Inexpensive method of measuring prostatic length by graduated catheter and retrograde urethrography

SURGEON’S WOHKSHUY

INEXPENSIVE METHOD

OF MEASURING PROSTATIC

LENGTH BY GRADUATED RETROGRADE MASARU MORITA, MASAKI OKAMOTO,

CATHETER AND

URETHROGRAPHY M.D. M.D.

KENJI

OCHI,

MASAFUMI

M.D.

TAKEUCHI,

M.D.

From the Department of Urology, Ehime University School of Medicine, Shigenobu, Ehime, Japan

Although one can roughly estimate the weight of a prostatic adenoma on a urethrogram preoperatively, it is difficult to measure accurately the prostatic urethral length because it is usually scaled up on an x-ray film. Weights of prostatic adenoma have been estimated based on prostatic profile length in urethral pressure profilometry. We have devised a catheter with which one can measure the prostatic urethral length and estimate the weight of prostatic adenoma (Fig. 1). This catheter consists of a loF Atom suction tube with radiopaque marks 1 cm apart and a 22-F silicone catheter. A 3-F ureteral catheter with markers replaced by metal clips is passed through the 10-F Atom suction tube. The Atom suction tube with the ureteral catheter inside is inserted into bladder. The distal end of the Atom suction tube is threaded through the eyelet of the 22-F Foley catheter. The Foley balloon is positioned in the fossa navicularis and inflated. The patient is placed in the right oblique position, and the radiopaque marks are positioned under fluoroscopit control in the posterior urethra. The bladder is emptied and about 100 ml of saline with 5-10 ml of contrast material (60% Urografin) are instilled into the bladder through the Atom suction tube to delineate the vesical neck. Contrast media are injected through the Foley catheter under fluoroscopic control, and a suitable spot film is obtained. Figure 2 shows a urethrogram using this catheter. The prostatic urethral length is about5 cm in this film; the prostatic profile length in the urethral pressure profilometry was about 6 cm. We consider that the prostatic length measured by this catheter and the prostatic profile length obtained by profilometry is almost

UROLOGY i

APRIL 1984 /

VOLUME

XXIII, NUMBER 4

FIGURE2. Arrows indicate: (1) bladder neck, (2) verumontanum, (3) membranous urethra, and (4) opacified prostatic ducts.

the same. One therefore does not need an expensive urodynamic instrument to measure the prostatic urethral length for the purpose of estimating the weight of a prostatic adenoma. Shigenobu,

Ehime, Japan (DR. MORITA)

387