Urethral bougienage is a harmful intervention or vital necessity

Many patients suffering from urological diseases are prescribed a procedure such as bougienage of the urethra. However, few people imagine what it is and for what purpose it is carried out.

What is urethral dilation?

The word "bougie" comes from the French language and literally translates as "candle". These are special devices for the treatment and diagnosis of long, hollow organs. In urology, such an organ is the urethral canal. The bougie procedure is the introduction of bougie of various diameters into the urethra in order to determine the areas of narrowing and inflammation. Most often, 2-3 procedures are enough. In the case when the disease is neglected, it may take up to five sessions.

Varieties of urethral bougie

Fixtures have different diameters and differ in length. Straight and short are used for women, as their urethra is shorter. Long and curved for men. There are also tools made of metal and synthetic fibers (plastic, rubber). Synthetic bougie is preferable, as it does not unnecessarily traumatize the already damaged urethra.

It is important to know that synthetic bougie is most often used for diagnostic purposes, and metal for medicinal. There are also balloon bougie. As for the main manipulation tool, bougie has special requirements. They should be atraumatic, that is, with rounded ends, easy to sterilize. The material from which the bougie is made must be hypoallergenic and rigid enough to ensure normal passage through the canal without crushing.

Indications for the procedure

In this case, urination becomes difficult, the bladder is not completely emptied from the urethra, the reproduction of pathogenic microflora begins. As a result, cystitis begins, which is no longer so easy to cure. Therefore, the timely and competent conduct of the bougienage procedure is the most important part in preventing further diseases of the entire genitourinary system.

These can be the consequences of trauma, sexually transmitted diseases or inept medical intervention. As a method of treatment, the procedure is performed for short strictures up to 1 cm.

Preparing for urethral bougienage

Such a serious, though not complicated procedure, is never carried out blindly. In preparation, a blood test (clinical and biochemical) will be mandatory. Also, the patient undergoes urine and feces analysis

Technique for performing manipulation

Most patients, especially men, are afraid of this procedure. In order for the patient not to harm his health because of his own fear, conversations with a psychologist are held. If such conversations are ineffective, relatives are involved. 12 hours before the procedure, it is not recommended to eat, and immediately before it is not allowed to drink.

The manipulation is quite simple and does not require anesthesia. In the first stage, small and medium-sized bougie are introduced. With a weak pain threshold, local anesthesia can be used. For such cases, a team of anesthesiologists is on duty nearby. 15 minutes before the introduction of bougie, a solution of Novocaine or Lidocaine is injected into the urethra. The man is placed on the urological chair. The procedure is performed under sterile conditions. The entire operating area is treated with a disinfectant solution.

Bougies use new ones or, if they are reusable metal, sterilized ones. If metal tools are used, nothing extra is required. When the procedure is done with a synthetic bougie, water or saline is injected into it to expand the constrictions. Before administration, it is lubricated with sterile glycerin to facilitate movement along the canal. The bougie is introduced slowly until an obstacle appears. Then it is replaced by a tool of a different diameter, or this one remains, but for no more than 10 minutes. In parallel with the extraction, the urethra is washed with an antiseptic solution, most often a furacilin solution.

Diagnostic bougienage

Unlike the medical one, the diagnostic study of the urethral canal is performed once. For this, synthetic bougie is most often used. The fact that the place of localization of the stricture has been found will be evidenced by the difficulty of moving the instrument along the canal. After diagnosis, the patient is not left under medical supervision in a hospital setting.

Consequences of the procedure

With careful and correct execution of urethral bougienage, serious side effects should not be observed. But the reaction of the body can be different, so the next few days the patient is under the close supervision of the attending physician. His temperature is regularly measured, the quantity and quality of urine excreted are monitored. The general physical and mental condition is also monitored.

Such a long stay under the supervision of medical personnel is explained by the fact that there is no possibility of a single procedure. Repeated execution of the manipulation allows you to minimize the risk of organ injury. A frequent complication after the procedure is pain and discomfort in the abdomen. The most serious consequence is the development of the inflammatory process of the urinary tract, as well as blood poisoning (sepsis). Such cases are not common. As a rule, the condition will return to normal after a few days.

In order to prevent all the side effects of manipulation, immediately after its implementation, the patient is prescribed a course of broad-spectrum antibiotics, lasting 10 days.

Contraindications for urethral bougienage

There are a number of conditions in which intervention in the urethral canal is highly undesirable and even dangerous.

• The most dangerous contraindication is the development of tumor processes at the site of the manipulation. As a result of the intervention, tumor cells can spread through the blood throughout the body. Even if there are no visible injuries, the appearance of microcracks is guaranteed.
• Urethral bougienage is not performed for prostatitis, acute and chronic urethritis.
• Inflammation of the glans penis and cystitis also interfere with the procedure.
• If there were injuries of the urethra before the operation or if a complete infection is diagnosed, bougienage of the urethra is contraindicated.
• If a history of a patient with pyelonephritis and renal failure is found, the bougienage of the urethra is postponed until complete recovery.
• The patient's unwillingness to perform the manipulation may become an obstacle.

In this case, you cannot do without the help of a qualified psychologist. This procedure is extremely important for the treatment and diagnosis of many urological diseases. An experienced doctor will perform the operation safely and with minimal consequences. Therefore, you should not risk your health because of unreasonable fears.