A new urethral catheterisation device (UCD) to manage difficult urethral catheterisation

Abstract

The cost of urethral catheterisation injury (UCI) is significant, but the true incidence of patient care error is difficult to establish in the absence of specific hospital codes recording difficult urethral catheterisation (DUC) and UCI. For many years urologists are familiar passing a non-traumatic hydrophilic guidewire blindly into the bladder to aid urethral catheter insertion in difficult circumstances. However, so far, no purpose-built regulated medical device was available on the market and clinicians had to improvise. Urethrotech filled that gap and developed the Urethral Catheterisation Device (UCD ® ), which integrates a standard hydrophilic Nitinol guidewire into a 3-way 16F Silicone urethral catheter design to enable safe second-line urethral catheterisation when first-line catheterisation with a standard urethral catheter is unsuccessful. The safety and efficacy of UCD ® catheterisation were evaluated in consecutive cohorts of men undergoing cardiac surgery and compared to the incidence of DUC and UCI with standard Foley catheterisation. A simple new Male Catheterisation Algorithm is proposed that can deliver a safe male urethral catheterisation treatment protocol for all clinical settings of healthcare services, which is easy to implement and integrate into standard catheterisation training programs to manage DUC and avoid UCI, empowering a frontline workforce to deliver better patient care.

Clinical efficacy of retrograde urethrography-assisted urethral catheterization after failed conventional urethral catheterization

“…Since the Seldinger technique, which involves using a guide wire to obtain safe access to blood vessels, was introduced [9], it has been applied as a second-line method after failed initial urethral catheterization [2,[10][11][12][13][14][15][16][17]. The Seldinger technique safely to indwell urethral Urethral catheterization using only hydrophilic guide wires for DDUCs has been introduced [11][12][13][14][15][16][17].…”

“…Recently, a novel Foley catheter that integrates a hydrophilic guide wire has also been introduced [2]. Physicians have advocated for the use of this device by reporting that it is relatively simple to use and its use results in high success rates with a 0% incidence rate of adverse events for nurse-led male urethral catheterization.…”

“…However, clinicians are sometimes faced with unexpected difficulties during urethral catheterization (DDUCs). Although DDUCs are not common, if this is not properly handled, they could cause critical problems, such as urethral injury [2]. Complications associated with urethral injury are significant hazards of urinary catheterization.…”

Innovations in indwelling urethral catheterisation

“…In a prospective observational cohort study of men undergoing elective cardiac surgery, no patients in the UCD group ( n = 100) had failed or traumatic catheterisation. In contrast, in the Foley catheter group ( n = 74), there were three cases of CAUI and two cases requiring suprapubic catheter insertion .…”

“…A different approach to combat CAUI has been taken by Urethrotech Ltd (Kingston upon Thames, Greater London, UK), which has developed and patented the Urethral Catheterisation Device (UCD ® ). The UCD is the first urinary catheter on the market to feature an integrated hydrophilic nitinol guidewire, which facilitates atraumatic male urethral catheterisation by a Seldinger technique . The majority of CAUIs occur as a result of repeated unsuccessful catheterisation attempts by non‐urologists, usually in the setting of benign prostatic enlargement.…”