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Ben Franklin - politician, statesman, author, diplomat, and urinary catheterization hero.People have been using catheters to address urinary issues since before there were even urologists. There are historical texts from ancient Greek, Asian, and Syrian societies detailing the use of catheters in order to drain overful bladders, as early as 3,000 B.C. Throughout history, a variety of different materials have been used as catheters. Ancient Chinese used onion stalks, the Romans, Hindus, and Greeks used tubes of wood or precious metals, and the Syrians used wooden reeds. Malleable catheters began to be developed in the 11th century. Silver was an especially popular material choice for these, due to its antiseptic characteristics and flexibility.

The earliest American invention of the flexible catheter came during the 18th century from a person you might recognize – Benjamin Franklin. He invented silver catheters for his older brother John, who suffered from kidney stones and had to place a bulky metal catheter into his bladder daily. In order to ease the suffering of John’s daily catheterization, Franklin collaborated with a local silversmith for a flexible catheter design. He wrote to John that it would “readily comply with the turns of the passage,” and bored holes into the side to allow for drainage. Franklin developed the same condition later in his life, and likely used his own invention to self-treat.

Example of an early silver urinary catheter

Rubber catheters were developed in the 18th century, but initially performed weakly at normal body temperature and left debris in the bladder. The invention of vulcanized rubber in 1844 was able to increase catheter firmness and durability, and permitted them to be mass produced. Also in 1844, French physiologist Claude Bernard performed the first cardiac catheterization. He entered a horse’s ventricles by way of the jugular vein and carotid artery. This modern application of the catheter has definitely persisted, as this catheterization technique is still used by neurosurgeons, cardiologist, and cardiothoracic surgeons.

The introduction of latex rubber led urologist Frederic E.B. Foley to develop the first latex balloon catheter in 1935. Even though this type of catheter is commonly referred to as the “Foley,” Foley actually lost the legal battle for the catheter’s patent to Davol. The Foley catheter continues to be the longest-standing catheterization device. The first self-retaining catheters had wing tips or flexible shoulders, and were either tied to the penis or sutured to the labia. The modern disposable catheter came from David S. Sheridan in the 1940s. Sheridan has more than 50 patents for medical instruments, and also invented the modern disposable plastic endotracheal tube, now used routinely in surgery. He started and sold four catheter companies in his lifetime, and eventually came to be known as the “Catheter King” in Forbes magazine in 1988. (Not sure if that’s a title to be proud of…)

University of Michigan urologist Dr. Jack Lapides introduced sterile intermittent self-catheterization in 1971, as an enhancement to Foley catheterization. Self-cathing, though it may seem somewhat gruesome, was a significant improvement on management of neurogenic bladders and retention, as well as the patient’s life. There was now a method to self-cath completely cleanly to help avoid infections.

Now, there are many different styles, methods, and materials (including silicone rubber, nitinol, nylon, polyurethane, PETE latex, and thermoplastic elastomers) for catheterization. Silicone catheters remain to be one of the most common choices, because it is inert and doesn’t react to body or medical fluids. However, as a slightly weaker material, silicone is more likely to fracture than its counterparts like polyurethane. 

What would you like to see covered in my next MedTech Memoir? Contact me at sam.brusco@advantagemedia.com with your ideas!

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