Characterisation of human urethral rupture thresholds for urinary catheter inflation related injuries

Davis, Niall F.; Cunnane, Eoghan M.; Mooney, Rory; Heß, Jochen; Walsh, Michael T.

doi:10.1016/j.jmbbm.2018.04.015

Cited by 10 publications

(2 citation statements)

References 17 publications

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“…The iatrogenic injury of the urethra and related complications were associated with significant cost and longer hospital LOS (25). Although some studies were conducted to design a safer urinary catheter system to prevent catheterization-related urinary injuries (26,27), iatrogenic urinary injuries continued to occur. However, for patients without catheterization in our study, the risk of iatrogenic injury of the urethra could be avoided.…”

Section: Discussionmentioning

confidence: 99%

A Novel Tubeless Urinary Catheter Protocol Enhanced Recovery After Minimally Invasive Lung Surgery

et al. 2020

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Objectives: Although previous studies have shown the feasibility of non-intubated techniques, it is unknown whether avoiding urinary catheters can enhance recovery. This study aimed to determine whether the tubeless urinary catheter protocol is feasible and beneficial for minimally invasive lung surgery. Methods: Patients were randomized to the control group, completely tubeless group, and partially tubeless group. A propensity score–matched (PSM) analysis was performed to balance the non-random baseline characteristics. Complications and postoperative recovery were compared. Regression analysis was performed to identify the independent predictors of complications. A nomogram for predicting the risk of non-automatic micturition was constructed and internally validated. Results: One hundred fifty-nine patients were enrolled. The incidence rates of urinary irritation and urinary tract infection (UTI) were significantly lower in the tubeless groups (74.4 vs. 39.5%, p < 0.001; 28.2 vs. 8.6%, p = 0.001, respectively). The tubeless group had a higher proportion of 0-degree discomfort (81.5 vs. 30.8%, p = 0.001) and shorter duration of postoperative hospital stay than the control group (4.59 vs. 5.53 days, p < 0.001). No difference was observed in terms of urination retention and urinary incontinence between the tubeless group and the control group. After PSM, the advantages of the tubeless group still existed, and comparing to the partially tubeless group, the completely tubeless group was of even less UTI and more 0-degree discomfort (18.5 vs. 0.0%, p = 0.019; 96.3 vs. 59.3%, p = 0.002). The tubeless protocol was the only independent protective factor of urinary complications. A nomogram was constructed and showed good predictive ability. Conclusions: The tubeless catheterization protocol led to fewer complications, better compliance, and shorter hospital length of stay. The advantages were more significant with the completely tubeless protocol. The utility of our nomogram can assist clinicians in avoiding risks in performing the tubeless protocol.

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Section: Discussionmentioning

confidence: 99%

A Novel Tubeless Urinary Catheter Protocol Enhanced Recovery After Minimally Invasive Lung Surgery

et al. 2020

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“…In experimental studies, urethral rupture in the thinnest urethras occurred when external urethral diametric stretch was 1.26 and greater, and balloon inflation pressures of 120 kPa or more. 3 A mean balloon inflation pressure across the 3 urethral ruptures was 165.16 kPa. The safety-valve eliminates user variability in inflation of the anchoring balloon and restricts balloon inflation pressure to below a safe level of under 150 kPa.…”

Section: Scientific Principle Of the Safety-valvementioning

confidence: 95%

Possible Use of a Safety-Valve with a Foley Catheter During Catheterisation of Male Spinal Cord Injury Patients for Prevention of Urethral Trauma Caused by Inflation of the Catheter Balloon in the Urethra

Vaidyanathan¹,

Soni²

2023

MDER

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We used a safety-valve (Trans-Urethral Catheterisation Safety Valve, Class Medical, Limerick, Ireland) to prevent urethral trauma due to inflation of the anchoring balloon in the urethra during catheterisation of male spinal cord injury patients in a spinal unit. The safety-valve is attached to the balloon channel of a Foley catheter. If the balloon is inflated when it is in the urethra, the pressure valve is activated. Any fluid pushed into the balloon channel leaks out and balloon inflation stops, indicating that the balloon is not inside the bladder. The safety-valve was used in 44 catheterisations. There was leakage of water during three catheterisations. In the first case, the health professional did not inflate and deflate the balloon prior to its use. This "pre-valve inflation" step overcomes the baseline resistance pressure of the balloon and prevents fluid leaking from the valve when the catheter is in the correct position. In the second instance, the valve was found to be defective. In the third case, the catheter had been misplaced; it was removed and repositioned; there was no leakage of water during inflation of the balloon. In one out of 44 catheterisations, the catheter had been misplaced; leakage of water from the safety-valve stopped inflation of the balloon and prevented iatrogenic urethral trauma. The safety-valve may be used during catheterisation of male patients in the spinal unit to prevent urethral trauma caused by inflation of the balloon of Foley catheter in the urethra. However, health professionals should remember the few shortcomings of the catheter safetyvalve.

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Computational Tools for the Investigation of the Male Lower Urinary Tract Functionality in Health and Disease

Fontanella

Carniel

2021

J. Med. Biol. Eng.

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Purpose This paper aims to show the potentialities of computational bioengineering in the field of lower urinary tract pathophysiology. Engineering methods allow the investigation of urine flow in healthy and pathologic conditions and the analysis of urethral occlusion by means of artificial urinary sphincters. Methods Computational models of bladder and urethra were developed and exploited to investigate the lower urinary tract physiology in health and in disease. Average male morphometric configurations were assumed, together with typical properties of both biological tissues and fluids. The reliability of the models was assessed by the mutual comparison of results and the investigation of data from experimental and clinical activities. Results The developed models allowed to analyze typical situations, such as the micturition in health and in disease, and the lumen occlusion by external devices. The models provided information that clinical and experimental tests barely provide, as the occurrence of turbulent phenomena within urine flow, the shear stresses at the lumen wall, the external pressure that is strictly required to occlude the lumen. Conclusions The methods of bioengineering allow broadening and deepening the knowledge of the lower urinary tract functionality. More in detail, modeling techniques provide information that contributes to explain the occurrence of pathological situations, and allows to design and to optimize clinical-surgical procedures and devices.

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Characterisation of human urethral rupture thresholds for urinary catheter inflation related injuries

Cited by 10 publications

References 17 publications

A Novel Tubeless Urinary Catheter Protocol Enhanced Recovery After Minimally Invasive Lung Surgery

A Novel Tubeless Urinary Catheter Protocol Enhanced Recovery After Minimally Invasive Lung Surgery

Possible Use of a Safety-Valve with a Foley Catheter During Catheterisation of Male Spinal Cord Injury Patients for Prevention of Urethral Trauma Caused by Inflation of the Catheter Balloon in the Urethra

Computational Tools for the Investigation of the Male Lower Urinary Tract Functionality in Health and Disease

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