The spontaneous variation of catheter life, i.e. the time in days between catheter changes, was observed in 20 long-stay geriatric inpatients with initially short catheter lives. The study ran for 6 months. The catheter regimen was standardized throughout the study. The intra-individual and inter-individual catheter lives showed considerable variation. Each patient retained his individual pattern of catheter life. It is concluded that, despite the variation of isolated catheter lives, the median value of repeated observations of catheter life provides a reliable parameter of catheter function.
An evaluation has been made of the clinical and laboratory effects of short-term (34 days), high-dose (2g x 3 daily) treatment with methenamine hippurate (MH) of 14 geriatric patients with an indwelling catheter and clinical features of urinary tract infection. During MH treatment the number of catheter changes was halved, each catheter remaining in situ for an average of 12.0 days as compared to 6.2 days in the pre-treatment control period and 5.2 days in the post-treatment control period; the difference is significant (p = 0.008; Friedman two-way analysis of variance). Urine pH was reduced (pH 7.0--6.5--7.0; p = 0.01) and the standard bicarbonate in blood was slightly elevated (24.1--25.7--25.0 mmol/l; p= 0.008) during the MH treatment period, when compared to pre- and post-treatment control periods. It is suggested that MH treatment reduced the complications associated with indwelling catheters due to reduction in urine pH, bacteriuria, and pyuria. Blockage of catheters is thought to be due to intraluminal salt precipitations with trapping of clumps, and is primarily not correlated with urine viscosity.
Catheterized patients with heavy bacteriuria and short catheter life received a short-course of antimicrobial therapy and then were allocated at random to double-blind treatment for 5 months with methenamine hippurate (MH), 1 g three times daily, or placebo 1 g 3 times daily. MH treatment reduced the number of catheter blockages and instances of spontaneous removal of the catheter, and doubled catheter life (p less than 0.001). It is suggested that the doubled catheter life was due to the reduced bacteriuria and lowering of urinary pH.
The pH of the urine within a blocked indwelling catheter was significantly higher than the pH of the first urine portion from the new catheter. This observation suggests that the urinary pH was changed in an alkaline direction within the indwelling catheter, probably due to the production of ammonia induced by urease from Proteus strains. This pH gradient could only be demonstrated under conditions where the circadian pH variations of the urine within the individual could be neglected.
Long-stay geriatric inpatients with an indwelling urinary catheter are harassed by foul-smelling urine, urine leakage, and frequent catheter blockages. It is reasonable to assume that catheter-induced bacteriuria plays an essential role in the catheter problems of these patients. An attempt to reduce the catheter-induced bacteriuria was made by the introduction of a latex catheter coated with a layer of copper metal. The antibacterial properties of the copper-coated catheters studied were, however, insufficient, probably due to too small amount of copper on the catheter. The copper layer was dissolved from the catheter in a few days. The effective time of copper treatment thus became too short.
The u r i n e sediment of 12 g e r i a t r i c p a t i e n t s w i t h i n d w e l l i n g c a t h e t e r s was quant i f i e d by t h e glutaraldehyde-cytocentrifuge method p r i o r t o , d u r i n g and a f t e r a c l i n i c a l t r i a l of methenamine h i p p u r a t e (MH), 2 g x 3 d a i l y g i v e n f o r 34 days as t h e s o l e t h e r a p e u t i c agent f o r u r i n a r y t r a c t i n f e c t i o n . c o n c e n t r a t i o n i n t h e u r i n e of t h e s e p a t i e n t s w a s 100 c e l l s / p l ( Q , -Q3 5 0 -3 5 0 ) ,
i . e . t e n f o l d h i g h e r than t h e upper normal l i m i t s r e p o r t e d i n h e a l t h y probands.The median b a c t e r i u r i a i n t h e c o n t r o l p e r i o d was 1 2 x lo5 b a c t e r i a / m l u r i n e , i n t e r q u a r t i l e range 10-60 x 10 500 x 10 b a c t e r i a / m l . n o t prominent and could n o t be c o r r e l a t e d w i t h MH t r e a t m e n t , n o r w i t h c a t h e t e r changes. The r e p o r t e d o b s e r v a t i o n s s u g g e s t t h a t short-term high-dose t r e a t m e n t w i t h MH as s o l e t h e r a p e u t i c agent reduced p y r u r i a and b a c t e r i u r i a i n t h e group of p a t i e n t s s t u d i e d .
A quantified sediment of the urine from patients with indwelling catheters was prepared by fixation of 0.1 ml urine in 0.9 ml 2% glutaraldehyde immediately after sampling. Slide preparations were then made from 0.2 ml of the glutaraldehyde suspension by means of a cytocentrifuge.were properly contrasted by the May-Grunwald-Giemsa stain but haematoxylineosin and the Papanicolaou stain were superior as regards leukocyte morphology.It is suggested that g l u t a r a l d e h y d e -c y t o c e n t r i f u g e preparations of the urine cytology may be useful in the evaluation of urinary infection and in the evaluation of the therapy of urinary infection.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.