Instrumental exploration of the urethra

For research of the urethra apply bugi - tools made either of metal (metal bugi)or of plastics, of silk or hempen basis, varnish impregnated (elastic bugi). Bugi have different thickness - from 0.33 to 10 mm in diameter. Elastic bugi usually straight, their end is cylindrical, oliveiras, Pugovkina or pointed form (Fig. 9). Metal bugi are direct, short (Fig. 10) to the front of the urethra and the long curved passing through the urethra and the end of his penetrating into the bladder. Central end of their forms curvature, corresponding to a curve of male urethra (Fig. 10, B).
On the peripheral end (pavilion) metal Buga has a wide flat plate, on which a number of bougie determining its diameter.
The caliber of Buga as other instruments inserted through the urethra (catheters, cystoscopy, lithotripters, be determined by special scales, of which the most accepted scale of charger (Fig. 11). This scale consists of consecutive on the periphery of the metal plates 30 round holes. The diameter of the first hole (#1) is equal to 0.33 mm Diameter each subsequent holes 0.33 mm of more diameter of the previous one. Thus, the diameter of the last hole (№ 30) equal to 10 mm or 1 cm Diameter any holes equal to its number, divided by 3. Introducing a tool into the hole plate with the scale of charger, you can define his caliber.
Instrumental exploration of the urethra should be carried out under aseptic conditions. Metal and plastic bugi boil, and elastic bugi and catheters are made of silk or hempen cloth, keep in particular sterilizers, where they are exposed to vapors formalin. Before use, the elastic instruments for about 5 seconds, immersed in boiling water to take away the traces of formaldehyde.
Bugi and the catheter is introduced into the urethra in case of horizontal position of the patient. Penis taking III and IV fingers of the left hand, turned palm up. I and II fingers of the same hand fix the knob and pushed the sponge external opening of the urethra. After wiping external opening of the cotton or gauze ball dipped 0.1% solution of sublimate, or oxycyanides mercury in the urethra right hand impose tool, greased sterile vaseline oil or glycerol. The penis when it is stretched to the folds of mucous membrane in the urethra not interfere with the passage of bougie.
The study started with elastic capitate burza № 16-18. OK this bougie passes freely, meeting only slight impediment in webbed Department of the urethra. If bougie meets insurmountable obstacle, say, how far it is, then move to gradually descending rooms burza as through stricture not pass bougie, the number of which will determine the degree of narrowing.
When a pronounced narrowing of the urethra used threadlike bugi very slim in size from 1 to 3 N9 on a scale of charger.
Instead capitate bogey to study the urethra can use capitate catheters or installers with the Central thin channel. The name "installer" is because this tool can be used introductions to the urethra a few drops of medicine (installations), such as silver nitrate, colloid, etc.
For fingering / research of the walls of the urethra are direct metal bogami. Above introduced into the urethra a bougie possible to feel infiltrates, scars in the wall, and increased, inflamed gland Littre (OK not apparently) in the form of small beans or peas. Metal bougie perceived friction tool on the stone of the urethra.
Patients with a heightened sensitivity can be pre produce anesthesia urethra by entering 10 ml 1-2% solution novokaina with a syringe with wears it tapered rubber tip. The solution novokaina hold in the urethra during 3 minutes, holding her outer hole thumb and forefinger or a special soft clip imposed behind the glans penis.
In acute inflammatory processes in the urethra, prostate, testes and epididymis of the introduction of any tools into the urethra is contraindicated.
Urethral fever. Introduction to the urethra instruments, if it is done carefully, without damage to the mucous membrane, is usually not accompanied by fever.
However, careful introduction of instruments can evoke patient response in the form of an acute attack of fever with a spectacular chills - the so-called urethral fever. It is the result of infection of the urethra into the bloodstream through areas where was compromised the integrity of the mucous membrane.
When surface detachment of the mucous membrane of acute febrile seizures in the same or next day ends drenching sweat and the temperature drops to normal. With deep injuries submucosal layer and the formation of a false stroke high fever and chills can stay with remissions in a few days.