In an ideal world no one would have a catheter - but the reality is that 100m patients world wide rely on an indwelling urinary catheter and they are badly served by the ubiquitous Foley design
Bladder management with a catheter is needed by a million people in the UK who have problems caused by inability to pass urine or excessive leakage; older people and those with a disability are most affected. People who use catheters need to have them changed at least every 3 months, but often much more frequently. Patients often experience problems, such as catheter-associated urinary tract infections (CAUTI), catheter blockages, leaking and bladder spasms [Wilde et al. 2016]. CAUTI are the most frequent nosocomial infections
[Jacobsen et al., 2008]. The financial burden has been estimated in the UK NHS to cost hundreds of millions of pounds, due to delayed discharge, staff resources and antimicrobial treatment [Davenport & Keeley, 2005; Plowman et al., 2001]. A better catheter would reduce CAUTI and could provide annual savings of £500 million in the UK, and $18 billion in the USA [Feneley et al. 2015].
What we've learned from more than 120 Community nurses caring for 2,500+ catheter patients...
- Infection; 48% of Foley users have been prescribed antibiotics for catheter associated urinary tract infections
- Blockage; 45% block within 4 weeks, 65% within 8 weeks and 90% within 12 weeks
- Leakage; 46% of patients suffer 'bypassing' (leakage)
Amazing video reveals the source of the problem...
Professor Roger Feneley has devoted his entire career to urology and catheter related problems in particular.... Here he narrates a video that clearly highlights the issues of the Foley design, with the soft bladder mucosa collapsing onto the hard tip of the catheter and even being sucked into the drainage eyes, being torn away and becoming an inherent focus for infection
Wilde MH, McMahon JM, Crean HF, & Brasch J (2016). Exploring relationships of catheter-associated
urinary tract infection and blockage in people with long-term indwelling urinary catheters. J Clin
Nurs. doi: 10.1111/jocn.13626.
Jacobsen SM, Stickler DJ, Mobley HLT, Shirtliff ME (2008). Complicated Catheter-Associated Urinary
Tract Infections Due to Escherichia coli and Proteus mirabilis. Clin Microbiol Rev; 21(1), 26-59.
Davenport K, Keeley FX (2005). Evidence for the use of silver-alloy-coated urethral catheters. J Hosp
Infect; 60(4); 298-303.
Cotterill N, Fowler S, Avery M, Cottenden AM, Wilde M, Long A, et al. (2016). Development and
psychometric evaluation of the ICIQ-LTCqol: A self-report quality of life questionnaire for long-term
indwelling catheter users. Neurourol Urodyn 35: 423-428.
Plowman R, Graves N, Griffin MA, Roberts JA, Swan AV, Cookson B, Taylor L (2001). The rate and cost
of hospital-acquired infections occurring in patients admitted to selected specialties of a district
general hospital in England and the national burden imposed. J. Hosp Infect; 47(3); 198-209.
Feneley RC, Hopley IB, & Wells PN (2015). Urinary catheters: history, current status, adverse events
and research agenda. J Med Eng Technol 39: 459-470.