1982 NOVEL URETHRAL CATHETER DESIGN MODIFICATIONS FOR SAFER OUTCOMES

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology I1 Apr 20121982 NOVEL URETHRAL CATHETER DESIGN MODIFICATIONS FOR SAFER OUTCOMES Alex Wu, David Aaronson, and Maurice Garcia Alex WuAlex Wu San Francisco, CA More articles by this author , David AaronsonDavid Aaronson Oakland, CA More articles by this author , and Maurice GarciaMaurice Garcia San Francisco, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2142AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The first report of an iatrogenic urethral injury from a urethral catheter was presented by Sellet, in JAMA (1971). Four decades later, these injuries continue to occur, but on an unknown scale and without a single safety modification to the urethral catheter. We sought to: (1) Identify the national incidence of non-infectious catheter related complications; and (2) Create and test a novel catheter design to mitigate urethral trauma caused by inappropriate catheter inflation within the urethra. METHODS To identify the national incidence of catheter related complications, we performed a cross-sectional analysis of the 2006 to 2008 National Inpatient Sample (a 20% stratified sampling of non-federal U.S hospitals), using ICD-9-CM codes. Standard (BARD) 16 Fr. catheters were modified by thinning out a circumferential area of the balloon-port shaft, and painting this area bright-red. When the retention balloon is inflated within the urethra, this thinned area (“Safety Balloon”) expands, and serves to: (1) Minimize pressure upon the urethra, and (2) Visually alert the operator. We measured pressure within the balloon-port during inflation in the bladders and urethras of fresh human cadavers, and in an ex vivo model. We assessed when the “safety balloon” inflates, and, whether its use lowers balloon-port pressure when malpositioned. RESULTS From 2006 to 2008, up to 111,353 patients experienced a non-infectious catheter related complication. Mean age of these patients was 68.4 years (± 18.8). Most were male (86.6%) and 46.2% required a procedure, such as cystoscopy or suprapubic tube placement. Balloon-port pressure after inflation within the bladder was similar among standard catheters and our catheter prototypes. After inflation within the prostatic and bulbar urethra, the “safety balloon” began to visibly expand immediately upon filling with 5mL. Furthermore, mean balloon-port pressure was 50% lower in our catheter prototype as compared to the standard catheter upon intraurethral balloon inflation. CONCLUSIONS Non-infectious catheter related complications occur regularly, and are likely underreported. Simple and intuitive modifications to the current urethral catheter design should reduce complications associated with intraurethral balloon inflation. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e799-e800 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alex Wu San Francisco, CA More articles by this author David Aaronson Oakland, CA More articles by this author Maurice Garcia San Francisco, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...