suprapubic cystostomy

1. Intravesical surgery (such as taking bladder stones, foreign bodies), removal of pedicled bladder tumors, bladder diverticulum, and bladder injury repair. 2. Urinary retention drainage. 3. The prostate is removed by the bladder or the urethra is performed. Treatment of diseases: bladder tumor bladder stones Indication 1. Intravesical surgery (such as taking bladder stones, foreign bodies), removal of pedicled bladder tumors, bladder diverticulum, and bladder injury repair. 2. Urinary retention drainage. 3. The prostate is removed by the bladder or the urethra is performed. Preoperative preparation 1. Preoperative control of urinary tract infections. Improve systemic conditions such as bleeding, shock, water and electrolyte imbalance. 2. Shave the front abdomen, groin and genital area, wash with soapy water and warm water, and disinfect with Xinjieer. 3. Put the catheter into the bladder before surgery, rinse it, fill it with flushing saline, indwell the catheter, and clamp the end. Surgical procedure 1. Position: The supine position is slightly lower than the high position, so that the abdominal intestine is moved to the cephalad. 2. Incision: For the median incision of the pubis, length 6 ~ 10cm, the rectus abdominis and cone muscles are separated to the sides, straight to the anterior space of the bladder. 3. Expose the anterior wall of the bladder: use a gauze wrapped finger to bluntly separate the preperitoneal fat and the peritoneal reflex, revealing the anterior wall of the bladder with longitudinal blood vessels. 4. Cut the anterior wall of the bladder: on both sides of the midline of the anterior wall of the bladder, clamp with two tissue clamps, lift the bladder wall, puncture with a syringe between the two clamps, pump out the saline filling the bladder, and then cut bladder. When the bladder fistula is cut, it can be cut 1~2cm, which can be used for finger exploration. Other operations can be expanded as appropriate. The overflowed lavage fluid is exhausted with an aspirator. 5. Exploring the bladder: use your fingers to probe into the bladder to determine the condition of the lesion. If possible, remove the lesion at the same time. 6. Stitching the anterior wall of the bladder: a balloon catheter, an umbrella or a sputum catheter is placed into the bladder incision. The bladder wall is sutured in two layers. The inner layer is sutured with 2-0 chrome gut full-thickness (in the case of no gut, the muscle layer can also be sutured intermittently with silk, but not through the mucosal layer to avoid postoperative stone formation); Sutured intermittently with a 4-0 silk thread. The catheter is led through the upper corner of the abdominal wall incision. 7. Drainage and suture: The wound was washed with saline, and a cigarette was placed in the anterior space of the bladder, which was taken out from the lower corner of the abdominal wall incision. The anterior sheath of the rectus abdominis, subcutaneous tissue and skin were sutured layer by layer. When the rectus abdominis is sutured, a needle can be fixed on the top of the bladder to prevent the bladder from contracting. The catheter should be ligated with a skin suture to prevent it from coming out.

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