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Research project: The role of bladder stretching in maintaining bladder health during long-term catheterisation

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Urinary catheters are frequently used in clinical practice to manage bladder dysfunction by facilitating drainage of urine via a catheter inserted into the bladder. However, catheter-associated complications, including urinary tract infection (which can lead to life threatening infection), bladder spasm and recurrent catheter blockage by mucoid and/or mineral deposits from urine, are very common. Long-term catheter use may also be linked to cancer.

Catheters are usually allowed to drain freely into a urine collection bag; but cyclical bladder filling and emptying reflects normal physiological behaviour more closely and can be achieved with a catheter valve. Our working hypothesis is that maintaining the normal cycle of stretching and relaxation of bladder tissue may help maintain a level of structural and functional integrity that will help minimise complications or help delay their onset. There is currently a lack of research evidence to guide clinical practice in catheter management and none which demonstrates the influence of cyclical stretching on bladder health. Improved maintenance of structural and functional integrity of the bladder may be a key factor in promoting clinical efficacy and cost-effectiveness by reducing the risk and impact of catheter associated complications on healthcare services and on patients’ health and quality of life. We intend to investigate this in two ways; (i) by analysis of urine and plasma markers in catheterised patients on free drainage compared to those using a catheter valve to enable cyclical filling; (ii) in laboratory studies using bladder tissue/animal models.

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