Chapter 2359: 2364.2278 Urinary catheter, saline, syringe

2364.2278 Urinary catheter, saline, syringe

The problem at hand is rather tricky.

Because the patient had undergone sex reassignment surgery, Zheng Ren was encountering such a case for the first time. He lacked rich clinical experience to rely on, and since it wasn't a surgery, he couldn't enter the System Space to try different methods of removal.

Everything could only be figured out in his mind, finding a logical and feasible solution.

Zheng Ren was familiar with sex reassignment surgery; if he were the lead surgeon, there could be dozens of surgical approaches.

But the current situation is vague; Zheng Ren also doesn't know exactly how the patient underwent this procedure. Theoretically, the patient couldn't possibly come to the hospital with a complete surgical record.

Entering the treatment room, the long-legged, slim-waisted woman sat on the bed, looking innocently at the baffled doctors. The surgical outcome was still quite good; at least Zheng Ren couldn't see any problem.

If you didn't know, you'd surely think she was a pretty girl.

No one spoke; the room was silent as if a medical accident had just occurred.

Perhaps in Thailand, sex reassignment surgery is common, but domestically very few people choose to undergo it. The doctors at People's Hospital exchanged glances, all at a loss.

Zheng Ren glanced at the woman and asked, "What size tampon?"

Seeing two more unfamiliar doctors arrive, she also felt helpless and gestured with her fingers.

"Why don't we try an anal scope?" said one doctor.

This is an instrument used to examine rectal and anal lesions, a common tool for proctological exams, available in traditional and electronic versions.

Zheng Ren thought for a moment and said, "No, the view is limited; we still wouldn't see anything."

That doctor was somewhat surprised; he glanced at them, not recognizing the person in front, nor Lin Yuan behind him.

He had merely made a casual suggestion; its rejection didn't matter, and he himself didn't think it feasible. But the speaker's tone… seemed like that of a chief, beyond question.

"If not, let's take a look with a fiber colonoscope," said another doctor.

"No!" Zheng Ren said, this time with a hint of sternness.

The first suggestion would just not work, while the second one carried greater risk.

"Inflating a colonoscope would risk overpressurizing her cecum, easily causing trouble," Zheng Ren said flatly.

Zheng Ren didn't say much—not because he was unfamiliar here, all were doctors and there was nothing he couldn't say—but because, facing the patient, it didn't feel right to launch into a head‑to‑toe reprimand of the doctors here.

That doctor started to look surprised, but after Zheng Ren gave a brief explanation, he understood.

Normally the deepest point is the posterior fornix of the uterus, about 12 cm. In the Emergency Department, Zheng Ren had also seen foreign objects; common ones are condoms, and occasionally patients drop a tampon in, which is usually easy to remove with a vaginal dilator.

But this patient, the intestine is substituted…

"Do you know which part of the intestine and how long?" Zheng Ren still wanted to give it a try.

The female patient's face flushed slightly, and she shook her head a little.

As expected, she knows nothing. This is the normal situation; if she could rattle off one‑two‑three‑four‑five while sitting here, not only Zheng Ren but everyone would be suspicious.

What should we do? Zheng Ren also felt a bit at a loss.

We don't know how deep it is; a small tampon is hidden inside. It looks simple, but extracting it would be extremely difficult.

Even veteran doctors sometimes slip up; Zheng Ren had just finished a cardiac conjoined‑twin separation surgery a few days ago, and he never imagined he'd be stumped by such a problem.

Indeed… Zheng Ren gave a helpless smile.

"Did you just look?" Zheng Ren asked the first female doctor to enter, guessing she was the Obstetrics and Gynecology Inpatient Chief, speaking directly.

Fully focused on assessing the patient's condition, Zheng Ren's speech was no longer polite but very direct, radiating the aura of a senior physician.

The Obstetrics and Gynecology Inpatient Chief stared for a moment, then instinctively used the tone of reporting to a chief: "The position is too high; after opening the vaginal dilator, my fingers go in all the way but I can't reach the bottom. I didn't dare use grasping forceps, fearing I'd injure the intestinal wall."

Zheng Ren nodded, placed his left hand under his right armpit, rested his right hand on his chin, assumed the pose of reading a film, and looked at the female patient before him.

The patient felt a bit creeped out being stared at, but couldn't get angry.

She could sense that this young‑looking doctor before her was wholeheartedly thinking of a solution, not scrutinizing her gender with odd looks over the rare domestic surgery.

"Why not try a colonoscope under anesthesia, giving as little gas as possible, just enough to see?" Lin Yuan whispered from behind.

Although Zheng Ren had rejected that suggestion, it now seemed the only viable option.

Zheng Ren shook his head slightly and then said, "Urinary catheter, saline, syringe."

The Emergency Department doctor's eyes lit up with excitement, he answered affirmatively, and began to look for what Zheng Ren had mentioned.

Although he didn't understand why a urinary catheter was needed to remove intestinal foreign matter, it didn't stop him from following Zheng Lao Ban's instructions.

Zheng Lao Ban was going to first drain the urine from the bladder, then… he didn't know what else to do, but anyway the legendary Zheng Lao Ban had shown up here and was about to tackle the tough problem!

Soon, the Emergency Department doctor came running back with the items.

Zheng Ren had the patient lie in the lithotomy position, reached out, paused for 1.2 seconds, then said in a low voice, "Sterile gloves…"

The Emergency Department doctor fetched another pair of sterile gloves and handed them to Zheng Ren.

"Zheng Lao Ban, how are you going to proceed?"

"Let's give it a try; I'm not confident either. If it really fails, we'll have to go onto the operating table and search with a colonoscope." Zheng Ren said.

That statement meant preparing for possible intestinal rupture; if a problem arose, they'd have to resuture.

Domestic experience with such cases is rare; if it were in Thailand, perhaps it would be much easier.

Zheng Ren repeatedly coated the urinary catheter with petroleum jelly three times, then inserted it into the intestine.

"Zheng Lao Ban, the urethra… the urethra…" the Emergency Department doctor whispered a reminder.

After surgery, the patient's urinary outlet had shifted; Zheng Lao Ban might have missed it. He was a bit worried, offering a well‑intentioned reminder.

"Hmm, I know." Zheng Ren looked up, smiled, and said, "Give me the opened syringe."

Before the Emergency Department doctor could act, Lin Yuan had already opened the syringe and placed it before Zheng Ren.

Then Lin Yuan attached the syringe needle to the saline bottle, tilted it, and set it before Zheng Lao Ban.

He drew 10 ml of saline, and Zheng Ren injected it into the urinary catheter's balloon port.

The front of the urinary catheter has a balloon, also called a water balloon; normally after inserting the catheter one injects about 5 ml of saline. The balloon expands, lodging at the bladder‑urethra opening to prevent the catheter from slipping out.

But what is Zheng Lao Ban trying to accomplish by doing this?