INTRODUCTION AND OBJECTIVES: Foley catheters are assumed to drain the bladder to completion. We have previously shown that dependent loops along the drainage tubing create air-locks, which obstruct antegrade urine flow and result in un-drained residual bladder urine. We hypothesized that drainage characteristics of Foley catheters remain poorly understood by urologists and general surgeons. We conducted a nationwide survey of general surgery and urology training program faculty and residents, to assess perceptions of Foley catheter drainage. We designed a novel catheter drainage tube/bag that eliminates air-locks. METHODS: An anonymous illustrated questionnaire assessing Foley catheter use patterns and perception was sent to general surgery and urology residency programs (N=108) nationwide. A modified catheter drainage tube/bag unit was designed and tested. An ex vivo catheterized bladder model was designed to measure and compare urine drainage rates with the standard drainage system, versus with our novel design. RESULTS: A total of 307 responses were collected from residents (55%) and faculty (45%); responses were similar among both groups (p<0.05). The majority reported that at their centers Foley catheter drainage tubes are generally positioned with a dependent loop (94.1%), and, that positioning with a dependent loop, versus without (78.1%) promoted optimal drainage. Antegrade drainage does not occur with a traditional drainage system when a >5.5 inch dependent loop in place. With our proposed design, which eliminates dependent loops, the bladder model emptied to completion consistently. CONCLUSIONS: Traditional Foley catheter drainage systems, as commonly used, evacuate the bladder sub- optimally. More reliable and complete bladder drainage may decrease the incidence of catheter related UTI. The novel modified Foley catheter drainage tube/bag design presented here eliminates dependent loops, to optimize antegrade drainage.
INTRODUCTION AND OBJECTIVES: Foley catheters are assumed to drain the bladder to completion. We have previously shown that dependent loops along the drainage tubing create air-locks, which obstruct antegrade urine flow and result in un-drained residual bladder urine. We hypothesized that drainage characteristics of Foley catheters remain poorly understood by urologists and general surgeons. We conducted a nationwide survey of general surgery and urology training program faculty and residents, to assess perceptions of Foley catheter drainage. We designed a novel catheter drainage tube/bag that eliminates air-locks. METHODS: An anonymous illustrated questionnaire assessing Foley catheter use patterns and perception was sent to general surgery and urology residency programs (N=108) nationwide. A modified catheter drainage tube/bag unit was designed and tested. An ex vivo catheterized bladder model was designed to measure and compare urine drainage rates with the standard drainage system, versus with our novel design. RESULTS: A total of 307 responses were collected from residents (55%) and faculty (45%); responses were similar among both groups (p<0.05). The majority reported that at their centers Foley catheter drainage tubes are generally positioned with a dependent loop (94.1%), and, that positioning with a dependent loop, versus without (78.1%) promoted optimal drainage. Antegrade drainage does not occur with a traditional drainage system when a >5.5 inch dependent loop in place. With our proposed design, which eliminates dependent loops, the bladder model emptied to completion consistently. CONCLUSIONS: Traditional Foley catheter drainage systems, as commonly used, evacuate the bladder sub- optimally. More reliable and complete bladder drainage may decrease the incidence of catheter related UTI. The novel modified Foley catheter drainage tube/bag design presented here eliminates dependent loops, to optimize antegrade drainage.