Leakage Associated With Urinary Catheter Usage

Robert Theriault, BSN, RN; Peggy Ward-Smith, PhD, RN; Charles Soper, MB, MRCP

Disclosures

Urol Nurs. 2012;32(6):307-312. 

In This Article

Potential Solution

Based on the review of the literature and clinical experience, the authors hypothesize that one cause of urinary catheter leakage is catheter tip kinking, which results in the catheter "eyes" becoming occluded. The authors further hypothesize that by revising the catheter design, urine is free to drain, unrestrained. Revision of the in dwelling bladder catheter should not include changing the catheter tip to a rigid material. Vaidyanathan, Huges, Mansour, and Soni (2008) stated that if the catheter tip was rigid and straight, it could puncture the bladder wall.

To facilitate drainage, the authors hypothesize that the original Foley-type urinary cathe ter be modified to include the placement of a third "eye," or opening. This "eye" should be located on the catheter tip just below the two current "eyes," yet above the balloon (see Figure 1). This modification should allow urine to flow without interruption. Although routine kinking of the catheter tip would continue to occur, this kinking would be at the level of the shaft where the two "eyes" are located. Placing the third "eye" below this juncture would allow urinary drainage to continue, even in the presence of a catheter kink.

Another option may be to place a third "eye'" on the catheter shaft just above the bladder neck. The section of the catheter shaft that contains this "eye" would remain inside the bladder (not inside the urethra) to provide continuous drainage. This intervention is theoretical because the current catheter balloon does not provide space for an additional "eye" in the right location. Yet, in theory, the placement of an "eye" below the catheter balloon but inside the bladder would allow debris to be drained from the base of the bladder and also prevent urine stagnation. Thus, if feasible, this modification may also reduce CAUTIs. Placement of this third "eye" would require a more radical redesign of the catheter balloon or the development of another method to anchor the indwelling catheter inside the bladder.

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