Male

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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Relaxation of pelvic muscles and sphincter

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

UroDapter insertion

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

Instillation speed

Begin slowly instilling the liquid. 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 his pelvic muscles and sphincter. Resume when the patient relaxed his sphincter.

Two-step process for male patients

Due to the long male urethra, a significant portion of the instilled solution remains in the urethra, which would be lost after removing the UroDapter. To avoid this and to deliver the whole amount of drug solution in the bladder, the two-step process should be followed in each male patient.

Instillation of the solution

After complete instillation of the solution, compress the urethra below the orifice with two fingers of your other hand and remove the Luer-Lock or Luer-Slip syringe with the UroDapter from the orifice.

Filling a Luer-Lock or Luer-Slip syringe with air

While keeping the compression of the urethra, fill up the Luer-Lock or Luer-Slip syringe with 20ml air.

Sealing

Re-insert the Luer-Lock or Luer-Slip syringe with the UroDapter into the still compressed orifice and ensure its complete sealing by the isolating collar.

Instillation of air

Release the urethral compression and push the air slowly into the urethra. The instilled air is capable and will push the remaining liquid into the bladder.

Air enters the bladder

As soon as the air reaches the bladder, the patient will report on an unfamiliar feeling and it is also sensible, typically audible for the physician. The small amount of instilled air is completely harmless and will be emptied with the first urination after the instillation.

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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Male Instructions

1 - Relaxation of pelvic muscles and sphincter 2 - UroDapter insertion 3 - Instillation speed 4 - Opening of the sphincter 5 - Sphincter contraction 6 - Two-step process for male patients 7 - Instillation of the solution 8 - Filling a Luer-Lock or Luer-Slip syringe with air 9 - Sealing 10 - Instillation of air 11 - Air enters the bladder 12 - Retention of solution

The process of disinfection

Expose the urethral orifice by completely pulling back the foreskin 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.