Violations in the structure of the urethra occur due to the influence of negative factors (infections, diseases, stress and hypothermia). Most often, the channel narrows, and for its treatment, a technique called "bougieurage" has been developed. The urethral dilator is used during the procedure. Buzh is used not only for treatment, but also for the diagnosis of pathologies of the urinary system in men, women and children.
Consider the features of the procedure, what types of bougie exist, why they are needed and whether there are contraindications.
What is urethral bougienage?
This is a manipulation during which mechanical stretching of the urethral canal occurs. This method has been used for a long time, but many still do not know why the urethral dilator is needed and when the procedure is performed.
Bougienage is necessary both as a treatment and for diagnostic purposes to identify pathologies of the urethra. It is with the help of such a diagnosis that it is possible to identify whether there are painful constrictions. Bougie therapy is used to facilitate urination and to stretch the urethral canal.
Expansion is an unpleasant, but quite tolerable procedure, and in some cases you can not do without it. The main indication for manipulation is a sharp narrowing of the urethral canal. It can be triggered by trauma, infection or surgery in men, women and children of different ages. In a child, the pathology can be congenital or acquired (as a result of improperly selected linen, diapers, or trauma during childbirth).
Symptoms of diseases of the urethral canal are almost the same for all. This is a small pressure of urine, a feeling that the bladder is not completely empty, and discomfort when visiting the toilet.
What tools are used
The urethra in structure of representatives of both sexes is slightly different, therefore, different types of bougie are used. The type of urethral dilator used may also depend on the purpose of the manipulation.
All tools for bougieurage can be divided into two types: metal and synthetic. The first type is used to eliminate constrictions in the urethra, the second - to correct narrowing or for diagnostic purposes. Also, bougie may vary in shape.
The following varieties of forms are found:
- curved - used in case of obstruction of the urethral canal in men;
- direct - for the treatment and diagnosis of urinary tract infections in women;
- short and long - their use depends on how far the pathology is located (in women, short is most often used);
- with expansion and smooth walls.
There is no ideal or universal bougie. Each species has its own characteristics of use. Most urologists prefer to work with synthetic instruments, since their use is not so painful, they do not injure the canal, as it can be when using a metal counterpart.
When a urethral dilator is used
The method of bougieuding is necessary in the presence of the following symptoms:
- painful ejaculation;
- regular false urge to the toilet;
- weak urine pressure;
- constant feeling of incomplete emptying.
Since the procedure is rather painful, it is not prescribed immediately, but after a comprehensive examination of the patient.
Also, manipulation can be performed to detect scars, for example, after surgery. Tools for bougieurage differ not only depending on the pathology, but also on who will undergo the procedure. The urethral dilator for women, as already mentioned, is short and straight, and for men, it is long and curved. It depends on the anatomical features of both sexes.
Features of the procedure for men and women
Before manipulating the urethral dilator, special training is performed. To begin with, the diagnostic methods determine where exactly the part of the urethral canal that is reduced in diameter is located, then the size of the urethral canal is examined, and after that the type of bougie is determined.
It is important that the patient undergoes all hygienic procedures before the procedure, as well as disinfection of the external genital organs - this way bacteria from the external environment will not enter the body.
In women, bougieurage is easier with a straight and short instrument pre-lubricated with petroleum jelly. First, a small diameter dilator is found, then a larger one, which stretches the urethra.
Probing in men, if the channel in the front of the organ is narrowed, is also carried out with a direct and short instrument, as in women, and it happens easily. But if the pathology is located a little deeper, then a long and curved catheter is used - the urethral dilator. In this case, the manipulation is more complex and can be painful for the patient.
The treatment is carried out over several days, since it is impossible to expand the urethra in one session. The number of procedures depends on the individual characteristics of each person. The interval between sessions is 12 hours or a day.
How is the recovery period?
After bougieurage using a urethral dilator, the sensations of which are different for each patient, the state of the person is monitored. Manipulation can cause an increase in temperature, change the amount and even the color of the discharge, while urinating immediately after the procedure can be quite painful. Also, the patient may feel discomfort in the lower abdomen.
After stretching the urethral canal, antibiotics are probably prescribed to prevent the development of the inflammatory process.
Contraindications
Now it’s clear why urethral dilators are needed. It is worth noting that not everyone performs a bowel movement in the presence of a narrowing in the urethra. There are a number of contraindications.
The procedure is not carried out in the following cases:
- benign or malignant neoplasms located in the organs of the genitourinary system;
- trauma to the canal or adjacent tissues;
- period of inflammation;
- cystitis;
- inflammation of the prostate gland;
- urethritis;
- phimosis or paraphimosis in men;
- pathology of the kidneys.
Also, bougienage often has to be canceled due to the fact that the patient is not mentally prepared for such a procedure. In this case, the specialist should clearly explain the importance and necessity of manipulation. If the patient's pain threshold is too low or the procedure is performed in children, then local or general anesthesia is used. When all the rules are followed, the expansion occurs quickly and does not cause side effects.
Side effects
The process of stretching and expansion of the urethra occurs in each person in different ways. It is noted that women undergo the procedure easily and almost painlessly. Using the male urethral dilator is a very painful procedure. In addition, a number of side effects and complications after manipulation may occur. Most often, they appear due to the fact that the preparation or the procedure itself was carried out incorrectly.
After bougieurage, the following complications occur:
- inflammation of the organs of the reproductive system during infection from the external environment;
- urethra injury
- fever, rash, and itching;
- pain during erection.
On average, several procedures are required to expand the urethra. If there is no progress after the fifth manipulation, surgery may be prescribed. It refers to radical measures, but can also lead to side effects in the form of scars and adhesions.
Where do bougienage do and how much does it cost
Having familiarized themselves with how the urethral dilator works and why it is used, many are wondering where it is done and how much it can cost. The procedure can be performed both in private clinics and in public medical institutions.
Free of charge (by compulsory medical insurance), manipulations are performed at the local clinic at the patient's attachment address. You may have to pay extra for improvised material for disinfection. Most patients prefer not to walk in public institutions, since they often use cheap metal tools that can injure the urethra.
In private clinics, the procedure is more comfortable, but much more expensive. For the manipulation will have to pay from 1200 to 7000 rubles. The price of the procedure is affected not only by the reputation of the clinic, but also by the nature of the bougienage and the location of the affected area.
Progressive medical centers practically do not use this technique, since the recurrence of stenosis after the procedure is too high - it is replaced with plastic surgery. Before making the final decision, a comprehensive diagnosis and determination of possible alternative treatment methods is carried out. If other therapy fails or is contraindicated, then bougieurage is performed.
Conclusion
Various infections, autoimmune diseases can adversely affect the human reproductive system. The narrowing of the urethral canal is a fairly common phenomenon that can occur regardless of age. To restore the urethra, the bougie method is used. Using a special dilator for the urethra, its walls are stretched.