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Experience with a New Silastic Catheter
Tu:E:
Vol. 93. F~k Printed in U,S,A,
.Joi:-n~ '\L OF UJWLOGY
Copyright@ HJ65 by The Williams & ,Yilkins Co
EXPERIEKCE WITH A NEW SILASTIC CATHETER NORMA~ S. SHERWOOD* From the Department of Urolog?J, Division of Surgery, f,Vayne State University School of ilJedicine, and the Deirnii Receiving Hospitul, Detroit, Michigan
The purpose of thi,; papc:r is to present early results from the use of a designed silastic snJlrapubic rnthcier (f-ig. 1). The de~ign of thi.~ catheter :md its material offer advantages over prnvions suprapllbic cathc:Lern. The: catheter is silicone rubber, medical trade name sila.~lt, is completely inert in vivo, completely non-toxic. non-soluble: and non-wettable. This material has had some practical clinical applica
quently than a latex catheter, and 5) better tolerated the patient.
Lrr,
METHOD
At the present time 41 patient" have lmcl 28F indwelling suprapubic: silastic catheters for bladder drainage for periods up to 16 months. In the majority drainage was necessary beca11se of urethral stricture or prostatic obstructioP.
Fm. 1. No. 28F silastic catheter. Photo courtesy of Dow Corning Corporation, Midland, Michigc1n
tio11 in hurnnns for approximatc:ly 10 yearn. The to thrse catheters arc: l) they can be 2) their c::rne of insertion, 3) they lessen but do not completely eliminate the deof rnlcimn rnlts in tlw bladder uncl catheter, can be changed rousiderably less freAccc:pted for publication .July 21, l\JCi4. ·Read before Detroit Branch, American L;ro!uc., DC'trc,it, Michigar1,
logical Association, May 27, 1\l(i4.
* Present address: Cornmunitv Drive I\1eclica.l Center, J'v1anhassct, N. Y. ·· t Silastic, trade name of Dow Corning Corporai;ion, l\1idlnncL :\IichigarL
These suprapubic catheters were insert0d in che usual manner, stretching the tip on a standard stylet after it was well lubricated. In~ertion of this catheter was considerably easier thai1 the previously used No. 32F de Pezzer latex r:athetm~. Some patients who had been on for long time recognized a differnuce and anothe\r silastic catheter when the time came i;o make a change. Several bitterly corr,, plained of a burning sensation for tlw first tn days that was found to be seumdary to reRidua1 catalyst on the catheter rnrface. t.o 307
308
SHERWOOD
this discovery, no catheters were released until all the residual catalyst had been removed by the factory. RESULTS
Good results (32 patients) were interpreted to be: none to minin1al encrustation and tube change no more often than every 2 months, in one instance 14 months and in a number of others greater than 6 n10nths between changes. Fair results (5 patients) were interpreted to be: minimal to moderate encrustation and tube change at least every 2 months. Poor results (4 patients) were interpreted to be: marked encrustation and tube change more often than every month. The first 14 patients selected for use of the new catheter had been bothered by severe encrustation and had to have latex tube changes from 1 to 3 weeks for as long as 5 years. Of this group, 12 had good and two had poor results with the silastic catheter. Another 13 patients
had latex suprapubic catheters as long as 6 years with good toleration. The only difference with the silastic catheter was a longer than 6-week interval between tube changes, which was the usual interval with latex, and continued good results. The remaining 14 patients in this series all had the silastic catheter inserted at the time of the initial cystostomy. There were several cases of failure to tolerate the catheter and some others did not show any significant difference, but in a large number of cases, there ,vas a significant advantage to the use of this catheter in both convenience for the physician and the patient. SUMMARY
Preliminary results of a new suprapubic silastic catheter, which has been used for up to 16 months and seems to hold promise for long-term use in suprapubic drainage, have been presented. Further long-term studies are in progress.
Vol. 93. F~k Printed in U,S,A,
.Joi:-n~ '\L OF UJWLOGY
Copyright@ HJ65 by The Williams & ,Yilkins Co
EXPERIEKCE WITH A NEW SILASTIC CATHETER NORMA~ S. SHERWOOD* From the Department of Urolog?J, Division of Surgery, f,Vayne State University School of ilJedicine, and the Deirnii Receiving Hospitul, Detroit, Michigan
The purpose of thi,; papc:r is to present early results from the use of a designed silastic snJlrapubic rnthcier (f-ig. 1). The de~ign of thi.~ catheter :md its material offer advantages over prnvions suprapllbic cathc:Lern. The: catheter is silicone rubber, medical trade name sila.~lt, is completely inert in vivo, completely non-toxic. non-soluble: and non-wettable. This material has had some practical clinical applica
quently than a latex catheter, and 5) better tolerated the patient.
Lrr,
METHOD
At the present time 41 patient" have lmcl 28F indwelling suprapubic: silastic catheters for bladder drainage for periods up to 16 months. In the majority drainage was necessary beca11se of urethral stricture or prostatic obstructioP.
Fm. 1. No. 28F silastic catheter. Photo courtesy of Dow Corning Corporation, Midland, Michigc1n
tio11 in hurnnns for approximatc:ly 10 yearn. The to thrse catheters arc: l) they can be 2) their c::rne of insertion, 3) they lessen but do not completely eliminate the deof rnlcimn rnlts in tlw bladder uncl catheter, can be changed rousiderably less freAccc:pted for publication .July 21, l\JCi4. ·Read before Detroit Branch, American L;ro!uc., DC'trc,it, Michigar1,
logical Association, May 27, 1\l(i4.
* Present address: Cornmunitv Drive I\1eclica.l Center, J'v1anhassct, N. Y. ·· t Silastic, trade name of Dow Corning Corporai;ion, l\1idlnncL :\IichigarL
These suprapubic catheters were insert0d in che usual manner, stretching the tip on a standard stylet after it was well lubricated. In~ertion of this catheter was considerably easier thai1 the previously used No. 32F de Pezzer latex r:athetm~. Some patients who had been on for long time recognized a differnuce and anothe\r silastic catheter when the time came i;o make a change. Several bitterly corr,, plained of a burning sensation for tlw first tn days that was found to be seumdary to reRidua1 catalyst on the catheter rnrface. t.o 307
308
SHERWOOD
this discovery, no catheters were released until all the residual catalyst had been removed by the factory. RESULTS
Good results (32 patients) were interpreted to be: none to minin1al encrustation and tube change no more often than every 2 months, in one instance 14 months and in a number of others greater than 6 n10nths between changes. Fair results (5 patients) were interpreted to be: minimal to moderate encrustation and tube change at least every 2 months. Poor results (4 patients) were interpreted to be: marked encrustation and tube change more often than every month. The first 14 patients selected for use of the new catheter had been bothered by severe encrustation and had to have latex tube changes from 1 to 3 weeks for as long as 5 years. Of this group, 12 had good and two had poor results with the silastic catheter. Another 13 patients
had latex suprapubic catheters as long as 6 years with good toleration. The only difference with the silastic catheter was a longer than 6-week interval between tube changes, which was the usual interval with latex, and continued good results. The remaining 14 patients in this series all had the silastic catheter inserted at the time of the initial cystostomy. There were several cases of failure to tolerate the catheter and some others did not show any significant difference, but in a large number of cases, there ,vas a significant advantage to the use of this catheter in both convenience for the physician and the patient. SUMMARY
Preliminary results of a new suprapubic silastic catheter, which has been used for up to 16 months and seems to hold promise for long-term use in suprapubic drainage, have been presented. Further long-term studies are in progress.