Freaky female anatomy - page 2
I'm starting to get a complex. In recent cath attempts, I keep running into patients who have stuff prolapsed, holes in strange places, and generally not at all textbook anatomy. I confirm with a... Read More
Sep 23, '02Good luck! Being in OB/GYN nursing these 5 years, I have found each person is indeed unique. I even found a uretral meatus once INSIDE a lady's vaginal introitus! YEP! It happens. I learn something new each time I take care of a patient; her anatomy is always different than the one before her. And cathing patients like this is sometimes a supreme challenge!
Sep 23, '02What about when you can't find the penis (is "hiding inside") That makes things interesting.
By the way, I'm talining about wayy elderly men. Once, I had to, like push on an old guy's perenium so that his penis and scrotum would come out (had retracted internally, I guess). Not easy to "get a grip" in order to insert cath, as you would imagine.Last edit by adrienurse on Sep 23, '02
Sep 23, '02I had a woman with one hole. I cathed it and discovered that that was her vagina. I left that one in, got another one and aimed above the first one. After I got in her bladder I took the one out of her vagina. I had a male patient who was so blocked that the catheter folded and came back out. I felt something bumping my hand when I was advancing the catheter. I looked and it was the tip.
Sep 23, '02I've had to cath several women who's urethra was up in their vagina. That doesn't seem to be very uncommon.
We have techs who cath patients and the look on one's face was priceless when she came out of the male patient's room saying she couldn't find any opening. Sure enough, hypospadius. She had never encountered it before and was amazed. I still smile thinking of the look on her face. heheheheeh
Back before DRG's, when a Dr. could just send a patient to the hospital to be admitted to the floor before they had even seen the patient..... I had a woman admitted because she coulnd't pee. Abd was distended and you could feel the bladder.... Got the cath kit out... looked at the perineum... totally flat! No labia majoria or minora! Called for a second nurse to glove up and to push up on the parinium. Sure enough anatomy fell into place. The woman had a prolapsed bladder resting on her perinum floor and it was full.... waaaaaaaaaayyyyyy full !!! I'm surprised she hadn't ruptured her bladder. I got something like 2500 cc of urine out of her bladder in clamping stages.
Called the Dr. told him what had happened. He never came into see the patient but just said to transfer her to the gyne floor and he would contact someone there to see her for repair work.
aaahhhh, there are times when I really do like DRG's.
I get called down to radiology a lot as well. Kids in for VCUG's. I've definitely run into some unusual anatomy there.
Sep 23, '02Since we're talking about caths, what is the easiest and most painless way to get a cath in a male? In the past I found it difficult getting past the prostate. Ideas? Outside of a coude'?
Sep 23, '02Katana, your story reminds me of a direct admit we had on my floor. Guy came from assisted living, had a slight case of senile dementia, admitted with a diagnosis of ARF/UTI. His belly was firm, distended, but no c/o of pain when I pressed it. He was pretty drowsy, and slept through most of the following.
Went to cath him and found he'd been a little incontinent in his Poise pad. Cathed him with little difficulty, other than accidentally getting a bit of lube on my fingers and thereby making the cath slippery. Got an immediate return of 1000 cc's.
Through the course of the shift, clamping/unclamping foley, the guy ended up having 6800 cc's of urine in his bladder. Not a typo - almost 7 liters. The urology guys rounded that morning and could barely believe it. I wouldn't either had I not witnessed it.
Best part of all, when I drained the last 800cc's out of the bag (nasty, purulent-looking urine), he let out a long satisfied "Ahhhhhhh.....". :chuckle
Sep 24, '02Watched a childbirth show on t.v. not long ago. One girl had a baby by c-section. The girl giving birth had two complete and seperate sets of reproductive organs. She was carrying a preg. in one uterus and still having a period from the other uterus every month.
Sep 24, '02audreyfay,
we had an inservice last year by one of the urologists. here's our hosp policy.
1. NEVER pre-test the balloon. (They're seldom faulty and it can cause small deformities which make insertion more diff.)
2. use about 1/2 to 2/3 of syringe of lubricant on the cath, insert remainder into the urethra of the male pt. (burns a little, but makes it slide in much more easily. )
3. If having diff getting by the prostate, angle peniis up toward pt.s head.
4. ALWAYS insert cath completely before inflating balloon. (we've had several pt.s in past couple of years who have came in with bulb inflated in urethra)
#2 is the key in my opinion. ive never had a prob, since i started injecting lube straight into the urethra, and i believe it makes catheritiazion (sp?) much less painful for us guys.
hope i helped
Sep 26, '02I had two ladies with their urethra in the vagina..........was impossible to be sterile and clean the inside of the vagina..........LOL was an experience............
Seen men with the problem of having hypospadius.........not sure if I am it right.
Sep 26, '02Lidocaine gel can be instilled into the urethra of males to make catheterization less uncomfortable. I do it tall the time and the patients are very appreciative.
Sep 26, '02i had to cath a 6 month old FTT baby girl for a urine cx.....using a 8 fr. ...omg were those holes little.......