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Urinary catheter ‘deflation cuff’ formation: clinical audit and quantitative in vitro analysis
Author(s) -
Parkin J.,
Scanlan J.,
Woolley M.,
Grover D.,
Evans A.,
Feneley R.C.L.
Publication year - 2002
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.2002.03014.x
Subject(s) - cuff , medicine , catheter , silicone , surgery , balloon , balloon catheter , chemistry , organic chemistry
Objective To investigate reports from district nursing staff of difficulty in removing long‐term urinary catheters (LTCs) because of the formation of a ‘cuff’ on deflating the self‐retaining balloon. Patients and methods Problems experienced by district nurses when removing urethral and suprapubic LTCs were audited, noting the type of problem, the catheter and any action taken. Quantitative in vitro studies were conducted on the deflated self‐retaining balloons after incubating a similar range of catheters in saline at 37 °C for 6 weeks, using suprapubic profilometry to assess the resistance to withdrawal (retention force). Results Questionnaires were returned on 154 patients with LTCs; 56% had urethral and 44% suprapubic catheters. The catheters were hydrogel‐coated (83%), all‐silicone (13%) and PTFE‐coated (3%). Twenty‐two (14%) of the sample reported problems with catheter removal in the previous year, including 15 (68%) with all‐silicone catheters and 15 (68%) with suprapubic catheters; cuff formation was noted in 60%. In the laboratory, 10 of the balloons formed a ‘cuff’ on deflation, but there was great variability in the effect this had on the retention force, with values of 0.5–3 N for different catheters. Conclusions Most problems with catheter removal involved all‐silicone and suprapubic catheters. Suprapubic profilometry confirmed increased resistance to withdrawal by formation of a ‘cuff’ on deflation of the balloon of all‐silicone catheters. These results suggest that the first choice of catheter material for long‐term urethral and suprapubic use should be hydrogel‐coated latex.