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

Figures & data

Figure 1 Transurethral catheter safety valve. The red tab should be pulled before using the valve.

Figure 2 Transurethral catheter safety valve is attached to the balloon inflation channel of a Foley catheter. A 10 mL syringe filled with sterile water is connected to the safety valve.

Table 1 Summary Sheet of the Evaluation Form for the Use of the Safety Valve

Question Number	Description	Findings
Q1	Type of the catheter used	Bardex: 21 cases	Silicone: 22 cases	Not recorded: 1 case
Q2	Size of the catheter: Size 12 CH	1	2	–
	Size 14 CH	8	7	1
	Size 16 CH	12	13	–
Q3	Was the balloon inflated and deflated prior to insertion of the catheter in the urethra?	Yes: 41	No: 3
Q4	Any difficulty in inserting the catheter?	Yes: 5	No: 39
Q5	Any bleeding while inserting the catheter?	Yes; 2	No: 42
Q6	How many attempts were made to insert the catheter?	1
Q7	How many health professionals attempted to insert the catheter?	1
Q8	Did urine come out of the catheter when the catheter was inserted?	Yes: 23	No: 21
Q9	Was there leakage of water from the safety valve when the balloon was inflated?	Yes: 3	No: 41
Q0	If there was leakage of water from the safety valve, what was done?
Q10	The balloon was deflated	Yes: 2	No: 1
Q11	The catheter was removed	Yes: 2	No: 1*
Q12	A senior nurse/doctor was called	Yes: 0	No: 3
Q13	Did a health professional insert a finger in the rectum to stretch the anal sphincter and guide the catheter?	Yes: 2 in two other patients	No: 3
Q14	Was the catheter inserted per urethra by the senior health professional?	Yes: 3
Q15	Was there leakage of water from the safety valve during this attempt at insertion of a catheter by the senior health professional?	Yes: 1**	No: 1***

Notes: * The senior nurse felt that the catheter was in proper place; therefore, the nurse decided to leave the catheter in place. Subsequently, the catheter drained urine; there was no bleeding per urethra. Probably, the transurethral catheter safety valve was defective. Unfortunately, the safety valve could not be checked because the used transurethral catheter safety valve had been discarded in the bin. ** The catheter was removed and then reinserted. Leakage of water from the safety port of the trans urethral catheter valve was observed once again. The transurethral catheter safety valve was disconnected from the catheter. Water was injected as though the balloon of the catheter was being inflated. There was leakage of water through the safety port when water was injected. Leakage of water when the valve was not connected to a catheter confirmed that the safety valve was defective. *** Absence of leakage of water through the transurethral catheter safety valve following removal and reinsertion of the catheter in this case illustrates that the safety valve prevented a mishap. The safety valve alerted the health professional to misplacement of the catheter. The safety valve stopped inflation of the balloon of the Foley catheter by the health professional and prevented urethral trauma. Thus in one out of 44 catheter insertions, the catheter had been misplaced and the safety valve protected the patient from developing urethral trauma. This is the real value of the transurethral catheter safety valve.