A Comparison of Intermittent Urinary Catheter Flow Rates - IUPUI

A Comparison ofIntermittent UrinaryCatheter Flow RatesDeborah McWilliams* MSN, RN, CPNP,Kathleen Carroll* BSN, RN, CNN,Kerrie Quenneville** MSN, RN, FNP-BCChildren’s Hospital of Michigan, Department of Urology*,Henry Ford Hospital, Vattikuti Urology Institute**Detroit, Michigan

Children’s Hospital of Michigan‣ CHM is a free standing,232 bed pediatricteaching hospital inDetroit• Urology Clinic cares forchildren with complexcongenital & acquiredconditions in the inpatient& ambulatory settings

Objectives‣ Discuss factors that impact catheter flowrates‣ Be able to educate patients and caregiversregarding appropriate expectations ofcatheter flow rate

Purpose of the StudyThis study is to determine if there is arelationship between urinary catheterintraluminal diameter (Fr size) and flow rateof catheterized urine.

Background‣ It is a common belief among clinicians thaturinary catheter flow rates increase as theFr size increases.‣ For patients who require clean intermittentcatheterization (CIC) for bladder management,faster flow rates may result in less time spent ontoileting.‣ More efficient bladder emptying may increasepatient satisfaction and improve quality of life(QOL).

Literature Review‣ One study of 3 – way catheter flow rates among variedcatheter sizes and manufacturers demonstratedsignificantly faster flow when manually irrigating thedrainage ports of #18 Fr and #20 Fr Rusch® catheterswhen compared with other brands (Manikandan et al,2009).‣ None of the catheters demonstrated increased flow rateswith increased Fr size when draining an artificial bladder.‣ Intermittent urinary catheters and pediatric sizes werenot included in the study.

‣ Artificial bladderMethods‣ 38 Mentor® and LoFric® catheters‣ Coude and straight tip 16 inch catheters weretested. All other catheters were straighttipped.‣ Flow rates were measured with a stopwatchand the mean was calculated for eachcatheter size and style.

Methods

Outcome‣ Dependent variable was catheter flow rate‣ Each catheter was compared with theother 37 catheters

Results‣ Increased flow rates were demonstrated with each incrementalcatheter size increase, however, statistical significance was notnoted until the 12 Fr was evaluated.‣ Faster flow rates were associated with larger intraluminal diameterand catheter length.• Comparison of flow rates with the short catheters (

Discussion‣ Catheter flow rates increased with catheterlength and intraluminal diameter.‣ Statistical significance was not demonstrateduntil the catheter size was increased to 12 Fr,however, the increased flow rate with largercatheter size may improve patient satisfaction.‣ Faster catheter flow rate may increase patientadherence to a clean intermittent catheterization(CIC) regimen and maximize bladder health andquality of life.

Implications‣ Awareness of catheter properties that mayenhance urinary drainage can be used toindividualize the catheter prescription forpatients who perform CIC.‣ Knowledge of catheter properties can aidin educating patients and caregiversregarding appropriate expectations ofcatheter flow rates.

Implications‣ Future research is needed to:• evaluate flow rates of catheters of multiplemanufacturers• test larger number of catheters• compare flow rates between straight andcoude tip catheters• evaluate the impact of catheter flow rate onpatient adherence to CIC and perceived QOL

Acknowledgements‣ Dr. Yegappan Lakshmanan, MD,Chief, CHM Urology‣ Dr. Jack S. Elder, MDChief, Vattikuti Urology Institute, HFHS‣ Hitomi Kobayashi, PhD, RNDirector, Center for Excellence in Pediatric Nursing‣ Ronald Thomas, PhDBiostatistician‣ Laborie Medical Technologies Corporation

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