Same Sized Three-Way Indwelling Urinary Catheters from Various Manufacturers Present Different Irrigation and Drainage Properties - Beyond the Abstract

The three-way indwelling urinary catheter (IUC) is used for continuous bladder irrigation and is considered the cornerstone for clinical treatment of patients with macroscopic hematuria. Every clinical situation leads to a particular kind of hematuria, which can be managed wh a greater or lesser irrigation flow in order to prevent complications.

During the clinical routine, we observed that the width of the catheters was not directly linked to the drainage and irrigation capacity. And this perception seemed to become even worse when the comparison was made between different brands available on the market.

The aim of this study was to compare the mechanical properties of different models of latex and silicone three-way catheters, of three different sizes, in an in vitro setting that resembles the clinical practice.

20-Fr, 22-Fr and 24-Fr Gold Silicone-Coated Rusch® (Model A); 100% Silicone Rusch® (Model B) and X-Flow Coloplast® (Model C) were studied (Figure 1).

types of catheters

This study shows that there are significant differences among three-way IUCs. The irrigation flow correlates better to the IUC model than to the IUC caliber. On the other hand, the drainage flow, besides varying from one IUC model to the other, also increases proportionally with the IUC caliber.

Another important finding of this study is that there is no alteration of flow related to the volume of the cuff. Although there is a maximum volume accepted by each specific IUC, which is determined by the manufacturer, the amount of saline used to insufflate the cuff varies from a surgeon to the other. Thus, one may over-inflate the cuff and temporarily place traction into the IUC in order to squeeze the bladder neck and diminish the pro-static bleeding without worsening the irrigation flow

The conclusion of our work was that different IUC models with the same external caliber have significantly disparate irrigation and drainage lumen calibers which consequently yield different irrigation and drainage flows. Understanding the properties of each IUC available facilitates the selection of the appropriate device that should be used in each clinical setting.

Written by: Guilherme Andrade Peixoto, MD, Sociedade Beneficente Israelita Brasileira Albert Einstein (HIAE), Assistant Physician of the Discipline of Urology, ABC Medical School (FMABC), Assistant Physician, Regional Hospital of Piracicaba - UNICAMP, São Paolo, Brazil; Marcelo Langer Wroclawski, MD, MSc, Renal Transplantation Program of the Social Responsibility Institute, Sociedade Beneficiente Israelita Brasileira Albert Einstein, São Paulo, Brazil; and Arie Carneiro, MD, PhD, ABC Medical School, CAPES Doctorate Sandwich program with Harvard Medical School, São Paulo, Brazil

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