Retrogrd urographia

Hogyan trtnik a vizsglat?

A hgyti szervek kontrasztanyagos rntgen vizsglatt erre szakosodott, tapasztalt
szakemberek (radiolgusok, rntgen szakorvosok) vgzik. A hgycs anatmia helyzete
miatt a katter bevezetse nknl knny, frfiaknl mr nehezebb. Az eszkz
felvezetse eltt rvid ideig hat nyugtat vns injekci adsa indokolt. Frfiaknl helyi
rzstelentt is alkalmaznak.A kattert cssztatanyaggal kenik be, majd a legnagyobb
kmlettel vezetik be a hgycsvn t a hgyhlyagba. A bevezetett katteren keresztl
retrogrd mdon kontrasztanyagot fecskendeznek be s feltltik a hgyvezetkeket s a
vese regrendszert. A vizsglat sorn rtg. felvteleket ksztenek.
Mire val a vizsglat s mikor van ilyen vizsglatra szksg?
A retrogrd urographia sorn a vese, a hgyutak kros anatmiai elvltozsai, mozgsihelyzetbeli eltrsei, mkdsbeli zavarai igazolhatk. A vizsglat abban az esetben
indokolt, ha egyb, a beteg szmra kevsb megterhel eljrsokkal nem lehet a
krismt fellltani, valamint, ha a kivlasztsos urographia sorn nem sikerlt megfelel
rntgenfelvteleket nyerni.
Mi a teend a vizsglat eltt?
A vizsglat eltt a beteg hgyomorra marad.
Mi a teend a vizsglat utn?
A rtg. vizsglat utn a szoksos napi tevkenysg folytathat, kmletre nincs szksg.
Milyen veszlyei vannak a vizsglatnak?
A vizsglat tapasztalt szakemberek kezben gyakorlatilag szvdmnymentesA modern
rntgen kszlkek mellett a szervezet elhanyagolhat rtg. sugrnak van kitve.Igen
ritkn elfordulhatnak szvdmnyek: az rzstelentszer vagy a nyugtat injekci irnti
tlrzkenysg; a katter okozta hgycs-, hlyagsrls, fertzs.

Abstract
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Ann Plast Surg. 2003 Apr;50(4):378-81.

Outpatient urethrocutaneous fistula repair with local anesthesia

in adult patients.
Sahin C1, Aksoy Y, Ozbey I, Polat O.

Author information

Mareal Cakmak Military Hospital, Urology Department, Erzurum, Turkey.

Abstract
The aim of this prospective study was to demonstrate that
urethrocutaneous fistulas could be repaired under local anesthesia in
adult patients without catheters. Between 1998 and 2000, 32 patients
with urethrocutaneous fistulas were repaired under local anesthesia.
The patients were divided into two groups in terms of whether they
did or did not have catheters. The catheterized group (group I)
included 15 patients and the uncatheterized group (group II) included
17 patients. Although the uncatheterized patients were discharged
the same day as their operation, catheterized patients were
discharged 4 to 6 days postoperatively. Patients were reevaluated on
postoperative day 7 and month 3 in terms of wound infection, urethral
stricture, and recurrence of fistula. All patients tolerated the fistula
repair under local anesthesia. The success rate of fistula repair was
93.3% and 94.1% in the catheterized and uncatheterized groups,
respectively. During postoperative days 1 through 7, wound infection
was seen in 2 patients in group I but was not noted in the
uncatheterized group. Fistulas recurred in one patient from each
group (6.6% and 5.8%, respectively) after 3 months postoperatively.
As a result, the authors suggest that catheterless fistula repair with
local anesthesia in the adult age group is an effective, safe, and
inexpensive procedure.

A nylon suture is fed through the stula tract and brought through the external urinary
meatus.
Figure 3
A polyglactin suture, running through the tip of thestula, is secured to the tip of the
external urinary meatus.

Author's personal copy

Conclusions
The PATIO technique for repair of urethrocutaneous stulafollowing hypospadias repair
is simple, easy to perform,and can be done with short hospitalization and a shortperiod
(24 h) of catheterization. It does not preclude theinterposition of healthy tissues between
the urethra andskin so as to reduce the risk of recurrence. Early results areencouraging,
but caution must be used as this is a smallseries and more studies need to be done.
Conict of interest/funding
None.
References
[1] Duckett JW, Kaplan GW, Woodard JR. Complications ofhypospadias repair. Urol Clin
North Am 1980;7:443