BJUI Mini Reviews - An indwelling urinary catheter for the 21st century

BERKELEY, CA ( - The indwelling urinary catheter is the most common cause of infections in hospitals and other healthcare facilities.[1] As long ago as 1958, Paul Beeson [2] warned ‘...the decision to use this instrument should be made with the knowledge that it involves the risk of producing a serious disease which is often difficult to treat.' Since then, scientific studies have progressed revealing a greater understanding of the bladder’s defence mechanisms against infection and how they are undermined by the Foley catheter.[3-5] In addition, the complications caused by the development of bacterial biofilms on catheters have been recognised and the ways in which these bacterial communities develop on catheters have become clear.[5, 6] It is now obvious that fundamental problems with the basic design of the catheter, which has changed little since it was introduced into urological practice by Dr. Fredricc Foley in 1937,[7] induce susceptibility to infection. These issues need to be addressed urgently if we are to produce a device suitable for use in the 21st century...View or save the full text Mini Review as a .pdf file

What's known on the subject? and What does the study add?
A vast literature has been published on the prevalence, morbidity and microbiology of catheter-associated urinary tract infections. Research and development in recent years has focused on producing antibacterial coatings for the indwelling Foley catheter with insufficient attention to its design.
This article provides a critical examination of the design of the indwelling Foley catheter. Design specifications are outlined for a urine collection device that should reduce the vulnerability of catheterised urinary tract to infection.

Roger C.L. Feneley, Calvin M. Kunin,* and David J. Stickler

North Bristol NHS Trust, Southmead Hospital, Bristol, England, School of Biosciences, Cardiff University, Cardiff, Wales, UK, *Department of Medicine, University of Arizona, Tuscon, Arizona,and Dept of Medicine, Ohio State University, Columbus Ohio, USA


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