Logo for the Journal of Rehab R and D

Volume 45 Number 4, 2008
   Pages 639 — 646

Abstract - A 24-hour feasibility study of intraurethral valved catheter for bladder management in males with spinal cord injury

Bradley G . Orris, MD;1-2 Andrew E. Jahoda, MD;1-2 James S. Walter, PhD;2-3* Bernard N. Nemchausky, MD;4 Rafael Wurzel, MD;5 Harvey D. Homan, PhD;5 Sally Melloy, LPN;3 John S. Wheeler, MD1-2

1Department of Surgery, Edward Hines Jr Department of Veterans Affairs (VA) Hospital, Hines, IL; 2Department of Urology, Loyola University Medical Center, Maywood, IL; Departments of 3Research and 4Spinal Cord Injury, Edward Hines Jr VA Hospital, Hines, IL; 5Urovalve, Inc, Newark, NJ

Abstract — This feasibility study was conducted to evaluate design features of the novel intraurethral valved catheter, Surinate (Urovalve, Inc; Newark, New Jersey). The device extends from the bladder neck to just beyond the external sphincter and contains a valve that can be activated by an external magnet for bladder emptying. Five patients were recruited from the Edward Hines Jr Department of Veterans Affairs Hospital spinal cord injury population. We conducted cystometry and cystoscopy to evaluate the lower urinary tract. Then, the device was inserted for 24 hours with careful monitoring. The catheter was removed from the first patient because he developed autonomic dysreflexia during implantation. The next four patients used the catheter overnight and tolerated it well: one with independent use and two with increased abdominal pressure. Emptying time was 208 +/- 99 s, residual was 42 +/- 33 mL, and the first-stream flow rate was 1.8 +/- 0.7 mL/s. The safety tether was used in three patients because the extraction device did not work. Results showed effective implantation and stability of the device in the urethra. However, objectives for use and extraction were not met. This feasibility study provided important information that will help guide design improvements for the intraurethral valved catheter.

Key words: catheterization, cystometry, cystoscopy, intraurethral valved catheter, neurogenic bladder, rehabilitation, spinal cord injury, urinary incontinence, urinary retention, UTI.

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