The indwelling Foley Catheter; an anachronism
The Simon Foundation for Continence was founded in 1982 by Cheryle Gartley to bring the subject into the open, remove the stigma surrounding incontinence and provide help and hope to the individuals. their families and their healthcare professionals. As President, Cheryle invited Roger Feneley, Calvin Kunin and David Stickler to the Foundations’ third conference in the series entitled Innovating for Continence: The Engineering Challenge in 2011, to talk about catheter drainage of the bladder. Their presentations each carried the same message that the design of the indwelling Foley catheter violated the integrity of the sophisticated defence mechanisms that protect the bladder from bacterial infection. The morbidity and mortality caused by the Foley catheter and their costs to health services are no longer acceptable. Research and Development of antimicrobial coatings alone will not resolve the problems of long-term catheterisation.
This meeting led to their publication ‘An indwelling catheter for the 21st Century’ in the BJUI. In an era witnessing outstanding technological advances in medical implants the simple task of draining urine from the bladder should be performed without producing infection and a range of associated complications. The cyclical filling and emptying of the bladder is crucial to the bladder’s defence against bacterial infection but the design of the Foley catheter with the drainage eyes in its protruding tip distal to the self-retaining balloon not only prevents the bladder from emptying completely but can seriously damage the integrity of the protective urothelial lining. Medical device manufacturers need to take up the challenge of producing a device which restores the function of the debilitated lower urinary tract without threatening its health.
This video explains the problem further.
The Simon Foundation’s 4th international conference, Innovating for Continence: The Engineering Challenge takes place this week in Chicago, IL
Dr David Stickler became interested in the problem of catheter-associated urinary tract infections in paraplegic patients at the Irish National Spinal Unit during his time as a lecturer in Trinity College Dublin in the early 1970s. Over the years as a reader in medical microbiology in Cardiff University he worked on many aspects of the problem from the fundamental biology of the bacterial biofilms that develop on catheters to the practical management of biofilm-induced catheter encrustation and blockage. Currently he is an honorary senior research fellow in the Cardiff University School of Biosciences.
Dr. Kunin received his MD from Cornell University College of Medicine in 1953. He is Emeritus Professor of Medicine at the Ohio State University and Clinical Professor of Medicine at the University of Arizona. He has a distinguished background in infectious diseases, antimicrobial pharmacology, hospital infection control, urinary tract infections and promotion of appropriate use of antibiotics. He has published over 350 scientific articles and a book on urinary tract infections. He is a past president of the Infectious Diseases Society of American, served on NIH and FDA advisory committees and is an honorary academic consultant to the National Health Research Institute in Taiwan.
Mr Roger Feneley is an Emeritus Consultant Urologist to the North Bristol NHS Trust and Visiting Professor in the Faculty of Applied Science at the University of the West of England (UWE). In 1998 he founded the BioMed Centre within the Bristol Urological Institute with the objective to improve the care of patients with intractable urinary incontinence. In 2009, he founded Alternative Urological Catheter Systems Ltd to develop new urine collection systems.
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