Complicated cases
When the canal closes, the passage is bouged along a conductor under ultrasound control or through a cystoscope inserted through the urethra - this avoids repeated puncture. If stones have formed on the drainage, they are crushed with a laser through the cystostomy canal or urethra, the bladder cavity is inspected and washed. A new drain with a larger diameter is installed. If there are signs of infection, a culture is taken and antibiotics are prescribed. Such a replacement is also indicated for patients whose planned replacements have repeatedly been accompanied by injury and bleeding.
Why and when to change
Cystostomy drainage becomes encrusted with salts, becomes clogged and becomes a source of infection, so it is changed regularly every 4–8 weeks (silicone - less often, latex - more often), and unscheduled - if it becomes clogged, urine leaks past the tube, or falls out. The first replacement is 4 weeks after installation, when the canal is formed.
If the drain falls out
The fistula tract narrows after just a few hours, so if the tube falls out, you need to go to the clinic on the same day: the canal can still be passed through with a catheter or expanded with bougies. A day later, a repeat puncture cystostomy may be required.
