Mechanical suction: an effective and safe method to remove large and tenacious clots from the urinary bladder

Area of Science:

• Urology
• Surgical Techniques
• Medical Devices

Background:

• Bladder clot retention poses a significant clinical challenge.
• Traditional clot evacuation methods, such as the Ellik evacuator, may be ineffective for tenacious or chronic clots.

Purpose of the Study:

• To describe an alternative technique for removing tenacious and chronic bladder clots.
• To evaluate the efficacy and safety of applying stronger suction pressure directly through the cystoscope sheath.

Main Methods:

• A technique involving direct attachment of a 25-F cystoscope sheath or 26-F resectoscope sheath to a centralized suction source was employed.
• Moderate negative pressure (up to 250 mm Hg) was applied for clot evacuation.

Main Results:

• The technique was successfully applied to 15 adult patients with clot retention, with an average duration of 36.5 hours.
• Complete clot clearance was achieved in all patients within an average operative time of 88 minutes.
• No significant complications were observed, aside from minor hemorrhagic spots on the bladder mucosa.

Conclusions:

• Moderate suction pressure applied directly through the cystoscope sheath is an effective and safe method for evacuating old, large, and tenacious bladder clots.
• This technique provides a viable alternative for patients who have failed traditional clot evacuation methods.