F- CLINICAL ASPECTS OF SPINAL CORD INJURIES
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3 occlusion of the lumen of the catheter by distortion of the balloon inflated eccentrically,
4 failure of the balloon to deflate when required.
These observations are in accordance with our own with this type of catheter. The
failure of the balloon to deflate when required necessitated either bursting the balloon
by overdistension, which is a bad method, as fragments of the rubber give rise to calculus
formation later, or dissolving the latex of the balloon by ether or chloroform, which
unless sterile paraffin was introduced into the bladder gave rise to irritation of the
mucosa. Before puncturing the balloon by surgical procedure, it is worthwhile trying
to pull the inflated balloon slowly and gently through the urethra. As Dr Melzak at
Stoke Mandeville repeatedly found, this gradually dilates the urethra to some extent and
changes the balloon's shape into a sausage-like elongation due to the elasticity of its wall.
In recent years rubber catheters have been replaced more and more by plastic catheters
which cause far less allergic reaction than occurs with rubber catheters in certain hyper
sensitive patients.
A more serious though rare complication of prolonged indwelling catheter drainage
is the pressure of the balloon within the bladder against the symphysis in women who
spent the whole day sitting in their wheelchair. The combined prolonged pressure from
the pelvic floor on the one hand the pressure from the balloon within the bladder on the
other may lead to a destruction of the symphysis resulting in separation of the ossa pubis
2-9-65
14-2-66
19-1O-66
26-1O-67
FIG. 160.
