Abstract：
PURPOSE:To review current practices in manual bladder washouts (MBW) for haematuria with clot retention, comparing those conducted by a urology unit to other inpatient services. Secondly, to describe a standardised protocol for MBWs. METHODS:Prospective data were collected for patients treated for clot retention, from initial management by referral units through to implementation of a standardised MBW by the urology service. Outcomes measured included re-catheterisation, MBW volumes, clot evacuated and time to discharge or subsequent intervention. RESULTS:Initial catheters inserted by referral teams were sized 16 Fr-20 Fr, all except one requiring upsizing. Mean washout volumes of 145 ml (SD 125) and 5392 ml (SD 847) were used by referring units and the urology service, respectively. Mean volume of clot evacuated by the standardised MBW was 617 ml (SD 313). Continuous bladder irrigation (CBI) was commenced in 16 patients (66%) prior to referral to urology. Median time to discharge was 48 h. CONCLUSION:Initial catheter insertion is of inadequate size, as is the volume of washout performed. Referring services fail to clear adequate amounts of clot with washouts posing potential risks to patients. The standard management of clot retention should involve the use of at least a 22 F catheter, implement best practice infection control and adopt the last Clot + 1L rule with catheter manipulation. The key points of our recommended MBW are summarised with the acronym CATCH-22. This protocol can guide initial management of clot retention and be used as an educational tool.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Clarebrough E,McGrath S,Christidis D,Lawrentschuk Ndoi
10.1007/s00345-018-2346-zsubject
Has Abstractpub_date
2018-12-01 00:00:00pages
2043-2050issue
12eissn
0724-4983issn
1433-8726pii
10.1007/s00345-018-2346-zjournal_volume
36pub_type
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journal_title：World journal of urology
pub_type： 杂志文章
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journal_title：World journal of urology
pub_type： 历史文章,杂志文章
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journal_title：World journal of urology
pub_type： 杂志文章
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journal_title：World journal of urology
pub_type： 杂志文章
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journal_title：World journal of urology
pub_type： 杂志文章
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journal_title：World journal of urology
pub_type： 杂志文章,评审
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journal_title：World journal of urology
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journal_title：World journal of urology
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pub_type： 杂志文章
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更新日期：2015-09-01 00:00:00
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journal_title：World journal of urology
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journal_title：World journal of urology
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journal_title：World journal of urology
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pub_type： 杂志文章,随机对照试验
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pub_type： 杂志文章,评审
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更新日期：2015-02-01 00:00:00
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journal_title：World journal of urology
pub_type： 杂志文章
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pub_type： 杂志文章
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journal_title：World journal of urology
pub_type： 杂志文章,评审
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journal_title：World journal of urology
pub_type： 杂志文章
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更新日期：2008-10-01 00:00:00
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journal_title：World journal of urology
pub_type： 杂志文章
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journal_title：World journal of urology
pub_type： 杂志文章
doi：10.1007/pl00007099
更新日期：2001-08-01 00:00:00
