|LETTER TO THE EDITOR
|Year : 2022 | Volume
| Issue : 5 | Page : 826-827
A novel equipment for monitoring urine output
Chelliah Sekar, Reeti Rani Kesh, Tuhin Mistry, Vinoth Kumar Subramanian
Department of Anaesthesiology, Ganga Medical Centre and Hospitals Pvt Ltd, Coimbatore, Tamil Nadu, India
|Date of Submission||25-Apr-2021|
|Date of Decision||03-Jun-2021|
|Date of Acceptance||08-Jun-2021|
|Date of Web Publication||13-Jan-2022|
Dr. Tuhin Mistry
Department of Anaesthesiology, Ganga Medical Centre and Hospitals Pvt Ltd, Coimbatore, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Sekar C, Kesh RR, Mistry T, Subramanian VK. A novel equipment for monitoring urine output. Med J DY Patil Vidyapeeth 2022;15:826-7
An indwelling urinary catheter connected to a urine collection bag helps anesthesiologists monitor hourly urine output in the perioperative settings. An infant feeding tube (IFT) or nasogastric tube can be used as an alternative to a Foley catheter in adult patients whenever negotiation is difficult due to various reasons. The IFT may not always fit appropriately into the drainage tube of the urine collection bag (DTUCB), resulting in urine leakage or disconnection. We report the novel use of a part of the blood transfusion (BT) set as an adaptor to connect IFT to DTUCB.
A 50-year-old male patient was scheduled for L2–L5 posterior decompression and fusion under general anesthesia. Following induction, subcoronal hypospadias with the narrowed meatal opening was noted while catheterizing the patient. Hence, a 520-mm length 8 FG IFT (Feedy, Romsons Scientific and Surgical industries Pvt. Ltd., Agra, India) was inserted under aseptic precautions and adequate lubrication without causing any trauma to the urethra [Figure 1]a. A free flow of urine confirmed the position of the tip of the IFT. However, we failed to connect the IFT with a urine collection bag (Polyurimeter Plus, PolyMedicure Ltd., Faridabad, India). The connecting ends of both the tubings had almost the same diameter [Figure 1]b and [Figure 1]c. To solve this problem, we used the patient end (latex connector with Luer lock) of a BT set (Bioset, Zenith Medical Equipments, Coimbatore, India) as a connector between two tubings [Figure 1d]. The Luer lock connector of the BT set was fitted with the female Luer mount of IFT, and the latex injection port side of the BT set was inserted into the tapered end of the DTUCB [Figure 1e]. The whole assembly was fixed securely after the application of a sterile dressing. Surgery was continued for 3 h, and total urine output was 300 ml. Postoperatively, IFT was removed after 12 h, and the patient was referred to the urologist following discharge from the hospital.
|Figure 1: (a) Catheterization with infant feeding tube (IFT) in adult patient with subcoronal hypospadias, (b) size 8 FG IFT, (c) inflow part of drainage tube of the urine collection bag (DTUCB), (d) cut end of a blood transfusion (BT) set, (e) Final assembly after connecting IFT and DTUCB|
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Hypospadias is a common congenital anomaly among males that may be left untreated until adulthood due to various reasons. The presence of hypospadias can be an incidental finding while catheterizing an adult patient after anesthesia induction. Due to the narrowed meatal opening, it is impossible to catheterize using an adult Foley catheter. The length of smaller size Foley catheter is also not adequate for an adult patient. Hence, we decided to use IFT in our patient to collect urine and monitor urine output. Ekeke et al. described a method using a 2-ml syringe without the plunger as a connecting device between the IFT and DTUCB. The nostril (tip) and the open end of the sheath (barrel) of the syringe were connected to IFT and urinary bag, respectively. However, there is a possibility of disconnection due to the increasing weight of the collection bag, as mentioned by the authors. In an alternative technique, the proximal end of IFT (after removal of funnel and cap) can be inserted into the DTUCB and fixed with adhesive tapes. However, this assembly may result in urinary leakage and tube disconnection. In our described technique, the IFT is tightly secured to the urine collection bag, and all the components are readily available in sterile packaging. The intravenous infusion set with or without Luer lock can also be used in place of the BT set. This equipment can be used for adults as well as in pediatric patients for connecting IFT to DTUCB. It will be applicable with other sizes of IFT as the size of the female Luer mount is same in all IFTs, only the tubing size differs.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Senkul T, Karademir K, Işeri CN, Erden DO, Baykal K, Adayener CN. Hypospadias in adults. Urology 2002;60:1059-62.
Ekeke ON, Abdel Goad EH, Bereczky ZB. Simplifying the feeding tube connection to the draining urinary bag. Trop Doct 2004;34:228-9.