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Circle Tube Cystostomy Drainage
Vol. 118, September Printed in U.S.A.
THE JOURNAL OF UROLOGY
Copyright © 1977 by The Williams & Wilkins Co.
CIRCLE TUBE CYSTOSTOMY DRAINAGE JOHN F. REDMAN
AND
NABIL K. BISSADA
From the Department of Urology, University of Arkansas College of Medicine, Little Rock, Arkansas
ABSTRACT
An unfavorable experience with the adaptation of the circle tube for cystostomy drainage is presented. The primary disadvantage is the dissatisfaction of patients with the presence of 2 tubes emerging from the lower abdomen. The circle or U-tube has been used increasingly with success for nephrostomy during the last 20 years.1--4 The advantages of circle tube nephrostomy are the decreased frequency and ease of tube changes and the diminished chance of tube loss. Beart and associates recently reported on the use of a circle tube for transhepatic drainage of the biliary tract. 5 Because of our personal success with circle tube nephrostomy drainage we believe that this type of drainage might well be suited to cystostomy drainage for selected patients requiring long-term vesical drainage. MATERIALS AND METHODS
Five patients requiring intermediate to long-term vesical drainage underwent suprapubic cystostomy drainage via a
that the circle tube be removed and replaced with a single tube to obviate the 2 protruding limbs. One patient asked that the catheter be removed after 1 month because of persistent leakage of urine. One patient was lost to followup for 6 months and returned with a periurethral abscess. It was noted at that time that the catheter had eroded through the bladder wall anteriorly. DISCUSSION
We were unable to find a previous reported instance of the use of a circle tube for cystostomy drainage. Although theoretically there are advantages to its use, primarily to prevent the dislodgement of the tube, it was significant that most of our patients were dissatisfied with the protruding 2 limbs of the
Immediate postoperative photograph shows position of catheter limbs silicone circle tube. A midline vesical incision was made in all cases. The limbs of a No. 22F circle tube catheter were brought out lateral to the vesical incision and through the rectus abdominis muscle and fasciae (see figure). The catheters used were those commercially available for use as nephrostomy tubes.*
tube. We have had no similar complaint from patients with circle tube nephrostomy drainage. REFERENCES
Tresidder, G. C.: Nephrostomy. Brit. J. Urol., 29: 130, 1957. 2. Weyrauch, H. M. and Rous, S. N.: U-tube nephrostomy. J. Urol., 1.
97: 225, 1967. RESULTS
The circle tube catheters were tolerated well by 3 patients for a minimum of 2 months. However, all 3 patients requested Accepted for publication December 17, 1976. * Heyer-Schulte Corporation of Santa Barbara, 600 Pine Ave., Goleta, California 93017. 390
3. Lyon, E. S., Ellis, J.E., Borden, T. A., Fried, F. A., Gill, W. B. and Wong, R. J.: Favorable experience with silicone circle ureterostomy tube diversion. J. Ural., 104: 821, 1970. 4. Bissada, N. K., Cole, A. T. and Fried, F. A.: Renal diversion with silicone circle catheters. Urology, 2: 238, 1973. 5. Beart, R. W., Jr., Putnam, C. W. and Starzl, T. E.: Use of a U tube in the treatment of biliary disease. Surg., Gynec. & Obst., 142: 912, 1976.
THE JOURNAL OF UROLOGY
Copyright © 1977 by The Williams & Wilkins Co.
CIRCLE TUBE CYSTOSTOMY DRAINAGE JOHN F. REDMAN
AND
NABIL K. BISSADA
From the Department of Urology, University of Arkansas College of Medicine, Little Rock, Arkansas
ABSTRACT
An unfavorable experience with the adaptation of the circle tube for cystostomy drainage is presented. The primary disadvantage is the dissatisfaction of patients with the presence of 2 tubes emerging from the lower abdomen. The circle or U-tube has been used increasingly with success for nephrostomy during the last 20 years.1--4 The advantages of circle tube nephrostomy are the decreased frequency and ease of tube changes and the diminished chance of tube loss. Beart and associates recently reported on the use of a circle tube for transhepatic drainage of the biliary tract. 5 Because of our personal success with circle tube nephrostomy drainage we believe that this type of drainage might well be suited to cystostomy drainage for selected patients requiring long-term vesical drainage. MATERIALS AND METHODS
Five patients requiring intermediate to long-term vesical drainage underwent suprapubic cystostomy drainage via a
that the circle tube be removed and replaced with a single tube to obviate the 2 protruding limbs. One patient asked that the catheter be removed after 1 month because of persistent leakage of urine. One patient was lost to followup for 6 months and returned with a periurethral abscess. It was noted at that time that the catheter had eroded through the bladder wall anteriorly. DISCUSSION
We were unable to find a previous reported instance of the use of a circle tube for cystostomy drainage. Although theoretically there are advantages to its use, primarily to prevent the dislodgement of the tube, it was significant that most of our patients were dissatisfied with the protruding 2 limbs of the
Immediate postoperative photograph shows position of catheter limbs silicone circle tube. A midline vesical incision was made in all cases. The limbs of a No. 22F circle tube catheter were brought out lateral to the vesical incision and through the rectus abdominis muscle and fasciae (see figure). The catheters used were those commercially available for use as nephrostomy tubes.*
tube. We have had no similar complaint from patients with circle tube nephrostomy drainage. REFERENCES
Tresidder, G. C.: Nephrostomy. Brit. J. Urol., 29: 130, 1957. 2. Weyrauch, H. M. and Rous, S. N.: U-tube nephrostomy. J. Urol., 1.
97: 225, 1967. RESULTS
The circle tube catheters were tolerated well by 3 patients for a minimum of 2 months. However, all 3 patients requested Accepted for publication December 17, 1976. * Heyer-Schulte Corporation of Santa Barbara, 600 Pine Ave., Goleta, California 93017. 390
3. Lyon, E. S., Ellis, J.E., Borden, T. A., Fried, F. A., Gill, W. B. and Wong, R. J.: Favorable experience with silicone circle ureterostomy tube diversion. J. Ural., 104: 821, 1970. 4. Bissada, N. K., Cole, A. T. and Fried, F. A.: Renal diversion with silicone circle catheters. Urology, 2: 238, 1973. 5. Beart, R. W., Jr., Putnam, C. W. and Starzl, T. E.: Use of a U tube in the treatment of biliary disease. Surg., Gynec. & Obst., 142: 912, 1976.