JPH02255155A - External urethral opening fixing type catheter to be retained in bladder - Google Patents

Abstract

PURPOSE:To eliminate the pain and uncomfortable feel of an anischuria patient and the restriction of his exercise and bodily movement by fixing the main tube of the catheter to the bladder and the urethral meatus by means of the balloons positioned in the bladder and the external urethral opening or a stopper and curving the tube in the vertical direction of the main axis. CONSTITUTION:The main tube 1 of the catheter has a shape to to draw a V shape or arc. Mounting of this tube in the case of a balloon type is executed by inserting the catheter 1 from the external urethral opening to toward the bladder and injecting a liquid first from a backflow preventive valve 5 to inflate the balloon 3, then injecting the liquid similarly from a backflow preventive valve 16 to inflate the balloon 14. As a result, the main tube 1 of the catheter is fixed by the inflating pressure of the balloons 3, 14. Mounting of the catheter of a stopper type is executed by inflating the balloon 3, then moving the stopper 10 to the margin of the external urethral opening and fixing the same. The pain at the time of the unavoidable bodily movement during mounting of the catheter to be retained in the bladder is, therefore, suppressed with either of these two types.

Description

[Detailed description of the invention] [Industrial application field] This invention is effective against bladder paralysis, urinary dysfunction, and urinary incontinence.

Medical aspects related to the management and treatment of paradoxical anuria.

This invention relates to a bladder indwelling catheter that is fixed to the external urethral meatus and was developed to solve various nursing and patient difficulties.

[Prior art] Bladder indwelling catheters that are widely used clinically today have a balloon at the tip of the catheter, as typified by the HoliDub, and this balloon can be inflated within the bladder. This catheter was developed to prevent the catheter from slipping out of the bladder and from being spontaneously removed, and to continuously excrete urine from the body (urine catheterization). This bladder indwelling catheter.

It is usually fixed on the inside of the thigh, and urine is directed into a urine storage container through an extension tube.

On the other hand, for occasional rather than continuous urinary catheterization, a method is widely used in which a single tube such as a Nelaton catheter is inserted into the bladder through the urethra and urine is measured.

However, as of today, no bladder catheter has been developed to deal with urinary incontinence, and the only way to deal with urinary incontinence is to barely dispose of incontinence and urinated urine using highly absorbent paper "diapers." ing. However, this method cannot be applied to people who lead a social life.

[Problem to be solved by the invention] Conventional bladder indwelling catheters as described above.

Catheters are usually inserted and removed on the bed or on the examination table, and in either case, the discomfort and pain associated with catheter insertion and removal are quite severe, and it is not possible for the patient to operate the catheter himself. It is possible.

Clinically, indwelling bladder catheters do not cause any inconvenience as long as they are used after surgery or in critically ill patients who require absolute bed rest.
This type of catheter can be used in patients who do not necessarily need bed rest, such as those with paradoxical anuria.

Needless to say, the patient suffers from the pain of having the catheter installed.
Mobility is severely restricted.

The basic rule is to rest on the bed while an indwelling bladder catheter is attached. This results in a decline in muscle strength and physical strength, and recovery of physical strength is one of the major treatment issues after long-term hospitalization. Furthermore, when an indwelling bladder catheter is worn for a long period of time, urine does not accumulate in the bladder, resulting in a decrease in bladder capacity, which is also a problem.

Recently, as the population ages, diseases specific to the elderly are increasing. Bladder paralysis, urinary dysfunction.

This includes urinary incontinence and paradoxical anuria.

In addition to this, the rapid increase in the number of so-called ``bedridden elderly'', such as senile dementia and patients suffering from half-body paralysis due to sequelae of cerebral hemorrhage, has become a social problem.

The biggest challenge in nursing, both in medical facilities and in home care, is the problem of excretion.

Countermeasures against excretion, especially urinary incontinence, such as the development and treatment of dermatitis on the vulva and entire genital area due to urinary incontinence, and washing of bedding and clothing, are the greatest demands of those involved in caring for the elderly.

In particular, women, whose urethra is anatomically shorter than men's, often incontinence after uterine cancer surgery or during exercise or during abdominal pressure loading, and bladder training is also effective. I often worry about not being able to play the song.

One effective way to manage urinary incontinence is to prevent leaking urine from being stored in the bladder, but this requires wearing an indwelling bladder catheter for a long period of time, which can lead to involuntary atrophy of the bladder. , resulting in frequent urination due to decreased volume after removal.

In order to rationally solve the above problems, it is necessary to provide patients with urinary incontinence with (1) no pain or discomfort, (2) exercise
Body movements are not restricted.

(3) Physiological bladder capacity can be maintained. (4) Able to urinate voluntarily. (5) There is a need to develop a device that does not leak.

[Means for Solving the Problems] In order to solve the above-mentioned problems, the present invention provides an indwelling catheter for the bladder by using an intravesical balloon (3) and a balloon (14) located at the external urethral orifice, or a stopper (10). The main tube (1) is fixed to the bladder and urethra, and the main axis is curved in the longitudinal direction to fit the vulva and the entire genital area, and the overall length of the catheter main tube (1) is shortened. This is a bladder indwelling catheter that is fixed to the external urethral meatus and is designed not to move due to body movements. In addition, by equipping the other end of the main catheter tube (1) with a two-way stopcock (6) that can be opened and closed, the patient or caregiver can urinate at any time and in a container as needed. The device was designed to be able to store urine in the bladder without causing urine leakage when closed.

The spacing between the main axes of the catheter main tube (1) of the balloons (3) to (14) is 3.-5 cm for women and 13-18 cm for men.

At the other end of the main catheter tube (1), its distal opening, which is equipped with a valve (6), a balloon (3), (14)
There are provided check valves (5) and (16), but it is desirable that these are bundled together by a cap (7).

However, if a stopper (10) is used instead of the balloon (14), the balloon (14) can be moved by moving the stopper (10).
) can be adjusted, so it can be used by both men and women, and there is no need for a check valve (16).

[Function] The external urethral meatus-fixed bladder indwelling catheter created as described above conforms well to the curvature of the vulva and becomes integrated with the vulva even when worn, so there is no discomfort when wearing it, tension caused by body movements, etc. Since no external force acts on the main catheter tube, you no longer feel pain.

[Example] Embodiments of the present invention will be described below with reference to nine drawings.

1 and 5 are detailed views of one embodiment of the present invention. As shown in FIG. 5, the present invention is characterized by a balloon (3) at the tip of the catheter main tube (1), unlike the conventional ones.
) toward the other end in the direction of the main axis, 3 to 5 cm (for women) or 13 to 18 cm (for men).
14) within the tube wall of the catheter main tube (1);
Or, after the injection path of the balloons (3) and (14) provided integrally with the catheter main tube (1) branches to the other end,
A two-way stopcock (7) for both opening and closing is attached to the end of the main catheter tube (1).
), and the catheter main tube (1) is equipped with a balloon (
14), and the length of the main catheter tube (, 1) at the other end of the catheter from the balloon (14) is short, within 100 cm, and backflow is prevented. It is also possible to include a cap that collectively encloses the valve (5), <16) and the distal end of the main catheter tube (1).

Note that the check valves (5) and (16) may each be provided with separate caps. In addition, the main catheter tube (1
) may be made of a flexible material that has the same effect without any special curvature.

Figure 1 shows a stopper (10) instead of a balloon (3).
, (13) represents the external urethral meatus fixed bladder indwelling catheter installed in the main catheter tube (1).

Since the stopper (10) can be freely moved in the axial direction, the interval between the inner urethra and the outer urethra can be adjusted freely. If a stopper is used, the thermal backflow prevention valve (1
6) becomes unnecessary. In addition, since the stopper (10) has a hole (12) smaller than the outer diameter of the main catheter tube, it will not slip down due to the elasticity of the main catheter tube.
It does not slide or move.

When using a catheter in the shape of a balloon (14), it is necessary to take into account individual differences in the length of the gap between the two balloons and create catheters in several stages for both women and men.

The catheter main tube, balloon, stopper, and other materials may be made of non-irritating soft resins, rubbers, silicone rubber, and other materials currently used for medical purposes. It is preferable to use a material that is as lightweight, flexible, and durable as possible.

In principle, the diameter of the main catheter tube (1) should match the diameter of the urethra, but when using it, choose a catheter with the smallest possible diameter.

In actual installation of the present invention, in the case of a balloon-type catheter, the catheter (1) is inserted into the bladder from the external urethral orifice in the usual manner, fluid is injected through the anti-reflux valve (5), and then the balloon (3) is inserted. Inflate, then reverse 1<C prevention valve (16)
Similarly, the balloon (14) is inflated by injecting liquid. As a result, the main catheter tube (1) is connected to the balloon (3).
, (14) is fixed by the turgor pressure.

In the case of a stopper type, after the balloon (3) is inflated, the stopper (1O) can be moved to the vicinity of the external urethral meatus and fixed therein.

Therefore, actual clinical examples have shown that any of the above techniques can suppress the pain that occurs when the body moves unavoidably while an indwelling catheter is attached to the bladder.

[Effects of the invention] When a conventional bladder indwelling catheter is attached, the external catheter fixed to the thigh is pulled by body movements, causing pain and discomfort to the internal urethral meatus and urethral mucosa due to friction and pressure. Ta. In other words, in conventional bladder indwelling catheters, the external urethral orifice is used as a fulcrum, and the point of action of external force applied to the catheter that is led out of the body for a long time is the mucous membrane of the bladder and urethra.

In the present invention, as a result of fixing the main catheter tube to the external urethral meatus with a flexible balloon (14) or a stopper (10), the fulcrum is on the outside of the balloon (14) or the stopper (10).

Also, the point of action has moved to the balloon (14) or stopper (10). Furthermore, the length of the main catheter tube is much shorter than that of a normal bladder indwelling catheter, and the catheter is in close contact with the vulva or the entire floor, so the external force applied to the main catheter tube is reduced to an almost negligible level. The main catheter tube (1) that comes out from the external urethral orifice is designed to draw a dogleg shape or an arc toward the distal end from the balloon (14) or stopper (10), so this curvature is caused by the main catheter tube. Since (1) is well adapted to the curvature of the vulva and all floors, it exhibits the effect of suppressing the external force applied to the main catheter tube (1) to a minimum.

The present invention can be fixed by simply wearing underwear or clothing without using any special fixing device 9 such as a bandage.

In men, the balloon (14) is located at the tip of the penis, but the balloon (14) is shaped so that it covers the glans penis, that is, it has a concave structure on the tip side of the main shaft. Good too. The stopper type is designed from the beginning to cover the glans penis, as shown in (13).

For women, balloons (14) and bust peaks (1)
0), (13) are located in the vulva, especially from the external urethral meatus to the vaginal vestibule. In the present invention, the distal end of the catheter does not necessarily have a male-like shape because it follows the curvature of the slit and the entire floor toward the anus. As long as the two-way stopcock (6) is closed, no hotbed is allowed. The principle is that the balloon (3) physically closes the internal urethral meatus in the bladder, and the closing effect is synchronized with the inflation pressure of the balloon (14) or the external urethral meatus compression effect of the stopper (10). balloon (14) or stopper (10)
Since the natural urethral meatus is closed, the hotbed prevention effect becomes even more reliable.

Due to this effect, the wearer of the present invention does not leak urine as long as the plug (6) is closed, so that urine accumulates in the bladder. If the patient feels the urge to urinate, the patient should place a two-way stopcock (
By opening 6), it becomes possible to urinate. Even if the patient is unable to open the stopper (6), the nurse or caregiver has the advantage of being able to open it at any time. It has become clear that the present invention can serve as an artificial penis with regard to urination.

Until now, long-term use of bladder indwelling catheters has caused unfavorable symptoms such as bladder atrophy, and for this reason, the range of applications of bladder indwelling catheters has been naturally limited. However, according to the present invention, bladder paralysis and urinary dysfunction.

Not to mention urinary incontinence and paradoxical anuria, senile dementia,
It is extremely effective for urinary incontinence that occurs in the lower half of the body due to the sequelae of cerebral hemorrhage.

It has become clear that this method can make a significant contribution in eliminating not only the pain of the patient but also the effort and effort of the nurses and caregivers.

The present invention is not limited to this, and has been proven to be effective in bladder cleansing using antibiotics, which has recently become rapidly popular.

That is, conventionally, antibiotics are injected from the external urethral orifice to treat nephritis, cystitis, etc. using an indwelling bladder catheter or urethral catheter.

With this method, the patient was forced to remain on the treatment table in a cramped position called the lithotripsy position, but with the present invention, the patient is not forced to remain in a humiliating position from the time of administration until the required time.

You can walk freely.

In addition, when this invention is installed, the external urethra and vaginal vestibule.

Alternatively, if a bactericidal/disinfecting ointment is applied to the glans, the applied ointment will remain locally for a long time and exert its disinfecting effect due to the diffusion prevention effect of the balloon (14) or the spray/par (10). Therefore, it effectively prevents upward infection and can be worn for a long period of time with a minimum number of sterilizations.

As described above, the external urethral meatus fixed bladder indwelling catheter according to the present invention can be expected to have the following effects.

(1) A bladder indwelling catheter, which has conventionally been unstable after installation, can be fixed.

(2) Pain and discomfort associated with wearing can be significantly reduced.

(3) Even when worn, it does not impair mobility and allows the person to return to society.

(4) No special fixing device is required when attaching the catheter.

(5) Hotbed, urinary incontinence can be completely prevented.

(6) No atrophy of the bladder due to attachment.

(7) Physiological bladder capacity can be maintained.

(8) Wearing it itself will train your bladder.

(9) Can be opened and closed at any time using the provided stopper.

You can urinate intentionally.

(10) During nursing and nursing care, bedding and clothing are prevented from being contaminated by urine, making it possible to maintain cleanliness without requiring human intervention.

(11) Since it does not contaminate the vulva and entire genital area of the patient who is wearing it, it is possible to prevent the development of dermatitis and sores due to urine infiltration.

(12) By using the present invention, it becomes possible to perform bladder irrigation with antibiotics without causing pain to the patient.

(13) The present invention exhibits particularly excellent effects in the care and nursing of "bedridden elderly".

(14) It prevents upward infection, enables long-term wearing, and minimizes the amount of management procedures required during that time.

(15) There is no need to wear paper diapers.

[Brief explanation of drawings]

FIG. 1 shows a stopper type external urethral meatus fixed bladder indwelling catheter. FIG. 2 is a cross-sectional view of the present catheter in plane A of FIG. FIG. 3 represents a side view of the stopper, and FIG. 4 represents a cross-sectional view of the catheter in plane B in which the stopper is located. FIG. 5 shows a two-balloon type external urethral meatus fixed bladder indwelling catheter. 6, 7, 8, and 9 represent cross-sectional views of the present catheter at C, D, E, and F, respectively. 1... Main catheter tube 2-- Bladder inner hole 3
・・・・−Tip balloon 4 −−−−−−One injection path 5−−−Return prevention valve 6 −−−−−−・
Two-way stopcock 7 --- Cap 8 ---
-----4 opening 9--- Balloon hole
10 ------- SFC Fever Ring 11 ----
--- Catheter main tube lumen (urinary tract) 12-
−−−−−− Stopper hole 13−−−−−−
Stopper wing 14-------Balloon 15-・
-Injection path 16- ・-Return prevention valve 17-・
・-・14 openings

Claims (1)

[Claims] (1) An open end made of flexible rubber or resin;
Alternatively, a balloon (3) is placed around the main catheter tube (1) at the distal end of the catheter main tube (1) having a hole, or adjacent to the distal end, and a balloon (3) is placed 3 to 5 cm axially from the main catheter tube (1), or 13 to 5 cm from the tip.
Independent balloons (14) were placed 18 cm apart, and each balloon (3)
, (14) is provided within the tube wall of the main catheter tube (1) or integrally with the main catheter tube (1), and is provided at the other end of the main catheter tube (1). This is a bladder indwelling catheter fixed to the external urethral meatus, characterized in that the injection paths (4) and (15) of the balloons (3) and (14) are branched or open. (2) The branch ends of the balloons (3) and (14) are equipped with check valves (5) and (16), respectively, and the distal end of the main catheter tube (1) is equipped with a two-way stopcock for both opening and closing, as well as a cap. (7) The external urethral meatus-fixed bladder indwelling catheter according to claim (1), wherein the distal end thereof has a shape to which an extension tube can be connected. (3) Alternatively, a balloon (3) is placed around the catheter main tube (1) at or adjacent to the tip of the catheter main tube (1), which has an opening or hole at the tip made of flexible rubber or resin. ), a trumpet-shaped or dish-shaped wing (13) that is movable in the axial direction around the main catheter tube (1), and a ring-shaped stopper (10).
A bladder indwelling catheter fixed at the external urethral meatus. (4) The penetration part (12) of the catheter main tube (1) at the center of the ring-shaped stopper (10) has a hole with a diameter slightly smaller than the outer diameter of the catheter main tube (1), and has a thick ring-shaped edge. An injection path (4) for injecting gas and liquid into the balloon (3) is provided in the wall of the main pipe (1), and branches or opens at the other end, and is connected to a check valve (5). and a cap (7), and a two-way stopcock (6) for opening and closing at the other end of the main catheter tube (1), according to claim (3). Indwelling catheter. (5) The main catheter tube (1) is characterized in that the shaft has a dogleg shape or a slight arc curve at the balloon (14) or stopper (10) portion. The external urethral meatus-fixed bladder indwelling catheter described in 1) and (3).