Percutaneous bladder catheterization in microgravity.

Jeffrey A. Jones, Andrew W. Kirkpatrick, Douglas R. Hamilton, Ashot E. Sargsyan, Mark Campbell, Shannon Melton, Yael R. Barr, Scott A. Dulchavsky

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

INTRODUCTION: Urinary obstruction (UO) or failure to void has been observed during several episodes of short-duration spaceflight, necessitating bladder catheterization. It should be considered a possible medical condition in long-duration space missions as well. Antiemetics used early in space flight add to the risk and severity of voiding problems, along with the sensory and psychological peculiarities of voiding without gravity and in the unusual setting of a spacecraft. Urolithiasis due to the above-normal calcium excretion increases the risk of UO in long duration space missions. Finally, the individual risk of UO is higher against the background of preexisting conditions such as benign prostatic hyperplasia (BPH) or urethral stricture. Both acute retention and ureteral obstruction are associated with substantial patient distress, and carry a risk of urosepsis and/or acute renal failure. If UO in orbital flight is unresolved or complicated, it would likely result in crew emergency return from orbit. Exploration missions, however, may require means for definitive treatment of urinary tract obstruction. This study documents successful ultrasound-guided percutaneous catheterization of the urinary bladder in microgravity. A porcine model of urethral occlusion was used. The results demonstrate an additional capability from our previous investigations describing endoscopic catheterization and stenting of the ureters in microgravity conditions. METHODS: In an anesthetized porcine model, a Foley catheter was placed in the bladder and clamped after instillation of 200 ml of colored liquid. The bladder was visualized and then drained under ultrasound guidance through suprapubic puncture, employing a 10.3 F pigtail catheter with introducer. The procedural elements were conducted only during microgravity portions of the parabolic flight. RESULTS: Ultrasound imaging was used to successfully perform image-guided percutaneous puncture through the anterior bladder wall with the catheter, without injury to adjacent organs. The percutaneous catheter was able to successfully drain the bladder in microgravity conditions. CONCLUSIONS: Percutaneous bladder catheterization and drainage can be successfully performed in weightless conditions under ultrasound guidance. Ultrasound provides a low-power, portable means to safely conduct minimally invasive procedures in pertinent organs and tissues. Percutaneous bladder catheterization is a standard procedure when luminal bladder catheterization is not possible; this technique can be successfully modified for use in space medicine applications.

Original languageEnglish (US)
Pages (from-to)3493-3498
Number of pages6
JournalThe Canadian journal of urology
Volume14
Issue number2
StatePublished - Apr 2007
Externally publishedYes

Fingerprint

Weightlessness
Catheterization
Urinary Bladder
Catheters
Space Flight
Punctures
Swine
Spacecraft
Aerospace Medicine
Urethral Stricture
Ureteral Obstruction
Preexisting Condition Coverage
Urolithiasis
Antiemetics
Prostatic Hyperplasia
Gravitation
Orbit
Ureter
Urinary Tract
Acute Kidney Injury

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Jones, J. A., Kirkpatrick, A. W., Hamilton, D. R., Sargsyan, A. E., Campbell, M., Melton, S., ... Dulchavsky, S. A. (2007). Percutaneous bladder catheterization in microgravity. The Canadian journal of urology, 14(2), 3493-3498.

Percutaneous bladder catheterization in microgravity. / Jones, Jeffrey A.; Kirkpatrick, Andrew W.; Hamilton, Douglas R.; Sargsyan, Ashot E.; Campbell, Mark; Melton, Shannon; Barr, Yael R.; Dulchavsky, Scott A.

In: The Canadian journal of urology, Vol. 14, No. 2, 04.2007, p. 3493-3498.

Research output: Contribution to journalArticle

Jones, JA, Kirkpatrick, AW, Hamilton, DR, Sargsyan, AE, Campbell, M, Melton, S, Barr, YR & Dulchavsky, SA 2007, 'Percutaneous bladder catheterization in microgravity.', The Canadian journal of urology, vol. 14, no. 2, pp. 3493-3498.
Jones JA, Kirkpatrick AW, Hamilton DR, Sargsyan AE, Campbell M, Melton S et al. Percutaneous bladder catheterization in microgravity. The Canadian journal of urology. 2007 Apr;14(2):3493-3498.
Jones, Jeffrey A. ; Kirkpatrick, Andrew W. ; Hamilton, Douglas R. ; Sargsyan, Ashot E. ; Campbell, Mark ; Melton, Shannon ; Barr, Yael R. ; Dulchavsky, Scott A. / Percutaneous bladder catheterization in microgravity. In: The Canadian journal of urology. 2007 ; Vol. 14, No. 2. pp. 3493-3498.
@article{d17f1b85d587499da544563db4be7c5b,
title = "Percutaneous bladder catheterization in microgravity.",
abstract = "INTRODUCTION: Urinary obstruction (UO) or failure to void has been observed during several episodes of short-duration spaceflight, necessitating bladder catheterization. It should be considered a possible medical condition in long-duration space missions as well. Antiemetics used early in space flight add to the risk and severity of voiding problems, along with the sensory and psychological peculiarities of voiding without gravity and in the unusual setting of a spacecraft. Urolithiasis due to the above-normal calcium excretion increases the risk of UO in long duration space missions. Finally, the individual risk of UO is higher against the background of preexisting conditions such as benign prostatic hyperplasia (BPH) or urethral stricture. Both acute retention and ureteral obstruction are associated with substantial patient distress, and carry a risk of urosepsis and/or acute renal failure. If UO in orbital flight is unresolved or complicated, it would likely result in crew emergency return from orbit. Exploration missions, however, may require means for definitive treatment of urinary tract obstruction. This study documents successful ultrasound-guided percutaneous catheterization of the urinary bladder in microgravity. A porcine model of urethral occlusion was used. The results demonstrate an additional capability from our previous investigations describing endoscopic catheterization and stenting of the ureters in microgravity conditions. METHODS: In an anesthetized porcine model, a Foley catheter was placed in the bladder and clamped after instillation of 200 ml of colored liquid. The bladder was visualized and then drained under ultrasound guidance through suprapubic puncture, employing a 10.3 F pigtail catheter with introducer. The procedural elements were conducted only during microgravity portions of the parabolic flight. RESULTS: Ultrasound imaging was used to successfully perform image-guided percutaneous puncture through the anterior bladder wall with the catheter, without injury to adjacent organs. The percutaneous catheter was able to successfully drain the bladder in microgravity conditions. CONCLUSIONS: Percutaneous bladder catheterization and drainage can be successfully performed in weightless conditions under ultrasound guidance. Ultrasound provides a low-power, portable means to safely conduct minimally invasive procedures in pertinent organs and tissues. Percutaneous bladder catheterization is a standard procedure when luminal bladder catheterization is not possible; this technique can be successfully modified for use in space medicine applications.",
author = "Jones, {Jeffrey A.} and Kirkpatrick, {Andrew W.} and Hamilton, {Douglas R.} and Sargsyan, {Ashot E.} and Mark Campbell and Shannon Melton and Barr, {Yael R.} and Dulchavsky, {Scott A.}",
year = "2007",
month = "4",
language = "English (US)",
volume = "14",
pages = "3493--3498",
journal = "Canadian Journal of Urology",
issn = "1195-9479",
publisher = "Canadian Journal of Urology",
number = "2",

}

TY - JOUR

T1 - Percutaneous bladder catheterization in microgravity.

AU - Jones, Jeffrey A.

AU - Kirkpatrick, Andrew W.

AU - Hamilton, Douglas R.

AU - Sargsyan, Ashot E.

AU - Campbell, Mark

AU - Melton, Shannon

AU - Barr, Yael R.

AU - Dulchavsky, Scott A.

PY - 2007/4

Y1 - 2007/4

N2 - INTRODUCTION: Urinary obstruction (UO) or failure to void has been observed during several episodes of short-duration spaceflight, necessitating bladder catheterization. It should be considered a possible medical condition in long-duration space missions as well. Antiemetics used early in space flight add to the risk and severity of voiding problems, along with the sensory and psychological peculiarities of voiding without gravity and in the unusual setting of a spacecraft. Urolithiasis due to the above-normal calcium excretion increases the risk of UO in long duration space missions. Finally, the individual risk of UO is higher against the background of preexisting conditions such as benign prostatic hyperplasia (BPH) or urethral stricture. Both acute retention and ureteral obstruction are associated with substantial patient distress, and carry a risk of urosepsis and/or acute renal failure. If UO in orbital flight is unresolved or complicated, it would likely result in crew emergency return from orbit. Exploration missions, however, may require means for definitive treatment of urinary tract obstruction. This study documents successful ultrasound-guided percutaneous catheterization of the urinary bladder in microgravity. A porcine model of urethral occlusion was used. The results demonstrate an additional capability from our previous investigations describing endoscopic catheterization and stenting of the ureters in microgravity conditions. METHODS: In an anesthetized porcine model, a Foley catheter was placed in the bladder and clamped after instillation of 200 ml of colored liquid. The bladder was visualized and then drained under ultrasound guidance through suprapubic puncture, employing a 10.3 F pigtail catheter with introducer. The procedural elements were conducted only during microgravity portions of the parabolic flight. RESULTS: Ultrasound imaging was used to successfully perform image-guided percutaneous puncture through the anterior bladder wall with the catheter, without injury to adjacent organs. The percutaneous catheter was able to successfully drain the bladder in microgravity conditions. CONCLUSIONS: Percutaneous bladder catheterization and drainage can be successfully performed in weightless conditions under ultrasound guidance. Ultrasound provides a low-power, portable means to safely conduct minimally invasive procedures in pertinent organs and tissues. Percutaneous bladder catheterization is a standard procedure when luminal bladder catheterization is not possible; this technique can be successfully modified for use in space medicine applications.

AB - INTRODUCTION: Urinary obstruction (UO) or failure to void has been observed during several episodes of short-duration spaceflight, necessitating bladder catheterization. It should be considered a possible medical condition in long-duration space missions as well. Antiemetics used early in space flight add to the risk and severity of voiding problems, along with the sensory and psychological peculiarities of voiding without gravity and in the unusual setting of a spacecraft. Urolithiasis due to the above-normal calcium excretion increases the risk of UO in long duration space missions. Finally, the individual risk of UO is higher against the background of preexisting conditions such as benign prostatic hyperplasia (BPH) or urethral stricture. Both acute retention and ureteral obstruction are associated with substantial patient distress, and carry a risk of urosepsis and/or acute renal failure. If UO in orbital flight is unresolved or complicated, it would likely result in crew emergency return from orbit. Exploration missions, however, may require means for definitive treatment of urinary tract obstruction. This study documents successful ultrasound-guided percutaneous catheterization of the urinary bladder in microgravity. A porcine model of urethral occlusion was used. The results demonstrate an additional capability from our previous investigations describing endoscopic catheterization and stenting of the ureters in microgravity conditions. METHODS: In an anesthetized porcine model, a Foley catheter was placed in the bladder and clamped after instillation of 200 ml of colored liquid. The bladder was visualized and then drained under ultrasound guidance through suprapubic puncture, employing a 10.3 F pigtail catheter with introducer. The procedural elements were conducted only during microgravity portions of the parabolic flight. RESULTS: Ultrasound imaging was used to successfully perform image-guided percutaneous puncture through the anterior bladder wall with the catheter, without injury to adjacent organs. The percutaneous catheter was able to successfully drain the bladder in microgravity conditions. CONCLUSIONS: Percutaneous bladder catheterization and drainage can be successfully performed in weightless conditions under ultrasound guidance. Ultrasound provides a low-power, portable means to safely conduct minimally invasive procedures in pertinent organs and tissues. Percutaneous bladder catheterization is a standard procedure when luminal bladder catheterization is not possible; this technique can be successfully modified for use in space medicine applications.

UR - http://www.scopus.com/inward/record.url?scp=34347250913&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34347250913&partnerID=8YFLogxK

M3 - Article

C2 - 17466154

AN - SCOPUS:34347250913

VL - 14

SP - 3493

EP - 3498

JO - Canadian Journal of Urology

JF - Canadian Journal of Urology

SN - 1195-9479

IS - 2

ER -