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Can Urol Assoc J. 2010 December; 4(6): 434.
PMCID: PMC2997842

A technique using a resectoscope sheath under direct vision and nasogastric tube for difficult catheterization following TURP

Several different techniques under direct vision have been described for the management of difficult ureteral catheterization following transurethral resection of the prostate (TURP).13 However, all of these tecniques require a specific material (mini ureteroscope or The Peel-away sheath, [Bard, Covington, GA]) which may not available. I would like to describing a simple technique, which does not require special material, to make ureteral catheterization easier following TURP.

After failing an initial attempt to place a Foley urethral catheter, I placed a resectoscope sheath under direct vision into the bladder following TURP. When the resectoscope is inside the bladder, the optical lens and obturator are retrieved from the resectoscope sheath. After that, a nasogastric (NG) tube is advanced through the resectosope sheath into the bladder. When the NG tube is inside the bladder, the distal tip of NG tube is amputated and the resectoscope sheath is withdrawn. The NG tube is fixed to the penis with a standard plaster. The procedure takes about 3 minutes. The NG tube is retrieved 1 or 2 days after the procedure.

The procedure time is minimal. Placing the resectoscope is not technically difficult to maneuver by most urologists. The risk of urethral trauma should be minimized during the procedure. This technique can be performed in any operating room to avoid suprapubic catheterization following TURP.


Competing interests: None declared.

This paper has been peer-reviewed.


1. Villanueva C, Hemstreet GP. Difficult male urethral catheterization: a review of different approaches. Int Braz J Urol. 2008:401–11. [PubMed]
2. Rozanski TA, Salazar F, Thompson IM. Direct vision bladder catheterization using a short rigid ureteroscope. Urology. 1998;51:827–8. [PubMed]
3. Lowe MA, Defalco AJ. New endourologic technique for catheter placement after TURP, prostatectomy, and difficult urethroscopy. Urology. 1992;40:461–3. [PubMed]

Articles from Canadian Urological Association Journal are provided here courtesy of Canadian Urological Association