Unexpected urethral strictures after short-term catheterization in open-heart surgery

Area of Science:

• Urology
• Medical Devices
• Materials Science

Background:

• Urethral stricture is a potential complication following medical procedures.
• Indwelling catheters are commonly used in post-operative care, particularly after open-heart surgery.

Purpose of the Study:

• To investigate the cause of a high incidence of urethral strictures in male patients post-open-heart surgery.
• To determine the role of indwelling catheter material in the development of urethral strictures.

Main Methods:

• Retrospective analysis of patient data for urethral stricture development.
• Urethrograms to characterize stricture morphology.
• In vitro cell toxicity assays comparing latex and silicone catheter materials.
• Measurement of cell proliferation via thymidine incorporation.

Main Results:

• 59 out of 478 male patients developed urethral strictures after open-heart surgery.
• Strictures often presented as a "string-of-pearls" or long penile urethral narrowing.
• Symptoms included burning pain and dysuria, appearing after catheter removal.
• The incidence of strictures ceased after switching from latex to silicone catheters.
• Latex catheter eluates demonstrated significant cell toxicity in vitro, unlike silicone.

Conclusions:

• Indwelling latex catheters used during open-heart surgery were associated with a high rate of urethral strictures.
• The toxicity of latex catheter material is implicated as the causative factor.
• Silicone catheters represent a safer alternative, preventing this adverse event.