First experience with the Visus MG optical videoendoscopic urethral catheter for safe bladder drainage in various urethral injuries

Introduction. Despite the widespread use of bladder catheterization in both inpatient and outpatient practice, the procedure carries a risk of serious complications, including urethral trauma, strictures, and the development of false passages. According to published data, their incidence ranges from 10.2% to 17.7%. The most common causes of unsuccessful bladder catheterization are anatomical or pathological changes in the urethra, as well as insufficient experience of medical personnel. Repeated attempts at catheterization increase the risk of iatrogenic injuries. In military medicine and emergency care, the problem is aggravated by the high frequency of urethral trauma. Despite the availability of alternative imaging techniques (ultrasound, retrograde urethrography), the choice of the optimal drainage method remains unresolved, particularly in settings with limited access to advanced endoscopic equipment.

Aim. To evaluate the efficiency and safety of the Visus MG optical urethral catheter with a portable endoscopic system (PES) in various types of urethral injuries.

Materials and Methods. A prospective study was conducted at the Institute of Urology and Reproductive Health, Sechenov University, and at the S.M. Kirov Military Medical Academy. Eighty-five patients were included (60 and 25 from each institution, respectively). The efficacy and safety of bladder catheterization using the Visus MG optical urethral catheter with PES were assessed after unsuccessful attempts at standard catheterization, and in some cases without prior standard attempts. Indications included acute urinary retention, urethral trauma (combat or iatrogenic), preoperative drainage, and approximation of urethral edges before urethroplasty. The optical catheter provided visual control of urethral passage and enabled successful drainage in the presence of anatomical obstructions.

Results. Patient age ranged from 20 to 86 years (mean: 59.8). The mean prostate volume among non-prostatectomy patients was 33.7 cc, most often between 20–39 cc (42.1%). Bladder catheterization was performed primarily in the operating room (43.5%) or in procedure rooms (37.6%), most commonly under local anesthesia (61.2%). A history of prior urological procedures was documented in 70% of patients. The use of the Visus MG optical urethral catheter with PES achieved successful bladder drainage in 96.5% of cases (82/85) without complications. The main causes of failed standard catheterization were strictures, urethral trauma, and other obstructive conditions.

Conclusion. The Visus MG optical urethral catheter with a PES enabled safe and effective bladder drainage in 96.5% of patients after failed standard bladder catheterization. The method is minimally invasive, provides direct visual control, and reduces the risk of false passages and urethral injury. It may serve as an alternative to cystoscopy in settings with limited access to full endoscopic equipment.