You may not know what a catheter is unless you needed one for a medical condition. This big word simply means a thin, hollow tube.
Folks in medieval Europe discovered they could insert a thin, hollow tube made from gold, white lead, or copper into a body cavity, duct, or vessel. They developed all kinds of catheters for specific purposes.
For example, the inability to pass water (urinate) was a common male ailment hundreds of years ago. (Urinary retention was, and still is, a rare condition in women.)
A blocked bladder could be the result of syphilis, kidney stones, or bladder problems. To relieve the extreme pain and suffering, a urinary catheter was inserted through the patient’s urethra and on to the bladder for drainage.
Medieval doctors fabricated flexible catheters from palm leaves and leather which could be straight or curved.
The use of catheters to ease both incontinence and other urinary retention problems, as well as for drainage, actually goes back more than 3500 years ago. The word comes from Greek, meaning (appropriately) “to thrust into” or “to send down,” but the earliest record of using a catheter to treat urinary retention has been found on an ancient Egyptian papyrus (paper) dated 1500 BC. They used bronze tubes, reeds, straws and curled-up palm leaves.
The process of inserting a catheter is called catheterization. Not only can they drain pus or backed-up fluids from the body, they can be used to administer fluids or gases, as well as provide access by surgical instruments.
An indwelling catheter is left inside the body after surgery, either on a temporary or permanent basis. The latter is also termed a permcath. Most people with impaired bladder function can perform clean intermittent self-catheterization as an alternative to indwelling.
Today, as described by Medical Design & Outsourcing, the humble catheter helps by “treating life-threatening lesions, scraping calcified plaque off arteries, reshaping our hearts, delivering new artificial valves and snaking into our brain to prevent fatal aneurysms.”
The urinary catheter used today was designed in 1929 by Frederic Foley and bears his last name. It is an indwelling catheter inserted by a clinician.
The catheter’s tube separates into two channels, called lumens. One lumen is open at both ends and drains urine into a collection bag. The other lumen has a valve on the outside end which connects to a balloon at the inside tip. When filled with sterile water, the balloon keeps the catheter in place. Foley catheters are typically made from silicone or coated natural latex.
The downside of the Foley catheter, according to the U.S. National Library of Medicine’s National Center for Biotechnology Information (NCBI), is that it “can cause bacterial colonization, recurrent and chronic infections, bladder stones and septicaemia, damage to the kidneys, the bladder and the urethra, and contribute to the development of antibiotic resistance.”
The NCBI takes a dim view of the Foley catheter because complications from its use are costing lives (about 2100 die annually) and billions of dollars. The organization is calling for a new and better device.
Help is on the way – from across the Big Pond. British General Practitioner (GP) Dr. John Harvard from Suffolk began designing a new catheter in 2013. He created The Flume Catheter Company Limited and partnered with specialist engineering developers Arrotek Medical.
This year (2018), Flume is finalizing the new catheter’s design and getting ready for independent lab testing before government approval and clinical trials. The company expects to roll out their invention no earlier than 2019.
The Flume catheter was designed to help the 100 million people suffering worldwide from the negative side effects of the now-outdated Foley catheter. The new device claims to eliminate blockages, reduce leakage, and lower the incidence of infection from “the Foley’s sump of festering urine.”
Specifically, the Flume catheter eases:
• Bladder spasms
• Bladder bruising
• Bladder Mucosal Tears
• Residual Urine
Another catheter break-through comes from engineers at North Carolina’s Duke University who have developed “a new urinary catheter design that can eliminate nearly all of the hard-to-kill biofilm from the catheter’s walls.”
Biofilms are structures formed by bacterial colonies. They protect and harbor harmful bacteria which cause infections. The catheter developed at Duke uses physical forces to dislodge potentially infectious biofilms by flushing them out with the urine.
A third innovative catheter called the OptiVein system integrates optical fiber with an electronic unit to place peripheral intravascular (IV) catheters, a process called cannulation. It is “is routinely performed to enable delivery of medications and fluids, as well as to allow sampling of blood.”
A full third of first attempts to insert an IV catheter fail, causing the patient pain and increasing medical costs. There are several dire complications that can result from improper catheterization.
The OptiVein uses “transillumination of skin tissue to aid in cannulation.” The thinking behind this technology is that “visual confirmation is the core element to verify successful placement of the needle in the vein.”
Here’s how the OptiVein system works to guide the medical practitioner to the precise location for the tip of the insertion needle:
“The electronic unit generates visible light, which is released from the tip of the needle into the soft tissue around the tip of the IV catheter. Light is visible through the skin and helps mark the location of the tip of the needle under the skin and against the vein.”
All these innovations are incredibly ground-breaking and demonstrate that modern medical researchers are thinking about very old problems in very new ways.