Female

Before starting

The patient should empty the bladder completely
Residual urine should be checked prior to the first instillation

UroDapter should be mounted on a Luer-Lock or Luer-Slip syringe
The device is ready for use

The urethral orifice should be disinfected

Go to Instuctions

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Inserting the UroDapter

Insert the UroDapter into the urethral orifice and gently position the orifice under the symphysis toward the rectum. To achieve this, push downwards the labiae with your exploring fingers.

Spooning

Gently drive the Luer-Lock or Luer-Slip syringe with a “spooning” motion under the symphysis in all cases. This is crucial, as it allows for the liquid to flow from the syringe through the urethra.

Angle adjustment

After the "spooning" motion, adjust the angle of the Luer-Lock or Luer-Slip syringe so that it is parallel with the urethra. The optimal angle will cause the least resistance while pressing the plunger of the syringe. The proper angle might be depending on the pelvic anatomy, which usually relates to the patients’ age.

Relaxation of pelvic muscles

It is important to ask the patient to relax her pelvic muscles. The urethral sphincter should be relaxed to let the solution easily flow into the bladder.

Sealing

Make sure that the UroDapter has entered the orifice properly and the sealing collar covers the nearby tissues tightly. If not, leakage can occur.

Instillation speed

Begin slowly instilling the liquid and adjust the angle as needed: At the optimal angle you will feel the least resistance while pressing the plunger of the syringe. Perform the instillation at low speed.

Opening of the sphincter

During proper instillation the instilled solution will increase the intraurethral pressure above the sphincter pressure and will completely open the already relaxed sphincter, allowing the solution to easily flow into the bladder.

Sphincter contraction

Slow down or pause the instillation if the sphincter is constricted. Instruct the patient to take a few deep breaths, and relax her pelvic muscles and sphincter. Resume when the patient relaxed her sphincter.

Leakage during instillation

If there is any leakage during the instillation, it can have different causes, like insufficient coverage of the sealing collar, too little or too much pressure on the Luer-Lock or Luer-Slip syringe.

Leakage after instillation

Some minimal leakage may occur after instillation. Usually, it is insignificant, only a few drops.

Retention of solution

The patient should retain the instilled solution in the bladder for the time recommended by the therapist, but no more than 3 hours.

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Female Instructions

1 - Inserting the UroDapter 2 - Spooning 3 - Angle adjustment 4 - Relaxation of pelvic muscles 5 - Sealing 6 - Instillation speed 7 - Opening of the sphincter 8 - Sphincter contraction 9 - Leakage during instillation 10 - Leakage after instillation 11 - Retention of solution

The process of disinfection

Expose the urethral orifice by parting the labia minora and wipe the urethral orifice area with disinfectant.

Emptying the bladder

Most patients do not have significant residual urine in their bladder after urination. However, since the UroDapter is not suitable to drain urine from the bladder, post-void residual urine should be checked prior to the first instillation (e.g., with ultrasound).

In patients without significant post-void residual urine, drainage of urine prior to intravesical instillations is not necessary. Patients should be asked to go to the restroom and empty their bladder before instillations. The minimal amount of urine still in the bladder after urination will not cause any significant dilution of the instilled solution.

In the minority of patients with a significant post-void residual urine intravesical instillations should be performed using a standard catheter.