The present invention pertains generally to urethral catheters and more particularly to improved flow indwelling urinary catheters.
Urinary catheters have been available and used for decades to facilitate draining urine from a bladder in situations where a person is incontinent, has urethral obstructions, such as strictures, or to assist in urine drainage where the bladder muscle is, not functioning normally. Indwelling urinary catheters are typically delivered through the urethra and into the bladder. A distal end of the catheter is positioned above the bladder neck and a small balloon is inflated to retain the catheter in the bladder. Conventional urinary catheters, such as a Foley catheter, have become ubiquitous in the art and, typically, have a distal end with flow ports passing through side walls of the distal end of the catheter. These flow ports are typically positioned proximal to a distal tip of the catheter, leaving a relatively large distal portion of the catheter and typically have openings that are oriented perpendicular to the longitudinal axis of a flow lumen in the catheter with which the openings communicate.
A major shortcoming of conventional indwelling urinary catheters is that the inflow openings are either positioned a relatively great distance distally from the balloon and open perpendicular to the longitudinal axis of the drainage lumen in the catheter. This configuration leads to inefficient bladder drainage and occlusion of the inflow openings by the urethral walls as the catheter is being withdrawn from the bladder.
Mikhail et al. (U.S. Pat. No. 6,050,934) have disclosed an indwelling urinary catheter having a palpitatable multi-axial dome-type discharge valve with protective shoulders. The protective shoulders are raised above other unprotected portions of an outer surface of the valve. The valve wall is made substantially of a first material and each of the protective shoulders include an elongated thickness of a second material which is more rigid than the first material. The valve has a peripheral trough to maximize drainage. Valve openings traverse an arcuate pathway, and adjacent valve elements are separated by an intermediate rib to ensure a reliable closure. The catheter body in Mikhail et al. defines a central lumen extending from and communicating with Murphy Eye openings through the side wall of the catheter body.
However, the Murphy Eye openings in Mikhail et al. have a serious defect. Urine inflow ceases or dramatically slows down as soon the Murphy Eye openings pass into the bladder neck a short distance and are occluded by either the bladder neck tissue or the urethral tissue.
Vega (U.S. Pat. No. 4,249,536) teaches a flexible retention catheter that includes a soft, pliable cone-shaped tip with a reduced urethral contact surface defined by spiral grooves or hair-like projections. A magneto-insert embedded within the tip is used in cooperation with an electromagnet externally of the catheter to propel the catheter along the urethra by repulsive or attractive lines of magnetic force. The tip of the catheter is partially divided along one transverse line to form a hinged tip segment. The tip portion may also be divided longitudinally along a line intersecting with a transverse dividing line forming two hinged tip segments. The segments are releasably joined by releasable fasteners. The hinged tip segments are swung about the hinge connection against the inflated surface of the balloon by tension strips that extend along the balloon and move in response to a distention thereof to expose the drainage lumen within the tip. Other string actuators also traverse the balloon and elastically spread diametrically-divided end segments of a portion of the lumen to retain a segment of the catheter in situ in the urethra while the remaining portion of the lumen disjoined therefrom is withdrawn from the urethra. The implanted portion of the catheter is adjoined with an inflation lumen that extends along the length of the urethra. A collapsible sheath is adhered to the implanted segment in a fluid-conducting relation with the drainage lumen thereof.
Vega has designed drainage eyelets extending in the side wall of the tip to drainage lumen. However, the drainage eyelets in have the same a serious defect. Urine inflow ceases or dramatically slows down as soon the drainage eyelets pass into the bladder neck a short distance and are occluded by either the bladder neck tissue or the urethral tissue.
A recent attempt to address some of these disadvantages of the Foley catheter has been undertaken by The Flume Catheter Company (Suffolk, Great Britain) as exemplified in U.S. Pat. No. 10,195,394. The urine inflow openings of the FLUME catheter are positioned much closer to the proximal end of a channeled balloon than is found in the Foley catheter and some distance from the distal tip of the catheter. This position of the urine inflow openings, however, has been found to become easy occluded as the balloon is deflated for withdrawal or either or both of the balloon channels is not clear to allow urine flow to the urine inflow opening. Both of these situations lead to disadvantageous cessation of urine flow and inadequate bladder emptying.
It is an objective of the present invention to provide an indwelling urinary catheter in which inflow openings communicating with a catheter flow lumen are positioned a relatively minor distance distally from a catheter balloon.
It is a further object of the present invention to provide an indwelling urinary catheter in which the inflow openings are oriented on a distal facing bias and non-perpendicular relative to the longitudinal axis of the flow lumen.
It is a still further objective of the present invention to provide an indwelling urinary catheter having a generally conical distal tip, wherein the inflow openings are in the generally conical distal tip.
It is another objective of the present invention to provide an indwelling urinary catheter having a primary lumen for urine drainage and a secondary lumen for balloon inflation.
It is yet a further objective of the present invention to provide an indwelling urinary catheter having a tertiary lumen for delivery or withdrawal of fluids, such as drugs, that extends from a proximal end of the indwelling urinary catheter and open at a distal end of the indwelling urinary catheter.
It is yet a still further objective of the present invention to provide an indwelling urinary catheter that maintains patency of fluid flow into the flow lumen as the balloon is deflated and the catheter is withdrawn through the urethra.
It is yet another objective of the present invention to provide an indwelling urinary catheter that is configured to allow an increased volume of urine drainage from the bladder when it is placed in the bladder.
It is a further objective of the present invention to provide an indwelling urinary catheter that is configured to allow for an increased rate of urine drainage from the bladder when it is placed in the bladder.
It is still another objective of the present invention to provide an indwelling urinary catheter having a balloon with a shape and inflation capacity that is configured to decrease the bladder insertion distance of the catheter to achieve urine drainage from the bladder.
It is yet still another objective of the present invention to provide an indwelling urinary catheter wherein the balloon shape, inflation capacity, and positioning of the urine inflow openings of the urinary catheter are configured to increase the urine drainage volume and drainage velocity from the bladder, while increasing patient comfort while the urinary catheter is in place in the bladder.
It is still another objective of the present invention to provide a method of draining urine from a urinary bladder in which the urinary bladder is at least substantially emptied of urine and without appreciable urine load remaining within the bladder.
It is yet another objective of the present invention to provide a method of draining urine from a urinary bladder that includes the steps of placing the inventive indwelling urinary catheter within a urinary bladder through the urethra, inflating the balloon thereby securing the indwelling urinary catheter in the bladder and positioning the urine inflow openings superior to and adjacent a distal of the balloon, draining urine through the urine inflow openings and into a urine drainage lumen within the indwelling urinary catheter, and upon removal of the indwelling urinary catheter, maintaining urine flow into the urine inflow openings during removal of the indwelling urinary catheter to at least substantially empty the urinary bladder.
A feature of the present invention is that the catheter allows a continuance flow of urine during the catheter is withdraw in the urethra.
Another feature of the present invention is that the intra urethral leakage can be reduced or eliminated by reducing the balloon inflated volume.
The above features and advantages and other features and advantages of the present invention are readily apparent from the following detailed description of the best modes for carrying out the invention when taken in connection with the accompanying drawings.
The present invention is illustrated by way of example, and not by way of limitation, in the figures of the accompanying drawings and in which like reference numerals refer to similar elements. All the figures are schematic and generally only show parts which are necessary in order to elucidate the invention. For simplicity and clarity of illustration, elements shown in the figures and discussed below have not necessarily been drawn to scale. Well-known structures and devices are shown in simplified form, omitted, or merely suggested, in order to avoid unnecessarily obscuring the present invention.
The terminology used herein is for the purpose of describing example embodiments only and is not intended to be limiting. For purposes of clarity, the following terms used in this patent application will have the following meanings:
The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. It will be further understood that the terms “comprises,” “comprising,” “includes,” and/or “including,” when used herein, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof.
When an element or layer is referred to as being “on,” “engaged,” “connected,” or “coupled” to or with another element, it may be directly on, engaged, connected or coupled to the other element or layer, or intervening elements or layers may be present. In contrast, when an element is referred to as being “directly on,” “directly engaged to,” “directly connected to,” or “directly coupled to” or with another element or layer, there may be no intervening elements or layers present. Other words used to describe the relationship between elements should be interpreted in a like fashion (e.g., “between” versus “directly between,” “adjacent” versus “directly adjacent,” etc.). As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items.
Although the terms first, second, third, etc. may be used herein to describe various elements, components, regions, layers and/or sections, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms may be only used to distinguish one element, component, region, layer or section from another region, layer or section. Terms such as “first,” “second,” and other numerical terms when used herein do not imply a sequence or order unless clearly indicated by the context. Thus, a first element, component, region, layer or section discussed below could be termed a second element, component, region, layer or section without departing from the teachings of the example embodiments.
Spatially relative terms, such as “inner,” “outer,” “beneath,” “below,” “lower,” “above,” “upper,” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. Spatially relative terms may be intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “below”, or “beneath” other elements or features would then be oriented “above” the other elements or features. Thus, the example term “below” can encompass both an orientation of above and below. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
“Substantially” is intended to mean a quantity, property, or value that is present to a great or significant extent and less than, more than or equal to totally. For example, substantially vertical may be less than, greater than, or equal to completely vertical.
“About” is intended to mean a quantity, property, or value that is present at ±10%. Throughout this disclosure, the numerical values represent approximate measures or limits to ranges to encompass minor deviations from the given values and embodiments having about the value mentioned as well as those having exactly the value mentioned. Other than in the working examples provided at the end of the detailed description, all numerical values of parameters (e.g., of quantities or conditions) in this specification, including the appended claims, are to be understood as being modified in all instances by the term “about” whether or not “about” actually appears before the numerical value. “About” indicates that the stated numerical value allows some slight imprecision (with some approach to exactness in the value; approximately or reasonably close to the value; nearly). If the imprecision provided by “about” is not otherwise understood in the art with this ordinary meaning, then “about” as used herein indicates at least variations that may arise from ordinary methods of measuring and using such parameters. In addition, disclosure of ranges includes disclosure of all values and further divided ranges within the entire range, including endpoints given for the ranges.
Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the recited range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein.
References to “one embodiment,” “an embodiment,” “example embodiment,” “various embodiments,” etc., may indicate that the embodiment(s) of the invention so described may include a particular feature, structure, or characteristic, but not every embodiment necessarily includes the particular feature, structure, or characteristic. Further, repeated use of the phrase “in one embodiment,” or “in an exemplary embodiment,” do not necessarily refer to the same embodiment, although they may.
As used herein the term “method” refers to manners, means, techniques and procedures for accomplishing a given task including, but not limited to, those manners, means, techniques and procedures either known to, or readily developed from known manners, means, techniques and procedures by practitioners of the chemical, pharmacological, biological, biochemical, biomedical and medical arts. Unless otherwise expressly stated, it is in no way intended that any method or aspect set forth herein be construed as requiring that its steps be performed in a specific order. Accordingly, where a method claim does not specifically state in the claims or descriptions that the steps are to be limited to a specific order, it is no way intended that an order be inferred, in any respect. This holds for any possible non-express basis for interpretation, including matters of logic with respect to arrangement of steps or operational flow, plain meaning derived from grammatical organization or punctuation, or the number or type of aspects described in the specification.
This detailed description of exemplary embodiments makes reference to the accompanying drawings, which show exemplary embodiments by way of illustration. While these exemplary embodiments are described in sufficient detail to enable those skilled in the art to practice the disclosure, it should be understood that other embodiments may be realized and that logical changes and adaptations in design and construction may be made in accordance with this disclosure and the teachings herein without departing from the spirit and scope of the disclosure. Thus, the detailed description herein is presented for purposes of illustration only and not of limitation.
The present invention includes both an indwelling urinary catheter 10 and a method of at least substantially emptying a urine load from a urinary bladder without an appreciable urine load remaining within the bladder. In accordance with the method of the present invention, the method of draining urine from a urinary bladder includes the steps of placing the inventive indwelling urinary catheter within a urinary bladder through the urethra, inflating the balloon thereby securing the indwelling urinary catheter in the bladder and positioning the urine inflow openings superior to and adjacent a distal of the balloon, draining urine through the urine inflow openings and into a urine drainage lumen within the indwelling urinary catheter, and upon removal of the indwelling urinary catheter, maintaining urine flow into the urine inflow openings during removal of the indwelling urinary catheter to at least substantially empty the urinary bladder.
Turning now to the accompanying Figures in which exemplary embodiments of the present invention are illustrated and common reference numerals denote common features among the exemplary embodiments. Two main embodiments of the urinary catheter of present invention are illustrated in the accompanying Figures. A first embodiment is a two-way catheter 10, having a urine flow lumen and a balloon inflation lumen and a second embodiment is a three-way catheter 30, having three lumens, including a urine flow lumen, a balloon inflation lumen, and a tertiary lumen.
As illustrated in
A drainage port 18 is in fluid flow communication with the drainage lumen 24, shown in
While the inflow openings 20 may have a wide variety of transverse opening shapes in the plane of the distal tip 20, to maximize the open surface area of each of the inflow openings 20, the inflow openings 20 preferably have a transverse opening shape that conforms to the conical shape of the distal tip 16. The transverse opening shape of the inflow openings 20 may be substantially circular, elliptical, ovoidal, triangular, or the like that is configured to maximize the open area and urine inflow into the drainage lumen 24. In this manner, the open surface area of the inflow openings 20 at the surface of the distal tip 16 is configured to allow the greatest opening configuration to permit urine inflow into the inflow openings 20.
With particular reference to
The “X” dimension is determined the distance between bottom end of the inflow opening to the tip end of the catheter, and also the length of the conical shape. This dimension is variable and depends on the size of the drainage lumen. This is a design dimension for size 24 Fr catheter, that will be able to accommodate the size of the two inflow openings, which each one of them should have a cross section opening area is equal or greater than the cross-section area of the drainage lumen. Also this dimension was used as constant for guidance and to compare between the new design and Foley catheter. It is also used to shorten the neck of the catheter in order to almost empty the bladder of urine all the time and give the patient much more of comfort. None of the prior arts is determined the length of the conical shape.
Brief Summary of Table 1 as shown in
First condition: Balloon Deflated
S
PI
=M=K+2L & TPI=SPI+XPI
X
PI
=T
PI
−S
PI=40−33=7 mm
X
PI
=T
PI
−S
PI=30−23=7 mm
X
PI
=T
PI−(K+2L)=40−(25+2(4)=40−33=7 mm
X
PI
=T
PI−(K+L)=30−(25+(−2))=30−23=7 mm
The above equations can be used for all balloon inflated volumes settings, except at 10 ml balloon inflated volume, In this case the inflated potion of “M” is measured 21 mm and “K” as a fixed value=25 mm. Since M=K+2L Therefore 2L=M—K=(21−25)=−4 mm. and L=−2 mm
The distance between the bottom of the balloon to the bottom of the inflow opening is SPI. Hence (SPI=M=K+2 L), one of the “L” value is burred inside the bladder neck as it is shown in
SPI=M as the inflated potion plus the top portion of the uninflated (21+2)=23 mm
T
PI
=S
PI
+X
PI=32+7)=30 mm, and XPI=TPI−SPI=30−23=7 mm
Or XPI=TPI−K+L=30−(25+(−2))=7 mm
In summary: The following data are used only at 10 ml balloon inflated volume;
K=25 mm. L=−2 mm, SPI=K+L=23 mm, the actual expose value of M is 21+2=23 mm
While at 30 ml balloon inflated volume SPI=M=(K+2 L)=33=(25+2(4)=33 mm
T
PI
=S
PI
+X
PI=33+7)=40 mm, and XPI=TPI−SPI=40−33=7 mm
Where YF2, TF2, and Q2 are related to 2-way catheter, and YF3, TF3, and Q3 are related to 3-way catheter.
As shown in table 1,
As noted above, each of the inflow openings 20 has a distal facing bias. Each of the inflow openings 20 communicate with a fluid conduit 23, which, in turn, communicates with the drainage lumen 24 of catheter body 12. As shown in
It will be understood by those skilled in the art, therefore, that with both the two-way and three-way variants the indwelling urinary catheter 10, 30, respectively, of the present invention, the distal tip 16 and the inflow openings 20 are in far greater proximity to a distal end of balloon 14 than is found in conventional urinary catheters. This relatively closer approximation between the balloon 14 and the distal tip 16, positions the inflow openings 20 closer to the bladder neck relative to standard urinary catheters when the urinary catheter is properly positioned within the bladder.
A second embodiment of the indwelling urinary catheter 30 is a single unitary construct. It is illustrated in
In contradistinction to the standard indwelling urinary catheter 58, as illustrated in
In both the standard urinary catheters and the inventive urinary catheters, once the urine level in the bladder reaches the proximal end of the urine inflow openings 20, the urine flow will drain in a drop-wise fashion. If this condition remains for a period of time, solidification or crystallization of urine in the drainage lumen may occur. For example, during patient sleep cycles, the bladder will accumulate urine and with the patient in a horizontal position, the urine load level may not reach the level of the urine inflow openings 20 such that drainage will resume. As the patient assumes an upright position, the urine load will then reach the level of the urine inflow openings 20 and begin draining into the drainage lumen 24 A higher urine load level inside the bladder will result in a greater urine drainage flow velocity in the present invention, which will aid in flushing any solids or crystalline substances that may accumulate in the drainage lumen 24.
The same comparison is illustrated in
Thus, with respect to the Foley catheter, the present invention is advantageous in reducing the total length of the catheter inside the bladder. In one example of the embodiments of the invention, using the equation Q=TF−TPI. it can be calculated the catheter is capable of reducing the total catheter length inside the bladder by 17 mm for the two-way embodiment and 23 mm for the three-way embodiment when compared with a standard Foley catheter at different balloon inflated volume, as it shown in table 1,
Due to the generally ovular shape of the bladder, its widest dimension is intermediate the superior or inferior aspects of the bladder. Therefore, a reduction in the height of the urine load within the bladder does not directly correlate with the volume of urine drained from the bladder. A urine load height reduction of 1 mm at the center of the bladder is a greater reduction than a similar 1 mm urine load height reduction at the superior or inferior aspects of the bladder, both of which have smaller transverse cross-sectional areas. Based on that observation, a reduction of value of 8 mm or 10 mm in urine load height may present an empty bladder, except for residual urine around the balloon 14. Upon substantial drainage of urine from the bladder, any residual urine will have a very small volume due to its being located in the inferior aspect of the bladder. The height of a residual urine load in the bladder will depend upon the balloon capacity, which should not exceed 33 mm.
Under normal conditions, the bladder's muscular contractions will occur when the micturition response occurs, typically when the bladder is full and there is a need for urination. In this case, the muscular contractions of the bladder will force urine down into the urethral opening for drainage and an empty bladder. Where an indwelling urinary catheter is placed in the bladder, the patients discomfort occurs mostly from two factors: balloon size and a greater than normal amount of urine remaining in the bladder. These factors typically cause the urge to urinate more frequently. The muscular contraction of the bladder will raise the urine level around the balloon 14 periodically as will motion, such as walking or laying down. As these events occur, the urine will drain into the urine inflow openings 20 and drain into the urinary catheter 10. Because the bottom of the urine inflow openings 20 are positioned at substantially the same level as or below the superior balloon surface, urine will flow more readily and faster into the urine inflow openings 20. This will lead to at least substantially complete urine drainage from the bladder.
The prior art references are claiming, the proximal end of each urine inflow opening is even with or below a distal end of the balloon. But they did not give any details about the relationship between the balloon and the inflow opening. In this specification there are more specific details and clarification are provided. This specification claims, the urine inflow openings are at a distal end of the catheter body positioned such that the proximal end of each urine inflow opening is substantially even with or below a distal end of the balloon when the balloon is inflated. Table #2,
Moreover, the configuration of the inflow openings 20 both increases the urine flow rate and carry with any of the sloughed tissues (scabs) and/or any of the blood clots from the bladder, reduces the risk of solidification and blocking the catheter, eliminates the risk of the bladder wall being sucked into the inflow openings, and allows for drainage of urine as a result of the patient's normal movements. Further, as the balloon is collapsed and the catheter is being removed from the bladder, the flow of urine into the inflow openings 20 will continue until as long as the urethra remains patent during withdrawal. Where the balloon is partially collapsed, the muscular contractions of the bladder may drive the catheter into the urethra and, in conventional urinary catheters, either the balloon or the urethral walls will occlude the urine inflow openings 20 and cause stoppage of the urine into the drainage lumen. In the present invention, urine flow is maintained despite either full or partial collapse of the balloon or mispositioning of the catheter in the urethra. Overall, the foregoing advantages of the present invention will result in easier insertion into and through the urethra and into the bladder and less patient irritation and discomfort due to the greater bladder drainage and the increased velocity of urine flow into the drainage lumen.
When compared to the FLUME catheter, the present invention advantageously maintains urine flow when the balloon is collapsed, and the catheter is being withdrawn from the bladder and urethra. Further, because the balloon of the FLUME catheter is of a relatively large size and has two recesses or channels in the exterior surface of the balloon to channel urine to the urine inflow opening, that require the balloon to be folded over the distal tip, the risk of urine flow blockage is far greater than that with the present invention, leading to a greater risk of patient discomfort and irritation.
A study was performed to determine the impact of balloon capacity and balloon shape when inflated on the life span of the indwelling inflated balloon, the amount of urine remaining inside the bladder after drainage, balloon leakage and collapse, and patient acceptance. Five (5) samples each of silicon-elastomer coated latex Foley Catheters 24 Fr 30 ml balloon inflation capacity, manufactured by MEDLINE. Of both two-way (REF. #DYND11784) and three-way designs (REF. #DYND11804) were measured for physical dimensions of the following:
(1) Distance between two bonding lines of the balloon to the catheter; Measurement “K”; (2) Height of the inflated balloon; Measurement “M=K+2L”; (3) Extended length of the balloon beyond each bonding line; Measurement “L”; (4) Outer diameter of the inflated balloon; Measurement “N”; (5) Distance between the distal tip of the inventive catheter to the distal bonding line; Measurement “P=L+7 mm”; The dimensions in column “P” are intended to be exemplary and presented only as basic guidance to one skilled in the art to practice the present invention. (6) Distance between the bottom of the urine inflow opening to the proximal bonding balloon prior to balloon inflation; Measurement “S”; (7) Distance from the bottom of the each urine inflow opening to the proximal end of the inflated balloon at any inflation capacity in a standard Foley catheter; Measurement “YF=SF+L”; (8) Distance from the proximal end of urine inflow opening 20 to the proximal end of the inflated balloon at any inflation capacity in the inventive catheter; Measurement “YF=(SF+L)=(K+2L)=M” this equation is valid for all different setting of balloon inflated volume except when the balloon inflated to 10 ml volume (see section 0072 for more detail); (9) Distance from proximal end of urine inflow opening to the distal end of the distal tip in the inventive catheter; Measurement “X”; (10) Height of urine reduction inside the bladder; Measurement “Z=YF−M” this equation is valid for all different setting of balloon inflated volume except when the balloon inflated to 10 ml volume (see section 0072 for more detail); and (11) Ratio of urine reduction inside the bladder; Measurement “%=Z/YF”.
Brief summary of table 2 as shown in
Source of information are from
The condition: Balloon is inflated at different volume.
S=S
F & YF=SF+L
S
PI
=K+2L=M
Z=Y
F
−M Equation #1
Verification of value at 30 ml
Z
2
=Y
F
−M=41−33=8
Verification of value at 10 ml
Z
2
=Y
F
−M=35−23=12
Z=S
F
+L−M Equation #2
Verification of value at 30 ml
Z
2
=S
F
+L−M=37+4−33=8
Verification of value at 10 ml
Z
2
=S
F
+L−M=37+(−2)−23=12
Use this equation XPI=TPI−M Or M=TPI−XPI
Substitute M in this equation Z=YF−M
Z=Y
F−(TPI−XPI)
Z=Y
F—(TPI−XPI) Equation #3
Verification of value at 30 ml
Z
2
=Y
F—(TPI−XPI)=41−(40−7)=8
Verification of value at 10 ml
Z
2
=Y
F−(TPI−XPI)=35−(30−7)=12
Use this equation YF=SF+L
Substitute YF in this equation Z=YF−(TPI−XPI)
Z=S
F
+L−(TPI−XPI)
Z=S
F
+L−(TPI−XPI) Equation #4
Verification of value at 30 ml
Z
2
=S
F
±L−(TPI−XPI)=37+4−(40−7)=8
Verification of value at 10 ml
Z
2
=S
F
+L−(TPI−XPI)=37+(−2)−(30−7)=12
All the above four equations can be used to obtain the value of Z at any setting of the balloon inflated volumes The value of TPI at 10 ml inflated balloon volume was calculated differently as explained in section 0072
The value of Z at 10 ml and 15 ml balloon inflated volume are equal (12 mm for 2-way catheter and 14 mm for the 3-way catheter), but the position of the inflow opening at 10 ml inflated balloon volume is 2 mm below the position of the inflow opening at 15 ml inflated balloon. That will reduce tremendously the residual urine inside the bladder.
Where Z2 is the designation for the 2-way catheter, and Z3 is the designation for the 3-way catheter.
At 10 ml. inflation volume, the balloon was not inflated to its full geometry as shown in
This setting of 10 ml balloon inflated volume can be used to substitute any other setting of 30. 25. 20.15 ml in order to get the benefits of shorten the length of catheter by 2 mm inside the bladder plus increase the ability of the catheter to reduce the volume of the urine load within the bladder and increase patent comfort.
The height of urine reduction inside the bladder (Z=YF−M) this equation is valid for all different setting of balloon inflated volume except when the balloon inflated to 10 ml volume (see section 0072 for more detail); was calculated based upon the difference in distance between the bottom of the urine inflow opening in the Foley Catheter and the same measurement for the inventive catheter described herein.
Intra urethral leakage is a major issue in the catheter industry based on Mikhail et al (U.S. Pat. No. 6,050,934) Col. 1 line 41-53. The leakage phenomena, it is appear when the catheter outside diameter may not compatible to urethra inside diameter (the interference between them is insufficient). In this case during the bladder spasms and or bladder contraction some urine will leak out as a few drops or more of urine depend on the condition between the catheter outside diameter and the inside diameter of the urethra. That condition will cause a great of pain for the patient especially if the catheter was used after a surgery.
At the setting of 10 ml balloon inflated volume, the balloon is not fully inflated to its geometry, the maximum diameter of inflation will show up at the middle of the distance between the two bonding lines, then the diameter gradually will decrease to a point that shows a minor inflation at the bottom and top of the balloon (the balloon layer does not in contact with the catheter body), that will cause an slightly minor increase of the diameter at the both ends (like a soft couching). By pulling out the catheter 2 mm or slightly more until some kind of resistance is occurred, that action will help to seat the neck of the balloon inside the neck of the bladder properly. This action will create a firm interference between the bladder neck and the balloon neck. This interference will reduce or eliminate the intra urethral leakage between the urethra wall and the catheter body. See
In case of the balloon inflated at higher volume, the balloon is nesting in the bottom of the bladder, but the outer parameter of the balloon will raise up the neck of the balloon 0-4 mm from reaching the neck of the bladder as shown in table 2,
Inflating the balloon for the first time at 10 ml may not give a homogeneous shape (sometime the balloon is inflated on one side), therefore it is recommended, after the catheter is being inserted into the bladder. The balloon should be inflated to the maximum allowable value then deflated. Repeat this action at least twice in order to stretch the balloon layer and get a symmetrical shape along the longitudinal axis. then set the balloon to 10 ml inflated volume and secure it in place.
The Foley catheter balloon may be modified to change the distance between the two bonding lines of the balloon to the catheter (K) from 25 mm to 15 mm with the potential result in an additional approximately 6 mm of reduction in the urine level within the bladder after drainage (Z). A change in balloon length to 15 mm, together with the use of smaller inflation balloon capacities, may achieve some benefits similar to reduce the total length of the catheter, reduce the balloon size as inflated inside the bladder, reduce the weight of the inflated balloon on the bladder, increase the patient's comfort and increase the drainage of the urine flow that of using a shorter length and smaller diameter balloon. This changes, however, requires changes in manufacturing processes.
The data suggest that an inflated balloon with a capacity of 10-15 ml, rather than the 30 ml capacity of the Foley catheters, most improves urine drainage and control the intra urethral leakage if it exists. This same capacity reduces the hydrostatic stress on the control valve by about 50% relative to a 30 ml inflation volume, and the balloon at lower inflation volumes has less hydrostatic pressure on the balloon material, allowing it to be more pliable when in the bladder and able to accept normal micturition contractions of the bladder without adverse effects on the inflation control valve and/or the balloon wall itself. These factors result in increased lifespan and durability of the catheter balloon in the bladder, increased patient comfort and reduced patient irritation lending itself to a higher degree of patient compliance with the indwelling catheter and, therefore, allow the patient to have a more rapid recovery.
In some preferred embodiments of the present invention, the indwelling urinary catheter as shown in
As shown in
While the top position “A” of the urine inflow opening is typically located between “U” and “V”, the bottom position “W” of the urine inflow opening may be located below position “V”; at the same height or level of position “V”; or slightly above position “V.”
When the bottom position “W” of the urine inflow opening is located below position “V,” a part of the urine inflow opening passes through the lateral wall surfaces of the substantially frustoconical or conical distal tip. When the bottom position “W” of the urine inflow opening is located at the same height or level of, or above, position “V,” the entire urine inflow opening passes through the lateral wall surfaces of the substantially frustoconical or conical distal tip.
If measured along a measuring line that is perpendicular to the longitudinal axis of the catheter body as well as the longitudinal axis of the substantially frustoconical or conical distal tip, the urine inflow opening has a horizontal width that varies as the height of the measuring line varies. The horizontal width has a maximal value d at certain height, which is between the position “W” and the position “A.”
The height of the urine inflow opening Haw is defined as the height difference between position A and position W (for example 4 mm). The distance Duv is defined as the height difference between position U and position V. In particularly preferred embodiments, Haw is equal to or greater than 30% of Duv, 35% of Duv, 40% of Duv, 45% of Duv, 50% of Duv, 55% of Duv, 60% of Duv, 65% of Duv, or 70% of Duv. The maximal horizontal width d of the urine inflow opening is equal to or greater than 30% of catheter body diameter D, 35% of D, 40% of D, 45% of D, 50% of D, 55% of D, 60% of D, 65% of D, or 70% of D. The indwelling urinary catheter with these parameters can demonstrate numerous advantages over the prior art. For example, in the catheter as disclosed in Mikhail (U.S. Pat. No. 6,050,934) and Vega (U.S. Pat. No. 4,249,536), urine inflow ceases or dramatically slows down as soon its inflow openings pass into the bladder neck a short distance and are occluded by either the bladder neck tissue or the urethral tissue. In stark contrast, the distally biased orientation of the inflow openings in the inventive indwelling urinary catheter, causes the inflow openings to remain open and not become occluded by either the bladder neck or urethra as the catheter is being withdrawn even a relatively large distance, as compared to the known indwelling urinary catheter. In this manner, urine flow from the bladder and into the inventive indwelling urinary catheter remains continuous until either the muscles of the bladder or the bladder neck contract to seal off the bladder from the urethra.
Some of the prior arts are claiming that the taper end of the catheter will make the urine to continue to flow when the balloon inflated or even when the balloon deflated during the withdraw from the urethra, but they did not explain how that it is going to happened. In the above section there are more detail for this action.
If the end of the catheter is tapered to a point that its diameter is smaller than the inside diameter of the urethra after being shrunk down, that condition may allow some urine to be drained. In this case, it will be required the design of the tip of the catheter to be able to accommodate the diameter of the drainage lumen (the size of the drainage opening) and two wall thicknesses of the catheter body.
In the new design, the inflow openings are on the top of the conical shape that will allow the drainage to be continued even when the urethra inside diameter is smaller than what is shown in
Another situation, if the original diameter of the urethra is smaller than what is shown in
While the present invention has been described with reference to specific exemplary embodiments, it will be evident that various modifications and changes may be made to these embodiments without departing from the broader spirit and scope of the invention as set forth in the claims. Accordingly, the specification and drawings are to be regarded in an illustrative rather than a restrictive sense.
This non-provisional application is a Continuation-in-Part of U.S. patent Ser. No. 16/859,747 filed Apr. 27, 2020, the entire disclosure of which is incorporated herein by reference.
Number | Date | Country | |
---|---|---|---|
Parent | 16859747 | Apr 2020 | US |
Child | 18110735 | US |