On a Theory of the Infusion Method of Measuring the “Opening Pressure” in the Urethra

Abstract

At rest the muscles which control the urethra (urine duct) are contracted and its lumen is practically equal to zero over its entire length. To open the urethra, a mechanical effort (due, for example, to a pressure rise in the bladder) must be applied. Reduced contractile activity of the muscles may be one of the reasons for incontinence (enuresis). A widespread method of estimating the “blocking capability” of the urethra consists in inserting a catheter with lateral perforations near the end. The catheter enters the bladder and is then removed at a constant velocity while a fluid is constantly pumped (infused) into it by a syringe pump at a steady rate and then flows out through the gap between the catheter and the urethral wall. The pumping pressure is considered to be a local measure of the blocking capability, and its dependence on the location of the catheter is regarded as an important diagnostic characteristic. Below, we will consider the simple, longitudinally homogeneous model system formed by an elastic tube pulled over a catheter segment when the initial stresses in the tube are constant over its length. An incompressible viscous fluid flows out of the perforations and percolates in a thin layer along the catheter. In solving the model problem, we will use the lubricating layer approximation under the assumption of small layer curvature. On the basis of an analysis of the results and a comparison of the model with a practical intraurethral measurement procedure, we discuss, firstly, the relationship between the measured quantities and the real characteristics of the urethra and, secondly, the possible formulation of a more realistic model problem.