Disturbances 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 a technique called "bougienage" has been developed for its treatment. During the procedure, a urethral dilator is used. Bougie is used not only for treatment, but also for the diagnosis of pathologies of the urinary system in men, women and children.
Let's consider the features of the procedure, what types of bougie exist, what they are for and whether there are contraindications.
What is urethral bougienage?
This is a manipulation during which the urethral canal is mechanically stretched. This method has been used for a long time, but many still do not know why a urethral dilator is needed and when the procedure is performed.
Bougienage is necessary both as a treatment and for diagnostic purposes to detect pathologies of the urethra. It is with the help of such diagnostics that it is possible to identifyAre there any painful contractions? Bougie therapy is used to ease urination and stretch the urethral canal.
Expansion is an unpleasant but tolerable procedure, and in some cases it is indispensable. 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 all ages. In a child, pathology can be congenital or acquired (as a result of improperly selected underwear, diapers, or an injury during childbirth).
The symptoms of diseases of the urethral canal are almost the same for everyone. This is a slight flow of urine, a feeling that the bladder has not completely emptied, and discomfort while using the toilet.
What tools are used
The urethra is slightly different in structure for both sexes, so different types of bougie are used. Also, the type of urethral dilator used may depend on the purpose of the manipulation.
All bougienage tools can be divided into two types: metal and synthetic. The first type is used to eliminate constrictions in the urethra, the second - to correct the narrowing or for diagnostic purposes. Also bougie may differ in shape.
There are the following types of forms:
- curved - used in case of obstruction of the urethral canal in men;
- direct - for treatment andurinary tract diagnostics in women;
- short and long - their use depends on how far the pathology is located (in women, the short one is most often used);
- with expansion and smooth walls.
There is no ideal or universal bougie. Each type has its own characteristics of use. Most urologists prefer to work with synthetic instruments because their use is not as painful, they do not injure the canal, as it can be with a metal counterpart.
When a urethral dilator is used
The bougienage method is necessary if the following symptoms are present:
- painful ejaculation;
- regular false calls to the toilet;
- poor urine flow;
- constant feeling of incomplete emptying.
Since the procedure is quite painful, it is not prescribed immediately, but after a comprehensive examination of the patient.
Also, manipulation can be carried out to detect scars, for example, after surgery. Bougienage tools 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, while 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 manipulation with the urethral dilator, special preparation is carried out. To start with diagnosticmethods, the specialist determines exactly where the part of the urethral canal, reduced in diameter, is located, then there is a study of its size, and after that the type of bougie is determined.
It is important that the patient perform all hygiene 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.
For women, bougienage is easier with a straight and short instrument pre-lubricated with Vaseline. First, a small dilator is used, then a larger one that stretches the urethra.
Bougienage in men, if the canal in the front of the organ is narrowed, is also carried out with a straight and short instrument, like in women, and is easy. But if the pathology is located somewhat deeper, then a long and curved catheter is used - a urethral dilator. In this case, manipulation is more difficult and may be painful for the patient.
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 bougienage using a urethral dilator, the sensations of which are different for each patient, the condition of the person is monitored. Manipulation can cause an increase in temperature, change the amount and even color of discharge, while urination immediately afterThe procedure can be quite painful. Also, the patient may feel discomfort in the lower abdomen.
After stretching the urethral canal, antibiotics are likely to be prescribed to prevent the development of the inflammatory process.
Contraindications
Now it's clear what urethral dilators are for. It is worth noting that bougienage in the presence of a narrowing in the urethra is not carried out by everyone. There are a number of contraindications.
The procedure is not performed in the following cases:
- benign or malignant neoplasms located in the organs of the genitourinary system;
- injury to the canal or adjacent tissues;
- inflammation period;
- cystitis;
- prostate inflammation;
- urethritis;
- phimosis or paraphimosis in men;
- kidney pathology.
Also, bougienage often has to be canceled due to the fact that the patient is not mentally ready for such a procedure. In this case, the specialist must clearly explain the importance and necessity of manipulation. If the patient's pain threshold is too low or the procedure is performed on children, then local or general anesthesia is used. When all the rules are followed, the expansion is fast and causes no side effects.
Side effects
The process of stretching and expanding the urethra is different for each person. It is noted that women undergo the procedure easily and almost painlessly. Using a 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.
The following complications occur after bougienage:
- inflammation of the organs of the reproductive system when an infection is introduced from the external environment;
- injury to the urethra;
- fever, rash and itching;
- painful erection.
On average, it will take several treatments to expand the urethra. If there is no progress after the fifth manipulation, surgery may be prescribed. It refers to drastic measures, but can also lead to side effects in the form of scars and adhesions.
Where is bougienage done and how much does it cost
After learning how a urethral dilator works and why it is used, many are wondering where bougienage is performed and how much it can cost. The procedure can be performed both in private clinics and in public medical institutions.
Free of charge (according to compulsory medical insurance) manipulations are carried out at the local clinic at the address of the patient's attachment. You may have to pay extra for improvised material for disinfection. Most patients prefer not to have bougienage done in public institutions, since cheap metal instruments are most often used there, which can injure the urethra.
In private clinics, the procedure is more comfortable, but much more expensive. For manipulation, you 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 by plastic surgery. Before making a final decision, a comprehensive diagnosis and identification of possible alternative treatments are carried out. If other therapy fails or is contraindicated, then bougienage is performed.
Conclusion
Various infections, autoimmune diseases can adversely affect the human reproductive system. Narrowing of the urethral canal is a fairly common phenomenon that can occur regardless of age. To restore the urethra, the bougienage method is used. With the help of a special dilator for the urethra, its walls are stretched.
