US2936760A - Positive pressure catheter - Google Patents

Description

May 17, 1960 w. A. GANTS POSITIVE PRESSURE. CATHETER Filed Sept. 10, 1956 IN VEN TOR.

M'Z/z'a m A. 6B 7256 2,936,760 j I rosmvn'rnnssunn CATHETER William A. Gants, Barrlngton, .R.I., assignor to Dave] Rubber Company, a corporationof Rhode Island The instant invention relates generally to surgical rubber apparatus and the like and has particular reference to a novel catheter construction.

- A primary object of'the instant invention is the provision of a catheter particularly useful in connection with positive pressure urethrography:

urethraand 't herr introducing a contrast media under moderate pressure, whereby 'said media will pene' trate into any diverticula or lesions that exist in communi pressure urethrography technique to be effectively car- Anotherobject of my invention is the provision of a catheter 'whichwill permit the introduction of a contrast niedia, under pressure, into the urethra" while at the. same time closing both ends of the urethra, thereby preventing Still another object ofmy invention is the provisiomof ried out. My catheter will permit the introduction of a contrast media under pressure into the urethra, and at the same time, the presence of a fixed. balloon carried by the catheter and located within the patients bladder, in combination with'an eye on the catheter shaft proximal to this balloon, and in combination further with a sliding balloon on the catheter shaft, will permit the effective closure of both ends of the urethra. This insures that the contrast materials which are introduced into the urethra will be maintained therein without leaking' of same through eitherurethral orifice, which leaking would obviously render the whole technique ineffectual since the contrast media would then not be pressurized sufliciently' to penetrate into the various diverticular present within the urethra. At the same time, my catheter construction is such'that, although the ends of the urethra are effectively blockedfthere is no substantial. penetration into the urethral lumen by the balloons which function as the blocking means. Impingement of the balloons on the urethral lumen would result in the non-visualization of a positive pressure catheter which is simple and eeonorni-v cally feasible to manufacture but which, nevertheless ,.is

effective and durable in use. I I

Other objects, features and advantages of the invention will become apparent as the description thereof proceeds the portions of the urethra so covered land render the location of diverticula in those portions diflicult, if not impossible. i Referring'now to the drawings, the illustrated'cathe'ter generally designated at 10'i s preferably formed of flexible rubber, such as latex; and includes an elongated, generally when considered in connection with the accompanying illustrative drawings.

In the drawings which illustrate the best mode presently contemplated by mefor carrying out my invention:

Fig. l is a side elevation of a positive pressure catheter constructed in accordance with my invention, the balloons being in non-inflated condition;

.f Fig. 2 isa fragmentary sectlonal elevation, onan .en-

larged scale, of my improved catheteri; K

Fig. 3 is a section taken-on line 3-3 of Fig. 2; and

. ,ig, -4 is. a fragmentary sideelevation or'my catheter with both balloons in' distended position.

Suburethral diverticula in the female are thought by in existing cystoscopic and urethrographic diagnostic techniques. Existing techniques have proven particularly ineffectual in connection with the location of relatively small diverticula, which probably are much more common than the large ones, and which most frequently develop into large lesions. Thus it is of extreme importance that a diagnostic technique be available for the location of these relatively small diverticula, and to this end, it has been found that a relatively new technique, known as positive pressure urethrography, has met this need and has been found capable of demonstrating diverticula discovered at cystoscopy, as well as visualizing diverticula which have been overlooked at one or more cystoscopic examinations, despite careful scrutiny of the urethra with standard cystoscopic equipment.

Broadly speaking, positive pressure urethrography works on the principle of blocking off both ends of the cylindricaltubular body portion 12 having a main lumen orchannel 14 provided therein. Aninflatable balloonv 16 is provided adjacent the catheter distal end, said balloon overlying thebody portion 12 and being secured thereto by any desirable means, such as by ccmenting'or dipping, as'will be seen most clearly 'in Fig. 2. An inflatinglumen 18, also carried withinbody portion 12, communi+ cates with theballoon 16, whereby air or fluidunder pressure may be introduced into said balloon'to disten'd same.

Conventional outlets 20 and 22 communicate with thelumens 14 and 18,'respectively. V k

Aballoon unit 24 isslidably mounted on thebody portion 12 and includes a relatively thick centraltubular portion 26 having secured thereto by. any desirable means} such as cementing, anexpansible balloon 28," said balloon having arear extension 30, through which extends aninflation tube 32, whereby air or fluid under pressure may be introduced into theballoon 28 to inflate same. It will be noted that theballoon 28 is substantially triangular in cross section and that the base of the triangle is disposed toward the catheter distal end. It will further be noted that thebase end 34 of theballoon 28 is secured to the theballoon unit 24 as a whole may be slidably moved. alongbody portion 12 until the desired location of the.

balloon unit is achieved. Once theballoon 28 is dis tended, however, the pressure created by the inflation of the balloon will serve to maintain the unit in its desired FttenieaM 7, 19st;

40 is provided intubular body portion 12 intermediate theballoons 16 and 28, said eye communicating with themain lumenor channel 14. It has been .foundthat-best results are obtainedwhen theeyeldfl islocated adjacent the distal balloonlfi. I In operation and use, my catheter is inserted into the urethral tract so .that the'balloon 16 is positioned within the bladder, .and then said balloon is inflated with air. .The inflated bulb is drawn tight against the sphincter, or internal end of the urethra, and injection of the contrast media begun so as to clear the system of air and urine. As soon as reflux appears at the external meatus, or external urethra end, thesliding balloon 28 is advanced against the meatus and inflated, traction on the vesical balloon being maintained until inflation of the sliding balloon is completed. The injection of the contrast media can now be completed, an additional three or four cc. usually suflicing to distend and outline the urethra adequate'ly. Prior to injection'of contrast media, it is important to strip the urethra digitally, so as to evacuate any pockets of urine or pus present. After completion of the foregoing steps, radiographic study of the area involved will permit visualization of the diverticula present.

As will be obvious, it is important that theballoons 28 and 16 effectively block off the urethra orifices whereby to prevent any leakage of the contrast media, but at the same time, it is important that said balloons do not extend into the urethra for any substantial distance, since such a condition would cover up part of the urethral wall and thereby render visualization of diverticula located in this covered-up area impossible. For this reason, theballoon 28 is provided with its substantiallyflat bottom 34, which bottom is in alignment with the end 38 oftube 26, as aforedescribed. This particular configuration has proven to be extremely .efiective in connection with the blocking oif of the external urethra end. On the other hand, it

has been found that the contour of the bladder is suchthat a rounded balloon, such as 16, ismore effective in blocking off the internal urethra end. As will be obvious, the adjustability of theballoon 28 enables the catheter to be effectively set up and used in connection with diflerent individuals. 7

While there is shown and described herein certain specific structure embodying the invention, it will be manifest to those skilled in the art that various modifications and rearrangements of the parts may be made without departing from the spirit and scope ofthe underlying inventive concept and that the same is not limited to the particular forms herein shown and described except in so far as indicated by the scope of the appended claims.

I claim: v

1.. A positive pressure catheter comprising a tubular body portion having a longitudinally extending lumen therein, a first inflatable balloon carried by said body portion adjacent the catheter distal end, and aninflatable balloon unit slidably mounted on the body portion in spaced relation to said first balloon, the body portion having an inflation passage in its wall communicating with the interior of said first balloon, said inflatable balloon unit including a. flexible central tubular portion of appreciable Wall thickness slidable on the catheter body portion, a second inflatable balloon secured to said central tubular portion, an inflation tube communicating with theinterior of-said second balloon, and an eye in said catheter tubular portion located intermediate said first and second balloons and communicating with said longitudinally extending lumen. 1

2. A positive-pressure catheter comprising a tubular body portion having a longitudinally extending lumen therein, a first inflatable balloon carried by said body portion adjacent the catheter distal end, a second inflatable balloon slidablycarricd by said body portion in spaced relation with'said first balloon, and an eye in said tubular portion located intermediate said first and "second balloons and communicating with said longitudinally extending lumen,,said second balloon being of substantially triangular configuration and having its base end disposed toward the .catheterdistal end.- I

3. A positive pressure catheter comprising a tubular body portion having a longitudinally extending lumen therein, a first-inflatable balloon carried by said body-poi. tion adjacent the catheter distal end, and an inflatable balloon unit slidably mounted on the body portion in spaced relation to said first balloon,- the body portion having an inflation passage in its wall communicating with the interior of said first balloon, said inflatable balloon unit including a flexible central tubular portion of appreciable wall thickness slidable on the catheter body portion, a second inflatable balloonsecured to said central tubular portion, .an. inflation tube communicating with the in: terior of said second balloon, and an eye in said catheter tubular portionlocated intermediate said first and second balloons and communicating with saidlongitudinally extending lumen, said second balloon being of substantially triangular configuration andhaving its base end disposed toward thecatheter distal end.

4. 'In the catheter ofclaim 3, said second balloon base end beingsubstantially flush with the adjacent end of the central tubular portion.

References Cited in the file of this patent UNITED STATES PATENTS 2,547,758 Keeling A es, *1951' 2,642,874 Keeling June 23, 1953 2,687,131 Raiche Aug. 24, 1954

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