A comparative assessment of irrigation and drainage characteristics for commercially available urethral catheters

Abstract

IntroductionWe aimed to investigate irrigation and drainage characteristics of commercially available urethral catheters and determined which catheter offers the best flow characteristics.Material and methodsTwelve different commercially available urethral catheters from three companies (Bard™, Rusch™ and Dover™) were investigated to compare their irrigation and drainage properties. Irrigation port, drainage port and overall cross-sectional areas for a 24Fr 3-way catheter was measured and compared. The maximum (Qmax) and average (Qavg) irrigation and drainage flow rates for each catheter was measured for 20–40 seconds using uroflowmetry. The primary endpoint was to determine which catheter offers optimal irrigation and drainage parameters.ResultsOverall cross-sectional area, irrigation port cross-sectional area, and drainage port cross-sectional area differed significantly for each 24Fr 3-way catheter assessed (p <0.001). The 24Fr 3-way Rusch Simplastic™ catheter consistently demonstrated the greatest maximal flow rate (Qmax: 5 ±0.3 ml/s) and average flow rate (Qavg: 4.6 ±0.2 ml/s) for irrigation. The 24Fr 3-way Dover™ catheter provided the greatest drainage properties (Qmax: 19.7 ±2 ml/s; Q avg: 15.9 ±5 ml/s). In the setting of continuous bladder irrigation, the 24Fr 3-way Rusch Simplastic™ catheter provided the highest irrigation rates (Qmax: 6.6 ±1.8 ml/s; Q avg: 4.6 ±0.9 ml/s).ConclusionsThree-way catheters demonstrate significant differences in their irrigation and drainage characteristics. The type of catheter selected should be based on the appropriate prioritization of efficient bladder irrigation versus efficient bladder drainage.

Analysis of flow rate of continuous bladder irrigation according to the height of the irrigation infusion set

“…First, when the temperature of the irrigation fluid, bladder pressure, and height of the irrigation infusion set are held constant, the flow rate increases with the increasing diameter of the indwelling catheter. These results are consistent with previous findings 2 , 11 , 16 , 23 showing a positive relationship between catheter size and flow rate, which enables the effective elimination of urine, including thrombosis in the bladder. Based on the friction-adjusted Bernoulli's equation used in this study, the flow rate of the irrigation fluid entering the bladder is directly proportional to the diameter of the indwelling catheter.…”

“…With reference to the height of the fluid bags proposed in previous studies 2 , 12 , the height of the irrigation infusion set in this study varied by 10 cm from 0 to 120 cm to analyze the flow rates according to the height.…”

“…With South Korea being an aged society, the incidence of aging-related urological conditions, such as benign prostate hyperplasia (BPH) and urinary incontinence 1 , has increased. The main symptoms of urological diseases include voiding disorder or bladder hemorrhage, and bladder hemorrhage should be monitored, particularly after surgeries or procedures such as transurethral resection of the prostate (TURP) and open prostatectomy 2 – 4 . Patients who are anticipated to develop bladder hemorrhage or those who have developed it undergo intermittent or continuous bladder irrigation (CBI) through indwelling catheters to prevent and remove thrombi in the bladder 3 , 5 , 6 .…”

“…Normal saline (NS) at room temperature is generally used for bladder irrigation to prevent bladder spasms and water intoxication 6 , 9 , and cold saline (4 °C) may be used to reduce hemorrhage through vasoconstriction in cases of severe bladder hemorrhage 10 . CBI is generally performed using a three-lumen catheter 3 , 11 , with an 18Fr catheter for patients without severe hematuria and a 22Fr catheter for those expected to develop severe hematuria 2 .…”