The changes on the surface and within the lumen of a double-J catheter dependently on its maintenance in the urinary tract
Article published in Urologia Polska 2005/58/3.
Waldemar Różański 1, Leszek Klimek 2, Krzysztof Leńko 1, Rafał Kliś 1
- 1 Klinika Urologii i Rehabilitacji Urologicznej ICH Uniwersytetu Medycznego w Łodzi
Kierownik kliniki: prof. UM dr hab. Marek Sosnowski
2 Instytut Inżynierii Materiałowej Politechniki Łódzkiej
Dyrektor instytutu: prof. dr hab. inż. Piotr Kula
urinary tract, Double-J catheter, crystals and non crystal urinary components
- The aim of the study.
- The purpose of the study is to assess the grade of adherence of urinary crystals and organic urinary components to Double-J catheters dependently on the time of their maintenance in the urinary tract.
- Material and method.
- 27 Double-J catheters were subjected to macroscopic and microscopic evaluation. The time of their maintenance in the urinary tract ranged from 7 to 90 days. The catheters were inserted in 23 patients treated for urolithiasis and two patients due to urinary tract neoplasm and two due to the damage of the ureter during surgical operation. The evaluation of the surface and sections of the catheters was performed using a scanning electron microscope Hitachi S 3000N (Hitachi, Tokyo, Japan). To enhance the quality of scans the catheters were covered with a thin layer of gold Au-4N (99,99% Au). The covering, using a thermal technique, was conducted in a vacuum sputter coater Jeol Jee-4X (Jeol, Tokyo, Japan). Microscopic evaluation was performed with an accelerating voltage of 15 kV and under a pressure of 10-5 Pa. A magnification range was 30 to 18000x.
- In all 27 cases the surfaces of catheters were partially or nearly completely covered with organic or mineral urinary components. This process was developing with different intensity dependently on the time of catheter maintenance in the urinary tract and the presence of urinary infection. Crystals and organic components covered the surface of catheters and incrusted their lumens. It has been stated that catheters left in a urinary tract for 14 to 21 days are covered not only by organic urinary components but also by crystals, while those left in a urinary tract for 21 days or longer are covered by crystals of increased proportions. In 9 cases they caused a complete obstruction of a catheter and urine retention. If a catheter was kept in the urinary tract as long as 90 days the incrustation of a catheter's surface was observed in all patients.
- Urinary tract infection and long period of catheter maintenance in the urinary tract intensify the process of adherence of urinary crystals and organic urinary components to the surface of "Double-J" catheters. Another observed process is a gradual incrustation of catheters' lumens and the central canal which leads to catheter obstruction.
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