Method of catheterization elderly female patients

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     Of: Guoxue Lan, Chen Huiping, Li Fenglan

     [Keywords:] old female patient catheterization

     As we all know, short and straight female patients urethra, easy intubation. But for some elderly elderly female patients, catheterization often encounter difficulties to find the urethra, the clitoris in the vagina before the urethra after the non-visible. I Section 2007 In May -2009 25 cases in

    January to find difficult urethral old female patient was

    analyzed and discussed to find the anterior vaginal wall from the urethra to find ways.

     A typical case

     Example 1: Female, 80 years old. Because of femoral neck fracture, cerebral thrombosis emergency hospitalization. Patients with incontinence. In order to keep beds clean and dry, to prevent bedsores, observed urine output, reserves the catheterization. When the size of the labia and then disinfect disinfect the urethra When found in the vagina before the clitoris urethra, vagina and saw a serious decline in the

    smaller vagina.

     Example 2: Female, 78 years old. Perineal laceration due to old grade ??, ?? degree of uterine prolapse and infection in hospital. Disinfection of the vulva at the time, see the clitoris, labia sizes are shrinking. Clitoris and vaginal

    opening in use between separate left and right fingers and repeatedly to find, but not the urethra. see vaginal prolapse beyond the 12cm ?? 9cm uterine body, surface erosion, necrosis, was dark purple, pale mucosa of the vestibular area.

     Example 3: Female, 75 years old. Cervix, urinary retention. Catheterization in the normal anatomical position while the same can not find the urethra.

     2 methods in

     After routine disinfection of the vulva and gloves left index finger, middle finger close together and gently inserted into the vagina of about 1.5 ~ 2cm, the mean flexion, the anterior vaginal wall tension eversion, eversion of the mucosa in the urethra can be found. Variation The urethra is generally not deep, not too deep finger into the vagina.

    catheters into the direction is not straight, but smooth flip of the anterior vaginal wall caused by the curvature slowly into the vagina can be.

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     3 Discussion

     Before the normal urethra in the vagina, clitoris, after

    about 2.5cm, the sagittal split, bulge around the papillary. Old age, the perineal muscle relaxation, resulting in retraction of the urethra. Vaginal mucosa and the muscle is composed of the pipeline. Non-elderly female vagina There are

    many stripes and folds and covered elastic fibers [2]. urethra with circular striated muscle is generally believed that after the age of 60, women's body begins to age, reaching old age. The connective tissue of the muscles tend to atrophy [3],

    pale, smooth vaginal mucosa urethra became smaller. These 3 patients were elderly women are old, they fully comply with vulvovaginal changes the physical characteristics of old age. because of muscle atrophy of connective tissue, leading to vaginal atrophy, vaginal atrophy stretch the back contraction of the urethra, only to make it into the anterior vaginal wall into. urethra so the patient can not be found in the normal anatomical position.

     [References] 1 Yu Aizhen. Based nursing. Nanjing: Jiangsu

    Science and Technology Press ,1985,144-146. 2 chauki

    branches. Based care guidance. Beijing: China TV

    Press ,1990,113-115. 3 Liu Fang. Human anatomy. Beijing: People's Medical Publishing House, 1996,416.

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