Leakage associated with urinary catheter usage: a design challenge

Indwelling bladder catheter-associated leakage, or catheter bypassing, is a frequently experienced problem, necessitating a carefully planned intervention. Once a bladder catheter is in place, urine may flow intermittently between the catheter shaft and the urethra mucosa, or from around the catheter when inserted suprapubically. A review of the literature identified several reasons for this leakage, including catheter size and anatomical abnormalities. Based on clinical experience, the authors posit that indwelling catheter leakage may also occur as a result of a catheter design flaw. This article provides the theoretical rationale for this hypothesis and a potential solution; formal, rigorous, and appropriate research should be performed to test the hypothesis.