Possible Use of a Safety-Valve with a Foley Catheter During Catheterisation of Male Spinal Cord Injury Patients for Prevention of Urethral Trauma Caused by Inflation of the Catheter Balloon in the Urethra

Abstract

We used a safety-valve (Trans-Urethral Catheterisation Safety Valve, Class Medical, Limerick, Ireland) to prevent urethral trauma due to inflation of the anchoring balloon in the urethra during catheterisation of male spinal cord injury patients in a spinal unit. The safety-valve is attached to the balloon channel of a Foley catheter. If the balloon is inflated when it is in the urethra, the pressure valve is activated. Any fluid pushed into the balloon channel leaks out and balloon inflation stops, indicating that the balloon is not inside the bladder. The safety-valve was used in 44 catheterisations. There was leakage of water during three catheterisations. In the first case, the health professional did not inflate and deflate the balloon prior to its use. This “pre-valve inflation” step overcomes the baseline resistance pressure of the balloon and prevents fluid leaking from the valve when the catheter is in the correct position. In the second instance, the valve was found to be defective. In the third case, the catheter had been misplaced; it was removed and repositioned; there was no leakage of water during inflation of the balloon. In one out of 44 catheterisations, the catheter had been misplaced; leakage of water from the safety-valve stopped inflation of the balloon and prevented iatrogenic urethral trauma. The safety-valve may be used during catheterisation of male patients in the spinal unit to prevent urethral trauma caused by inflation of the balloon of Foley catheter in the urethra. However, health professionals should remember the few shortcomings of the catheter safety-valve.

Keywords:

• spinal cord injury
• urethral catheterisation
• patients
• iatrogenic
• catheter
• urethra

Data Sharing Statement

All relevant data are provided in the manuscript. Details of individual patients such as names, date of birth, NHS number were removed to maintain confidentiality of the patients.

Ethical Statement

This study was approved by the Clinical Audit and Effectiveness Office of the Southport and Ormskirk Hospital NHS Trust vide audit number 22–154 “Audit on the use of transurethral catheter safety valve”. The use of the catheter safety valve was approved by the New Interventional Procedures, Techniques and Advancing Practice Committee of the Southport and Ormskirk Hospital NHS Trust. The safety valve was shown to the patients, the authors discussed how the safety valve worked and the potential benefit of using a safety valve and the shortcomings including the cost of the safety valve. Following the discussion, the patients gave verbal informed consent to use the safety valve during urethral catheterisation. No patient declined. This audit is a shared venture between the health professionals and the patients. This study complies with the Declaration of Helsinki.

Acknowledgment

The authors are grateful to Mr Niall Davis, Consultant Urological Surgeon, Royal College of Surgeons in Ireland, Tissue Engineering Research Group, Dublin, Ireland for valuable comments; Dr Hugh Flood, Chief Medical Officer, Class Medical, Unit 1 D, Annacotty Business Park, County Limerick, Ireland for online discussion; Mr James Wright, Managing Director, MedTech Connect Ltd, Saint Helens, England for providing the safety valves for this study. The authors are most grateful to Mr James Wright for payment of the article processing fee for this manuscript.

Disclosure

All authors declare no conflicts of interest in this work.