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April 19, 1947


JAMA. 1947;133(16):1237. doi:10.1001/jama.1947.02880160063020

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To the Editor:—  The terms "tidal drainage" and "tidal irrigation" used in the article "Urologic Complications in Injuries of the Spinal Cord" in The Journal, February 8, are confusing. As many different designs of tidal drainage apparatus have appeared in the literature, it is not clear which apparatus was on trial or, in fact, whether or not one type of apparatus was used for "tidal drainage" and another for "tidal irrigation."It is to be expected that hand irrigation would be more effective than the use of the apparatus, because none of the commonly used tidal drainage designs are capable of irrigating the bladder in the usual sense of the term. These devices merely mix fluid very slowly with the urine in the bladder until a predetermined intravesical pressure is reached, at which point they aspirate the mixture. The efficiencies of the various designs vary widely: some of them aspirate

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