PN.6.
Instruirea studenților
în montarea cateterului suprapubic
- util sau nu?
C. Toma, C. Nechita, C. Sima, M. Dumitrache,
D. Radavoi, D. Badescu, V. Jinga
Universitatea de Medicina si Farmacie
“Carol Davila”,Bucuresti, Romania
Spitalul Clinic “ Prof.Dr. Theodor Burghele”,
Bucuresti, Romania
Introducere: Cistostomia se realizeaza pentru a elibera re-
tentia de urina atunci cand sondajul uretrovezical nu se poate
realize sau este contraindicat. Cateterul suprapubic nu este
de putine ori montat in camera de garda si de catre person-
al cu putina experienta – aspect care pot duce la complicatii
semnificative si ireversibile. Folosind simulatoare medicale de
tip task-trainer pentru a instrui studentii medicinisti in intele-
gerea si realizarea acestei procedure poate duce la rezultate
mai bune pentru pacient si pentru sistemul medical.
Materiale si metode: 93 studenti medicinisti de an 5 au fost
instruiti sa monteze cateterul suprapubic pe parcursul modu-
lului de urologie in cadrul departamentului nostrum. Studen-
tii au fost impartiti in grupe de 12-14 crusanti, li s-a prezentat
un material video demonstrative si s-au discutat indicatiile,
contraindicatiile si procedura pas cu pas impreuna cu lec-
torul. Dupa realizarea acestor pasi fiecare student a realizat
montarea unei cistostomii sub supraveghe pe un simulator,
iar fiecare student a jucat rolul asistentului, dar si de instruc-
tor corectandu-se reciproc. Ultimii cursanti au realizat corect
procedura. Studentii s-au autoevaluare inainte si dupa ate-
lierul practice, au raspuns si la o intrebare teoretica cu scopul
de a obiectiva intelegerea notiunilor invatate.
Rezultate: 92,5% ar monta cateterul suprapubic la pacientii
cu retentie de urina unde nu s-a putut monta sonda uretro-
vezicala sau montarea acesteia este contraindicata, iar doar
4,3% au raspuns gresit sustinand ca ar monta acest dispozitiv
la 10 cm superior de simfiza pubiana si doar 3,2% ar prior-
itize antisepsia penisului sau vaginului inainte de orice pas.
Niciunul dintre cursanti nu ar folosi manusi de examinare
pentru aceasta procedura. Autoevaluarea subiectiva sustine
ca studentii si-au imbunatit nivelul de incredere, cunostintele
teoretice si practice, dar nu la fel de mult ca in alte proceduri
predate precum sondajul uretrovezical sau tuseul rectal.
Concluzie: Cateterul suprapubic ar trebui sa fie predate stu-
dentilor medicinisti din ani terminali, iar simulatoarele med-
icale de tip tasktrainer cu ajutorul unui instructor sunt intr-
sumentele potrivite pentru a ii face sa inteleaga principiile,
indicatiile, contraindicatiile si pasii procedurii.
nr. 2 / 2018 • vol 17 Romanian Journal of Urology
Teaching students
Postere nemoderate
to place suprapubic cystostomy -
useful or not?
C. Toma, C. Nechita, C. Sima, M. Dumitrache,
D. Radavoi, D. Badescu, V. Jinga
University of Medicine and Pharmacy
“Carol Davila”, Bucharest, Romania,
“Prof.Dr.Theodor Burghele” Clinical Hospital,
Bucharest, Romania
Introduction: Suprapubic cistostomy is performed to relieve
urinary retention when the placement of urethral catheter is
unsuccessful or contraindicated. The suprapubic catheter is
not rarely placed in the ward and by unexperienced personal
which can lead to serious irreversible complications. Using
medical simulator task trainer to teach medical students to
understand and do this procedure can lead to better out-
come for the patient and for the medical system.
Materials and methods: 93 5th year medical students were
trained to place suprapubic cystostomy during the urology
module from our department. All the students were divided
in groups of 12 to 14 participants, they were showed one vid-
eo demonstration and then they discussed the indications,
contraindications and the step-by-step procedure with the
lecturer. After these steps they perfomed the procedure one
by one under supervision and they assited each other acting
as nurse and/or supervisor correcting and mastering the pro-
cedure by the end of the last student. They evaluated them-
selves at the beginning and ending of the workshop, they
answered 1 question to assess if they understood the main
principles of suprapubic catheterization.
Results: 92,5% understood that suprapubic catheter should
be placed at patients with urinary retention where urethral
catheter failed to give access or urethral catether is contrain-
dicated, 4,3% gave one wrong answer stating that it should
be placed 10cm superior to the pubic symphysis, 3,2%
sustained that the vagina and penis should be vigorously
cleaned before this procedure- wrong answer. None of them
would use non-sterile gloves to do this procedure meaning
that they understood that it is a sterile intervention. The sub-
jective answers showed that they improved their confidence,
theoretical and practical knowledge about these procedure,
but not as much as other procedures taught in our depart-
ment such as urethral catheter or digital rectal exam.
Conclusion: Suprapubic catheterization should be taught to
medical students in their final years and medical simulators
such as tasktrainer with the help of an instructor are good
instruments to make them understand the concept, indica-
tions, contraindications and steps of the intervention.
67