Blister catheter

a blister catheter is a tube, which is brought either over the urethra (transurethral) or the abdominal walls (suprapubisch or abdominal wall catheters) into the bladder. It serves for to the urine derivative or urine production. The length becomes in centimeters and the thickness in Charrière (1 CH = 1/3 mm)indicated.

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history

already in the antiquity were possibilities well-known, disturbances thatTo repair emptying of blister by catheters. The oldest well-known blister catheters originate from finds in Pompeji and were manufactured made of metal (bronze). For the Aufdehnung of the urethra Oribasios from Pergamon ( 325-403 n used. Chr.) Pergament, which it wound around a goose keel. It led this Stäbcheninto the urethra and it let three days lie. By the humidity the Pergament poured to the urethra up and extended thereby the urethra. Later bronze catheters were put. Paulus of Ägina described n around 340. Chr. a method of the blister flushing. For this one became with liquidfilled cattle blister to a bronze catheter fastens. With pressure on the cattle blister one could rinse the blister out of the patient. The Arab physician Albukassin used n around the year 1000. Chr. a stamp syringe. Only in 19. Century differently formed catheters became from vulcanized india rubber of Amussat (1796-1852), Maisoneuve (1809-1894), Nelaton (1807-1873) and Mercier (1811-1882) manufactured. Couvelaire (1903) developed a special catheter, which still often applies beside the Tiemann catheter today after view at that time. Leopold Casper (1859 1959) developed a catheter, which holds itself by its construction in the blister. In the year1927 developed the American Urologe F. Foley (1891-1966) that today generally as continuous catheter used balloon catheter, internationally as Foley catheters designates.

kinds of catheter

a distinction can be met after design, material or intended purpose. The distinction is most common after targeted application in transurethrale continuous and a mark cathetersas well as suprapubische catheters. In the following the individual kinds are differentiated more exactly.

Transurethrale blister catheter

schematische Darstellung von transurethralen Kathetern
schematic representation of transurethralen catheters

Transurethrale blister catheter are brought over the urethra into the blister. One differentiates with respect to transurethrale once and continuous catheter (also staying catheter called). Continuous catheters are by oneholding at the point attached balloon.

Transurethrale continuous catheters

today are implemented all transurethralen continuous catheters as balloon catheters. Beside the different forms of its point and the number of openings one differentiates here additionally with respect to 2-Wege and 3-Wege catheter.

The 2-Wege catheter has a channelto the urine derivative and a channel for filling the balloon. This catheter is used particularly for durable urine derivative.

The 3-Wege catheter has third channel, which is used for bringing in of rinsing solutions beside the channels specified above still another. This catheter occurs in the urologyeverything after transurethralen operations and with strong bleedings in the blister to the employment. Sense here is it to prevent over the flushing a coagulating of the blood in the bladder. These catheters can be implemented with strengthened wall, thus an active blister flushing (e.g. Take off from Blutgerinnselnwith a blister syringe) to collapsing the lumen does not lead.

The filling channel of the balloon is equipped with a valve, in order to prevent an escaping of the block medium. As filling medium for the balloon sterile distilled water, sterile 0.5% saline solution come or special 10% Glycerinlösung for application.

Transurethrale a mark catheter

a mark catheter serve the urine production, the unique urine derivative and the intermittent self catheterism. These catheters have only one lumen. Special, mehrlumige a mark catheters find with urologischen special investigations like the blowing jerk measurement application.

Suprapubi blister catheters

the suprapubische blister catheterserves primarily the durable urine derivative. Contrary to the transurethralen blister catheter this is brought not over a natural opening to separate by the abdominal wall invasiv above the pubic bone into the bladder.

Suprapubi blister catheters are either 1-Weg catheter, those by a seam, or 2-Wege catheter,over a blockable balloon to be fixed.

This kind of catheter can also for urodynamischen investigation is used, since the closing muscle is not impaired here.

catheter materials

the catheter materials went through straight in the last years a very interesting development. In the early period became onlyrigid materials such as metal or glass uses, later then rubber, which was replaced today by other flexible materials such as Latex , PVC and silicone. Catheters of newest generation are partly provided with a hydrophilic coating, which increases the gliding ability additionally. Catheters for application of long-terms can alsobreath-thin coatings from diamond-similar carbon (diamond like carbon or DLC) to be provided, in order to minimize a germ settling. The selection of the material determines essentially also the Liegedauer of the catheter in the patient.

a closed

hollow point with two facing eyes possesses designs Nelaton of these cathetersand/or. four shifted eyes. This type of catheter can be used both for female and for male patients. This type represents probably häufigst applied design both for transurethrale and suprapubische applications.

Thiemann

of the Thiemannkatheter possesses a curved conical approaching hollow point, those at the endis easily thickened. The Thiemannkatheter possesses usually only one eye. By its form it is particularly suitable for the Katheterisierung of the male bladder, since the point leads the catheter better by the urethra. For female patients it is less suitable.

Mercier

of the catheters afterMercier is developed in the form nearly like the Thiemannkatheter, only that its hollow point does not approach conical and it shifted two eyes possesses.

Couvelaire

of the catheters after Couvelaire possesses an in front open flute point with two lateral eyes. Because of his large opening at the point becomesit frequently for blister flushings uses.

Dufour

of the catheters after Dufouer is nearly as formed as a Thiemannkatheter, only that he shifted two eyes and an in front open flute point possesses.

Glad Mueller

it possesses a closed hollow point with three laterally shifted eyes. The point is as withThiemannkatheter somewhat curved, tapers itself however not in the diameter.

Foley

of the catheters after Foley is actually a catheter with Nelatonspitze, only that he possesses a balloon for the adjustment of the catheter in the blister. In addition, other catheter forms become (e.g. Tiemann) as Foleykatheter uses.

Pezzer

The catheter after Pezzer orders a mushroom-shaped extension for the adjustment of the catheter in the blister at the end. The hollow point is in front locked, the mushroom-shaped Verdickung possesses on the front two eyes. This catheter is not no more used today practically, there it only assistance of a staffto be introduced could, which stretched the mushroom-shaped part.

Malecot

of the catheters after Malecot has a similar head form as the catheter after Casper. It has in front two wings, which could become strained with a staff only. This catheter finds today practically no more use.

Casper

The catheter after Casper has a head form similarly a four-bladed Quirl and thereby in the blister is fixed. This catheter ceases to apply today practically, since it only assistance of a staff could be introduced, that stretched the front part of the catheter.

Stöhrer

relatively more againCatheter is the Stöhrer catheter. The characteristic of this catheter lies in its flexible point, which approaches conical and possesses at the end a small spherical Verdickung. By this point the catheter leaves itself open particularly easily into the urethra to insert, there a lower pressure at the pointthe urethra mucous membrane is exercised. Again at this catheter are also the particularly formed eyes, which limit an injury of the mucous membrane to a minimum.

catheter sizes

the catheters become in different sizes of Charrière 6 - 30 and in lengths of 20 - 40cm offered and are characterized by a color code or by the print of the size. Since short also special catheters are available for women, who are much larger only about 10 cm long and therefore not than a Lippenstift.

Frequently used lengths:
Catheter for men: 40 cm
catheters for women: 20 cm
catheters for children: 30 cm


usual catheter sizes:
Men: 14 - 18 Charr.
Women: 12 - 14 Charr.
Children: 6 - 10 Charr.


Color code
Charr. Color Charr. Color Charr. Color
6 = brown 16 = orange 26 = ?
8 = blue 18 = red 28 = green
10 = black 20 = yellow 30 = grey
12 = white 22 = violet
14 = green 24 = darkblue

technology of the application of catheters

major item catheterism

fundamental is a catheter only sterile appliedwill, in order to avoid a germ kidnapping into the bladder. This danger however in principle always exists with urethra catheters, since in the urethra germs are settled always, which are then pushed or carried forward into the blister.

With transurethralen continuous catheters first a sliding gel is brought into the urethra.Subsequently, the blister catheter is introduced. Wenn der Katheter sicher in der Harnblase platziert ist, wird der Ballon mit einer Kochsalzlösung, Wasser oder einem Spezialmedium gefüllt. With a mark catheters one proceeds similarly, here gives it however also particularly coated catheters, with those a sliding gel not separatelyto be brought in must. These are particularly meant for the intermittent self catheterism.

Suprapubi blister catheters are brought in in local Narkose. First the bladder must be filled up. Subsequently, above the pubic bone the local Narkose is set. The needle is constantly put forward, until urine can be aspiriert.Now the catheter is stung over a hollow needle. Subsequently, the adjustment by a seam or the balloon with following sterile federation of the parting place is made.

see also

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