Mcmahon, Mark H WilcoxAbstract:Objective:To compare the accuracy of three techniques that do not require central venous Catheter Removal to diagnose Catheter-related bloodstream infection.Design:Prospective cohort study of central venous Catheters from suspected cases of Catheter-related bloodstream infection.Setting:University t
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rapid diagnosis of central venous Catheter related bloodstream infection without Catheter Removal
The Lancet, 1999Co-Authors: P Kite, B M Dobbins, Mark H Wilcox, Mlchael J McmahonAbstract:Summary Background Current methods for the diagnosis of bloodstream infection related to central venous Catheters (CVC) are slow and in many cases require Catheter Removal. Since most CVC that are removed on suspicion of causing infection prove not to be infected, Removal of Catheters unnecessarily exposes patients to the risks associated with reinsertion. Methods The gram stain and acridine-orange leucocyte cytospin test (AOLC) is rapid (30 min), inexpensive, and requires only 100 μL Catheter blood (treated with edetic acid) and the use of light and ultraviolet microscopy. We assessed the gram stain and AOLC test in suspected cases of Catheter-related bloodstream infection, in comparison with two methods requiring Catheter Removal (tip roll and tip flush), and a third technique, done in situ (endoluminal brush) in conjunction with quantitative peripheral-blood cultures. Findings 128 cases of suspected Catheter-related bloodstream infection were assessed in 124 adult surgical patients (median duration of CVC placement was 16 days). In 112 (88%) cases CVC blood was obtainable. Catheter-related bloodstream infection was diagnosed in 50 cases (culture of the same organism from the Catheter, in significant numbers, and from peripheral-blood culture). The sensitivity of the gram stain and AOLC test was 96% and the specificity was 92%, with a positive predictive value of 91% and a negative predictive value of 97%. By comparison, the tip-roll, tip-flush, and endoluminal-brush methods had sensitivities of 90%, 95%, and 92%, and specificities of 55%, 76%, and 98%, respectively. Interpretation The gram stain and AOLC test is a simple, and rapid method for the diagnosis of Catheter-related bloodstream infection. This diagnostic method compares favourably with other diagnostic methods, particularly those that require the Removal of the Catheter, and can permit early targeted antimicrobial therapy.
George C. Velmahos - One of the best experts on this subject based on the ideXlab platform.
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Colovesical fistula repair: is early Foley Catheter Removal safe?
Journal of Surgical Research, 2009Co-Authors: Marc De Moya, Nikolaos Zacharias, Audley Osbourne, Muhammad U. Butt, Hasan B. Alam, Francis J. Mcgovern, David R. King, George C. VelmahosAbstract:Background Colovesical fistula (CVF) are the most common occurring fistulae secondary to diverticulitis. Review of the literature reveals great variability in postoperative Foley Catheter management, as well as the role of a cystogram. The purpose of this study was to review our experience in early vs. late Removal of the Foley Catheter after CVF repair secondary to diverticulitis. Our hypothesis was that early Foley Catheter Removal is not associated with increased complications, and postoperative cystogram is of low value. Methods This is a retrospective study (January 2002–March 2008) of all patients with a diagnosis of CVF secondary to diverticulitis, who were treated with a sigmoidectomy and takedown of the fistula. Hospital records were reviewed and demographics, days to Foley Removal, performance of cystogram, type of repair, complications, and comorbidities were recorded. Patients were separated into two groups according to early or late Foley Catheter Removal. Removal of the Foley Catheter in ≤7 d was considered early, and Removal in >7 d was considered late. Results Thirty-two patients were identified, with a mean age of 65.2 y (42–91). Mean duration of Foley Catheter stay was 15.6 d (3–42). Six patients had early postoperative Foley Catheter Removal and 26 patients had late Foley Catheter Removal. Four patients had complex bladder repair, and they all had late Foley Catheter Removal. From the 28 patients with simple bladder repair, six had early Removal and 22 had late Removal. Patients with early Foley Catheter Removal did not have significant complications compared with patients with late Foley Catheter Removal. Eleven patients got a cystogram postoperatively to detect possible bladder leaks. All cystograms performed were negative. Conclusions Patients with a diagnosis of CVF secondary to diverticulitis may have their Foley Catheter removed in 7 d without any increased complications. The role of the cystogram is unclear; however, no value was added in simple bladder repairs.
Samuel J Little - One of the best experts on this subject based on the ideXlab platform.
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urethral Catheter Removal prior to hospital discharge following radical prostatectomy
Urology, 1997Co-Authors: Christopher L Coogan, Samuel J Little, Richard Bihrle, Richard S FosterAbstract:Abstract Objectives To investigate the feasibility of early Catheter Removal following radical prostatectomy. Methods Fifty-eight consecutive patients underwent radical prostatectomy, with intent of early Catheter Removal. Catheter Removal was based on postoperative cystograms performed on postoperative day (POD) 3 or 4. Charts were retrospectively reviewed and patients were contacted by phone and specifically questioned regarding continence and bladder control. Results Fifty-one patients (87.9%) had a cystogram performed on POD 3 or 4. In 43 patients (74.1%), the Catheter was successfully removed prior to hospital discharge. Eight patients experienced either early or late complications (excluding incontinence); these included 3 patients with a superficial wound infection, 2 patients with hematuria requiring reinsertion of a urethral Catheter, 1 patient with a spontaneous pneumothorax, 1 patient who developed a deep vein thrombosis and lymphocele, and 1 patient with a bladder neck contracture. Urinary continence was reported as excellent to good in 86% of the patients at a mean followup of 17.4 months. Three patients (5%) underwent placement of an artificial urinary sphincter. Conclusions Catheter Removal prior to hospital discharge after radical prostatectomy is feasible without any increase in morbidity.
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early urethral Catheter Removal following radical prostatectomy a pilot study
Urology, 1995Co-Authors: Samuel J Little, Richard Bihrle, Richard S FosterAbstract:Abstract Objectives Postoperative urethral Catheter drainage after radical prostatectomy is bothersome to patients. A pilot study was initiated to determine if urethral Catheter Removal prior to hospital discharge is feasible. Methods Thirty-three consecutive men undergoing radical retropubic prostatectomy were prospectively studied and followed for a minimum of 6 months (mean, 8.5). Postoperative cystography was utilized to direct early Catheter Removal. Results Of 33 patients, 27 (82%) underwent successful Catheter Removal at a mean of 4.2 postoperative days. No patient experienced urinary retention, urinoma development, pelvic abscess, or anastomotic stricture. Urinary continence is excellent (no pads required) in 70% and good (stress incontinence requiring 1 to 2 pads/24 hours) in 18% of patients at last follow-up. Conclusions Following radical prostatectomy, early Catheter Removal prior to hospital discharge is feasible. Early results suggest no deleterious consequences. Prospective monitoring of more patients is needed to determine if this practice is widely applicable.