ZHANE METHOD

From Big Medical Encyclopedia

ZHANE METHOD ( J. Janet , the fr. urologist, 1861 — 1942) — plentiful washing of an urethra antiseptic solutions. It is offered Ge. Jean in 1892 for treatment of an acute gonorrheal urethritis

. the m in complex treatment of gonorrheal damages of an urethra, especially before use of antibiotics, took the leading place among other methods of topical treatment of acute gonorrhea. However this method did not lose the value and in the 70th. It is applied in case of unsuccessful treatment by antibiotics acute and hron, a gonorrheal urethritis, their complications — an epididymite, prostatitis, and also not gonorrheal inflammatory diseases of urinogenital bodies

. the m promotes mechanical removal of pus, gonokokk and their toxins from a mucous membrane of an urethra and considerably reduces terms of treatment.

At acute inflammatory process apply hl to washing. obr. solution of potassium permanganate since it does not destroy a mucous membrane of an urethra and interferes with development of gonokokk. At other inflammatory diseases use solution of oxymercuric cyanide.

Frequency of washings, concentration of the solutions applied to these purposes and a way of washings depend on sharpness and localization of inflammatory process.

At an acute gonorrheal urethritis washing is appointed by 2 — 3 times a day within a week; after subsiding of the acute inflammatory phenomena — 1 times a day and even in 2 — 3 days before total disappearance of an infection.

At the beginning of a disease apply less concentrated solutions of potassium permanganate (1: 20 000); gradually, in process of subsiding of the acute phenomena, concentration it is increased to 1: 5000. Depending on localization of process wash out front department or all urethra. After subsiding of an acute inflammation apply deep washing — enter liquid before emergence of a desire to an urination to open a sphincter of a bladder.

A technique

Washing across Zhane is carried out by means of an irrigator or the special syringe with a capacity of 100 — 200 ml, observing methods of an asepsis. Temperature of the solutions applied to washings of an urethra shall correspond to body temperature not to cause a spasm of a sphincter. Before washing of the patient previously empties a bladder. Then the tampon moistened with solution of oxymercuric cyanide 1:1000 process an outside opening of an urethra, a balanus and a prepuce.

It is more convenient to carry out washing when the patient is in horizontal position, in some cases carry out in a standing position. The graduated vessel with solution for washing shall be at the height of 50 — 70 cm over the level of a table. The tip (glass or plastic) is brought to an outside opening of an urethra, and the fluid jet is sent to the canal. Pour in liquid in slowly small portions (5 — 6 ml) to fill the forefront of an urethra. Then administration of liquid is stopped and it freely follows from an urethra. Such manipulation is carried out repeatedly.

For washing of back department of an urethra the vessel is lifted on height of 60 — 80 cm over the level of a table, for the end of the syringe dress a rubber tip, densely it is put to an outside opening of an urethra and under pressure enter 15 — 20 ml of liquid. Pressure of liquid overcomes reduction of an outside sphincter, and solution gets into a bladder. At a desire to an urination stop administration of liquid and to the patient suggest to urinate. Deep washing of an urethra is made until try to obtain release of the solution which is not changed on color. At a persistent spasm of a sphincter follows, previously having washed out a front urethra, to enter into it for 2 — 3 min. 5 — 8 ml of 5% of solution of novocaine. For deep washing use on average 400 — 500 ml of solution, combining solution of potassium permanganate 1:5000 and solution of silver nitrate 1:2000.


Bibliography: Jean Ge. Diagnosis and treatment of male and female gonorrhea, the lane with fr., M. — L., 1930.

D. V. Kan.

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