The Aging Behavior of Polyurethane-based Ureteral Catheters

Ureteral catheters, commonly known as double j stents according to their specific shape, are largely used worldwide with good results to assure proper renal drainage and to overpass ureteral obstacles successfully. This study deals with the aging behavior of polyurethane-based urinary catheters, explanted at different time intervals: 22 days, 29 days, three months, and eight months respectively. TGA (Thermogravimetric analyses) tests showed significant differences in the thermal behavior of polyurethane-based material, especially at eight months, where a higher thermostability was noticed. Also, the DSC (Differential Scanning Calorimetry) curves presented different shapes for the samples of polyurethane-based urinary catheters after three months and eight months. FTIR (Fourier-Transform Infrared Spectrometry) spectra gave a detailed picture of the chemical trans-formation which has occurred within the material at eight months. All the analyses gave an overview of the aging process of polyurethane-based urinary catheters and showed insights into the chemical/ physical transformations that the polymeric material suffers from prolonged usage.

Percutaneous antegrade removal of foreign bodies in the urinary tract: a 20-year, single-center experience

Background While removing urinary tract foreign bodies is mostly performed through retrograde cystoscopy, antegrade removal using interventional procedures is reported less frequently. Purpose To evaluate the safety and effectiveness of percutaneous antegrade removal of urinary tract foreign bodies. Material and Methods A total of 14 consecutive patients (age range 9–80 years) who percutaneous antegrade removal of urinary tract foreign bodies between January 2001 and March 2020 were reviewed. Detailed removal procedures and complications were reviewed retrospectively. Results Types of foreign bodies were sheared percutaneous nephrostomy (PCN) catheters (n = 5), sheared double J stents (n = 3), migrated ureteral catheters (n = 3), embolization coils (n = 2), and a 0.018-inch guide wire (n = 1). The mean and median indwelling times (range 0–306 days) of the foreign bodies were 58.3 and 1.5 days, respectively. Computed tomography (CT) scans were conducted in six patients, and the extent and nature of the foreign bodies were well-visualized on CT scans. The removal access was new PCN access (n = 8), the tract missing PCN catheter (n = 3), pre-existing PCN access (n = 2), and percutaneous dissection (n = 1). The removal success rate was 92.9% (13/14) with either a simple (n = 8) or modified (n = 4; combination of a snare and guide wire is used) snare technique or a direct forceps grasp (n = 1). The mean procedure time for successful cases was 14.2 min (range 7–25 min). Procedure-related hematoma with (n = 2) or without (n = 1) renal pelvis injury occurred in three patients, which were all self-limited within one week. Conclusion Percutaneous antegrade removal is safe and effective for urinary tract foreign bodies.

Laparoscopic Surgery for Ovarian Cyst Infection with Avoidance of Ureteral Injury and Uterine Perforation following Intrauterine Insemination after Abdominal Modified Radical Trachelectomy

Pelvic inflammatory disease (PID) sometimes develops after intrauterine insemination (IUI). We herein present a case of PID which developed after IUI performed after abdominal modified radical trachelectomy (AmRT) and was treated with laparoscopic surgery. To our knowledge, this is the first case report of laparoscopic surgery for PID that occurred after AmRT in Japan. A 39-year-old woman who was diagnosed with cervical cancer stage IA1 with lymphovascular invasion underwent AmRT and pelvic lymphadenectomy. At 3 years and 6 months after the surgery, she had fever and pain in her left lower abdomen 10 days after IUI. She was diagnosed with PID with left ovarian cyst infection and underwent laparoscopic left ovarian cystectomy. Before surgery, bilateral ureteral catheters were inserted because of possible difficulty identifying the ureters. During surgery, severe adhesion was seen in the pelvic cavity. By moving the catheters manually back and forth from outside the body, we were able to identify the ureters visually. A uterine manipulator was inserted during surgery, rather than before surgery, to avoid the risk of uterine perforation. Laparoscopic surgery with ureteral catheters and a uterine manipulator can be applied safely for such cases after AmRT even when severe intraperitoneal adhesion is present.