From indwelling Foley to fail-safe voiding: Proposed changes in design and thinking

Abstract

The Foley indwelling urethral catheter (IDC) has been an effective part of the clinician’s armoury for more than 80 years. It meets wide clinical needs, such as overcoming urinary retention for men and perioperative management, but its use risks the major iatrogenic conditions of catheter-associated urinary tract infection and urethral injury (CAUI) – the latter mainly in men. This article focuses on CAUI, examines some factors contributing to these risks, makes suggestions for design solutions which may help tackle them and invites collaboration to develop more effective and fail-safe IDC or voiding solutions.

Letter to the Editor re Gration, 'From indwelling Foley to fail safe voiding: Proposed changes in design and thinking', Journal of Clinical Urology, 4 November 2020

“…We read with interest the recent article by Gration, 'From indwelling Foley to fail safe voiding: Proposed changes in design and thinking'. 1 The author comments on the catheter-associated urinary tract infection rates as highlighted by the NHS safety thermometer report over 10 years and further comments on the more serious problem of catheter-associated urethral injury. 1 The study proceeds by referencing the work of Davis et al which highlighted that inappropriate balloon inflation is a common cause of catheter related urethral injury.…”

“…1 The author comments on the catheter-associated urinary tract infection rates as highlighted by the NHS safety thermometer report over 10 years and further comments on the more serious problem of catheter-associated urethral injury. 1 The study proceeds by referencing the work of Davis et al which highlighted that inappropriate balloon inflation is a common cause of catheter related urethral injury. 2 The article proceeds to discuss the multiplicity of potential design solutions available and alludes to product packaging warnings for female catheters and specific to male catheters, and the role of the urethrotech device with its safety guide wire is mentioned.…”