Causes and management of difficult drainage tube removal from urological incision When there is difficulty in drainage tube removal from urological incision, if the tube is forcibly removed, it will lead to fracture of the drainage tube and the stump will be left behind. from January 1997 to June 2005, we used the method of continuous or intermittent pulling on the wall of the tube to manage 5 patients with difficulty in drainage tube removal, and we report them as follows. Object and method I. Clinical data The five patients in this group, two males and three females, were 54 to 62 years old, with an average age of 58 years. Among them, 1 case was after radical prostate cancer surgery, 1 case was after total cystectomy with in situ ileal cystectomy, 2 cases were after ureterotomy and lithotomy, and 1 case was after renal pelvic dissection and lithotomy. The duration of tube placement ranged from 3 to 22 days, with an average of 18 days. The drainage tube materials were silicone tubes in all 4 cases except for 1 case which was a rubber tube. In one case, the drainage tube was forcibly removed, resulting in rupture, and in the other four cases, the wall was tractioned continuously or intermittently. One case of drainage tube rupture failed to remove the stump surgically, and no adverse effects were observed in 6 months of follow-up. 4 cases were successfully extracted after continuous or intermittent traction on the wall for 3-8 days, and one case failed to be extracted after 8 days of traction and slipped out by itself after lumbar anesthesia. Discussion The reason for the difficulty of extraction after urology, for the drainage tube placed for 2-3 days, the possibility of suturing part of the tube wall when closing the incision should be considered first, and one case in this group was found to have a residual line node on the tube wall after extraction, which was confirmed to be part of the tube wall suture. In addition, the possibility that the drainage tube is too long, twisted and knotted in the incision should be considered. For patients with long drainage time, in addition to the above reasons, it should be considered that due to long drainage time, granulation tissue grows into the small hole of the tube wall, resulting in close adhesion of the tube wall to the surrounding tissue. When it is difficult to remove the catheter, forcible removal is not allowed, because once the catheter rupture occurs, it is extremely difficult to handle. After catheter rupture, a small incision can be made in the drainage port position first on a trial basis, and the severed end can be taken out with proper separation; when it is difficult to take out, it can also be observed for a period of time, and if the surrounding granulation tissue has completely wrapped the tube wall and the patient has no uncomfortable reaction, it can be left untreated; if infection occurs in the residual tube wall, and an abscess is formed locally or ulcerated to the skin, it can be taken out as a foreign body. The four cases in this group all used the pulling method, first using scissors to separate the surrounding tissues tightly against the drainage tube, because the drainage tube was sutured more in the incision position, for patients with thin abdominal wall or wasting can be more effective. Generally 1 to 2 days trial extraction once, under continuous light tension, swinging the drainage tube from side to side, each time for 15 min, within 1 week can generally be extracted. If still unsuccessful, then try continuous traction, traction weight to about 2kg, a few days later that can be extracted. The principle of this method is: continuous or intermittent traction is equivalent to the chronic cutting effect, the silk suture around the tissue or adhesion tissue due to local ischemia, necrosis and slowly loosening, cutting.