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Urology. 2017 Apr;102:266.e1-266.e5. doi: 10.1016/j.urology.2017.01.022. Epub 2017 Jan 25.

Does Size Matter? Measured and Modeled Effects of Suprapubic Catheter Size on Urinary Flow.

Author information

1
Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, OH.
2
Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, OH; Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH. Electronic address: GillB@ccf.org.
3
Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, OH; Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH.

Abstract

OBJECTIVE:

To quantify the effects of catheter size and urinary sediment on catheter drainage, and to determine the French size at which catheter upsizing yields a diminished marginal return in flow.

MATERIALS AND METHODS:

Latex Foley catheters (12-26 French [Fr]) were connected to a simulated bladder. Passive drainage times of 450 mL water were measured over 5 successive trials for each catheter size. The effect of sediment was modeled by adding 2g of infant rice cereal to the water. Measurements were repeated in half-length catheters to assess the effect of catheter length. A computational model of resistance was compared to measured data. Percent differences in catheter resistance based on measured catheter dimensions were determined.

RESULTS:

Catheter resistance significantly decreased (P < .001) with increasing catheter size. All catheter sizes had significantly faster (P < .001) drainage times after being shortened, except for the 16 Fr catheter. All catheter sizes exhibited significantly prolonged (P < .001) drainage times after the addition of sediment, except for the 16 Fr catheter. Beyond 18 Fr, larger catheter sizes provided diminishing marginal returns in flow; upsizing from 18 Fr to 20 Fr reduced measured resistance by 19%, which was the lowest improvement in resistance between 2 catheter sizes. The coefficient of determination (R2) between measured and modeled resistances was 0.9754, confirming that the model of catheter performance was accurate.

CONCLUSION:

Marginal improvement in urine flow occurs with catheter upsizing after 18 Fr; however, shortening catheter lengths may serve as another means of improving flow.

PMID:
28131923
DOI:
10.1016/j.urology.2017.01.022
[Indexed for MEDLINE]

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