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Bioengineering in Urology > Catheters > Flashcards

Catheters Flashcards

1
Q

Indicators for catheterisation

A
  • neurological conditions
  • bladder outlet obstruction
  • urinary retention
  • peri/pre/post operative bladder drainage
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2
Q

Causes of neurological conditions causing bladder problems

A
  • spinal cord injury
  • MS
  • spina bifida
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3
Q

Examples of bladder outlet obstruction causes

A

BPH

urethral stricture or injury

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4
Q

Examples of urinary retention causes

A
  • neurological conditions/bladder outlet obstruction
  • bladder injury
  • malformations
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5
Q

Standard colour sizes for catheters

A 
Light Green = 06
Blue = 08
Black = 10
White = 12
Dark Green = 14
Orange = 16
Red = 18
Yellow = 20
Purple = 22
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6
Q

Catheter modern materials

A
  • silicone!!

- silver impregnated latex

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7
Q

Advantages of silicone catheters

A
  • most common material for foley catheters
  • less prone to encrustation
  • tolerated by those with latex allergies
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8
Q

Bardex IC advantage

A
  • reduces risk of infection
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9
Q

Normal length of use for foley catheters

A
  • change every 4-6 weeks

- some approved for use up to 12 weeks

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10
Q

Complications of indwelling catheters

A
  • UTIs
  • bladder stones
  • catheter blockages
  • urethral and bladder trauma
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11
Q

Why is there a risk of UTI’s with indwelling catheters?

A
  • 5% daily risk of bacteriuria

- 40% of nosocomial infection are catheter acquired urinary tract infections (CAUTI)

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12
Q

How do bladder stones form?

A

A biofilm of calcium and magnesium develops on the catheter balloon which then build up forming stones and can block the catheter eyelets

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13
Q

How can bladder/urethral trauma occur?

A
  • severe encrustation = complications of catheter withdrawal

- LT urethral catheterisation = severe urethral erosion

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14
Q

Pros of suprapubic catheters

A
  • no urethral trauma

- sex is still possible

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15
Q

Cons of suprapubic catheters

A
  • no reduction in UTI risk
  • bladder stones same risk as indwelling
  • blockages same risk as indwelling
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16
Q

How is a suprapubic catheter placed?

A
  • relatively minor surgical procedure
  • passed through abdomen
  • just above pubic bone
  • into bladder
  • inflate balloon
  • 1st catheter inserted in hospital but then nurses/individual after this
  • completely reversible
17
Q

Define terms SCI, CIC, ISC?

A 
SCI = spinal cord injury
CIC = clean intermittent catheterisation
ISC = intermittent self catheterisation
18
Q

ISC Catheters Properties

A
  • hydrophilic catheters
  • coating binds water to the surface
  • reduced urethral trauma
  • reduced discomfort
  • sterile single use
19
Q

Material of ISC Catheters

A
  • PVP = polyvinylpyrrolidone (also polyvidone or povidone)
  • water soluble polymer
  • also silicon (too soft for ISC users to handle well)
  • PEBA (polyether block amide)
  • POBE (polyolefin-based elastomer)
  • PVC (moving away from this for environmental reasons)
20
Q

Parts of an ISC Catheter

A
  • connector/hub (colour coded by sizing)
  • catheter body (variety of plastics - PVC for e.g.)
  • coating (gel or hydrophilic)
  • eyelets (on sides)
  • catheter tip
21
Q

Type of catheter tips

A

Nelaton (rounded)

Tiemann (curved and tapered)

22
Q

Pros of ISC catheters

A
  • reduced UTI risk compared to indwelling
  • reduced stone risk compared to indwelling
  • reduction in trauma compared to indwelling
  • sexual function not impaired
  • increased independence
  • improved comfort
23
Q

Cons of ISC catheters

A
  • requires good hand function/dexterity to hold and insert
  • does not prevent leakage between catheters
  • more difficult for females (paraplegic women difficulty undressing/dressing/positioning)
24
Q

Why is there increased independence with ISC catheters?

A
  • less reliance of healthcare professionals

- more activity options = sports/shorts/skirts

25
Q

NICE guidelines for indwelling catheters

A
  • LT catheterization carries significant risk of symptomatic UTI which can lead to more serious complications
  • should only be used after alternative methods of management have been considered
  • discuss with patient about risks vs. other management options (higher incidence of bladder stones!)
26
Q

EAU/EAUN guidelines

A

EUA (european association of urologists)
EAUN (european association of urology nurses)
- avoid indwelling transurethral catheterisation and suprapubic cystostomy when possible as associated with a range of complications as well as enhanced UTI risk
- indwelling only when clear indication
- first consider alternatives
- catheter is last resort when other options failed/proved to be insufficient
- to insert a catheter only for comfort of nursing staff is irresponsible

27
Q

Mitrofanoff ISC

A
  • procedure
  • relatively rare
  • allows increased independence, particularly for SCI women
  • create a continent channel using a piece of bowel/appendix
  • exits at the naval
  • combine with a neobladder
28
Q

What is a neobladder?

A

new bladder created from bowel

29
Q

What is an indwelling catheter?

A

Catheter left in place and held in bladder by water filled balloon
Also known as a Foley catheter
Opposite to intermittent catheter

30
Q

Why are UTI’s such a large problem?

A
  • costs NHS around £1 billion a year

- antibiotic resistance increasing (20% to trimethoprim and 40% to amoxicillin)

31
Q

What are suprapubic catheters designed for?

A

To overcome urethral trauma associated with urethral indwelling catheters

Bioengineering in Urology (8 decks)

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