<i>In Vivo</i> Trial of a Novel Atraumatic Urinary Catheter Design for Prevention of Catheter-Induced Trauma

Azar, Ramyar; Shadpour, Pejman

doi:10.1089/end.2015.0827

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…These findings are clinically relevant as millions of urinary catheters are inserted annually and iatrogenic urethral injuries are a potentially preventable source of injury in patients (Manalo et al, 2011) (Wagner et al 2016, Azar et al 2016, Wu et al 2012 . Iatrogenic complications from UC are associated with medicolegal implications, financial penalties, longer inpatient stays and long-term urethral stricture disease.…”

Section: Discussionmentioning

confidence: 91%

“…Disruption of the epithelial layer is also evident in the MTC stain (indicated with an arrow). Azar et al 2016, Wu et al 2012. Recently, the incidence, cost, complications and clinical outcomes of iatrogenic urethral catheterisation injuries was prospectively monitored across 2 tertiary referral teaching hospitals and the incidence of urethral trauma was 6.7 patients per 1000 patients catheterised.…”

Section: Discussionmentioning

confidence: 99%

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

Davis

Cunnane

Mooney

et al. 2018

Journal of the Mechanical Behavior of Biomedical Materials

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Data on urethral catheter related injuries is sparse. In this study we aimed to characterise urethral diametric strain and urinary catheter inflation pressure thresholds that precede human urethral trauma during urethral catheterisation (UC). Human urethras were obtained from patients undergoing male to female gender reassignment surgery [(n = 9; age 40 ± 13.13 (range: 18-58)) years]. 12Fr urinary catheters were secured in the bulbar urethra and the catheter's anchoring balloon was inflated with a syringe pump apparatus. Urethral diametric strain and balloon pressure were characterised with video extensometry and a pressure transducer respectively. Immunohistochemistry, Masson's trichrome and Verhoeff-Van Gieson stains evaluated urethral trauma microscopically. Morphological characterisation of the urethral lumen was performed by examining non-traumatised histological sections of urethra and recording luminal area, perimeter and major/minor axis length. Tearing (n = 3) and rupture (n = 3) of the urethra were observed following catheter balloon inflation. The threshold for human urethral rupture occurred at an external urethral diametric strain ≥ 27% and balloon inflation pressure ≥ 120kPa. Significant relationships were identified between urethral wall thickness and the level of trauma induced during catheter balloon inflation (p = 0.001) and between the pressure required to inflate the catheter balloon and the length of the major axis of the urethral lumen (p = 0.004). Ruptured urethras demonstrated complete transection of collagen, elastin and muscle fibres. In conclusion, urethral rupture occurs at an external urethral diametric strain ≥ 27% or with balloon inflation pressures ≥ 120 kPa. Incorporation of these parameters may be useful for designing a safety mechanism for preventing catheter inflation related urethral injuries.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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

Davis

Cunnane

Mooney

et al. 2018

Journal of the Mechanical Behavior of Biomedical Materials

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“…Moreover, they are stable in storage according to the stability standard for pharmaceutical products 14,21 . In this study, we used catheters coated with both types of CHX‐NPs, CHX‐micelles and CHX‐nanospheres, to investigate the efficacy of catheters through urinary catheterization tests in rabbits for 7 day due to catheter colonization and following infection normally appear less than 7 day 11,15,24 …”

Section: Methodsmentioning

confidence: 99%

In vivo catheterization study of chlorhexidine‐loaded nanoparticle coated Foley urinary catheters in male New Zealand white rabbits

et al. 2021

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Foley urinary catheters were coated with chlorhexidine‐loaded nanoparticles (CHX‐NPs), encapsulated in the form of micelles and nanospheres. Both of nanoparticles were deposited by multilayer nanocoating through dip and spray coating on the catheter surface both inner and outer surface. In our previous studies, the nanocoating of Foley urinary catheters was studied for chlorhexidine release, degradation, antibacterial evaluation, cytotoxicity assessment, hemocompatibility, skin irritation, skin sensitization, and stability during storage. The results demonstrated the antimicrobial functions and biocompatibility of the coated catheters. In this study, coated urinary catheters were inserted in the bladders of rabbits for 7 day to investigate their efficacy. Histopathology results showed no inflammation, redness, or swelling on bladder and urethra tissues. Surface morphology comparison of uncoated catheters in the control group and coated catheters in the treatment group revealed more encrustation and crystallization on uncoated catheter than on coated catheter, indicating that catheters coated with CHX‐NPs showed efficacy in delaying encrustation and bacterial colonization. These findings suggest that nanocoating of urinary catheters can potentially enhance the biocompatibility of medical devices.

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“…Another mechanism for CAUI is accidental removal of the urethral catheter with the balloon inflated. Azar et al have patented the Atraumatic Urinary Catheter, which is designed so that excessive traction force disengages its retention balloon into proximal and distal segments, thereby emptying the balloon fluid via the main lumen of the catheter. In a rabbit model, forcible extraction of the Atraumatic Urinary Catheter led to fewer cases of CAUI compared with a standard Foley catheter.…”

Section: Cauimentioning

confidence: 99%

Innovations in indwelling urethral catheterisation

Jeffery

Mundy

2020

BJU International

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The indwelling urethral catheter remains an integral part of contemporary medical care, despite its significant design shortcomings. Urethral catheterisation is responsible for wellrecognised complications including catheter-associated urinary tract infection (CAUTI), catheter-associated urethral injury (CAUI), catheter blockage, and bladder mucosal irritation. In this narrative review, we provide an update on current innovations in urethral catheter design, aimed at safeguarding against these complications. There is an obvious need to improve catheter technology and urologists should support the translation of innovations into clinical practice. Keywordsindwelling urethral catheter, catheter-associated UTI, catheterassociated urethral injury, medical device innovation, catheter blockage

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In Vivo Trial of a Novel Atraumatic Urinary Catheter Design for Prevention of Catheter-Induced Trauma

Abstract: The two catheters bear similar efficacy for maintaining urine drainage; however, traumatic injury is significantly less common following forceful extraction of the AUC than a conventional Foley.

Cited by 6 publications

References 14 publications

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

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

In vivo catheterization study of chlorhexidine‐loaded nanoparticle coated Foley urinary catheters in male New Zealand white rabbits

Innovations in indwelling urethral catheterisation

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