The Liss maneuver: a nonendoscopic technique for difficult Foley catheterization

Area of Science:

• Urology
• Medical Devices
• Minimally Invasive Procedures

Background:

• Difficult male catheterization is a common clinical challenge.
• It often necessitates bedside cystoscopy, an invasive and expensive procedure.
• A simpler, less invasive alternative is needed to facilitate catheter insertion.

Purpose of the Study:

• To describe and evaluate a new technique for difficult male catheterization.
• To determine if a Super Stiff guidewire can increase Foley catheter stiffness.
• To assess if this maneuver can obviate the need for cystoscopy.

Main Methods:

• A 0.035-inch Amplatz Super Stiff guidewire was inserted into an 18F Foley catheter.
• The guidewire was clamped to impart stiffness to the catheter.
• Bending force and tip strength of various Foley catheter sizes were measured using a force gauge.

Main Results:

• The Super Stiff guidewire increased average catheter body stiffness by 359%.
• Catheter tip stiffness remained unchanged.
• The technique was successful in 5 out of 6 patients, failing in one with an undiagnosed urethral stricture.

Conclusions:

• The Super Stiff guidewire technique effectively enhances catheter stiffness for navigating tortuous male urethras.
• This maneuver offers a less invasive alternative to cystoscopy for difficult catheterizations.
• If unsuccessful, the guidewire can aid in subsequent endoscopic procedures.