METAL AND OTHER BOUGIES
Clutton’s urethral bougie
Identification points
· It is solid metal instrument with a curve end near the tip.
· The handle is flat and shaped like a violin.
· The other end is blunt.
· The size is written on the handle.
Why is the tip of this instrument blunt?
As the tip is blunt, there is a lesser chance to injure the urethra during a normal and false passage.
USES
· The blunt tip flows easily into the urethra.
· Lubrication is used.
· The curve conforms to the normal anatomical size and shape of the male urethra near the bladder.
· The upper denomination indicates the diameter of the tip (in mm). 6/10 denotes that the tip is 6 mm in diameter and the base 10 mm.
Lister’s bougie
Identification points
· The tip is olive pointed.
· The shaft is more curved.
· The handle is round like a coin.
· The size is marked in English scale.
How to use the Lister’s bougie?
· The instrument is lubricated with sterile KY gelly and passed in urethra with the convex curbe towards the patient.
· The bougie passes with its own weight and reaches the bulbar urethra. At this point, one has to rotate through 180° and depress the bougie when the instrument follows natural curve of urethra and the tip enters the bladder.
Introducer
Identification points
· It is stiff wire instrument with a curvature like a metal bougie and has a blunt tip.
· The handle is of the shape of large elongated ring.
Uses
· This wire instrument can be introduced into the rubber urethral catheter.
· The stiffened rubber catheter can now be introduced like a bougie.
Other Bougies
Filiform bougies are fine soft malleable-gum elastic instruments that are used to treat strictures. These are passed up to the strictures.
Uses
· More than one can be passed. These bougies are graduated in French scale (charriere).
· It is usual to start with 10F, and negotiation is begun till one of them, on rotation, passes through the strictures.
· Some have a screw for large bougie.
· The filiform acts as a guide for this screw on dilator which passes.
· The advantage of this bougie is that there is less risk of trauma to the urethra.
Any questions be sent to drmmkapur@gmail.com
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