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TissueDB/Simulators/Urinary Catheterization Simulator (Gillis)

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General Information

Figure 1 by Gillis et al. 2020, CC BY 4.0 (Cureus 12(5):e8377).

The Urinary Catheterization Simulator (Gillis) is a low-cost 3D-printed model for undergraduate Foley catheter passage training.[1] The build combines a PLA bladder, a Grey Pro SLA valve at the bladder neck, a 178 mm × 7 mm silicon urethral tube, and Smooth-On 00-30 silicone external genitalia. A 1/8 inch (3.2 mm) acrylic front window enables visual confirmation of catheter advancement and balloon inflation. The valve provides a mechanical resistance gradient that the source authors describe as representative of breaching the internal urethral sphincter.[1]

Field Details
General Information A low-cost 3D-printed simulator for undergraduate urinary catheterization training. The simulator is positioned as a low-fidelity alternative for pre-clerkship workshops where commercial catheterization mannequins are scarce or cost-prohibitive.[1] It is a second-generation iteration of an earlier design by the same authors published in the Dalhousie Medical Journal in 2019, with first-generation feedback incorporated.[2] Components include FDM-printed PLA on an Ultimaker 3 (bladder, base, curved barbed urethral connector) and SLA-printed Grey Pro resin on a Formlabs Form 2 (threaded insert and one-way bladder-neck valve). Smooth-On 00-30 platinum-cure silicone forms the external genitalia, a 178 mm × 7 mm silicon tube forms the urethra, and silicone caulking seals a 1/8 inch (3.2 mm) acrylic bladder front window.[1]
Features and Basic Operation A water-fillable PLA bladder discharges through a screw-in Grey Pro valve at the bladder neck. The valve gives modest mechanical resistance during catheter passage that the source authors describe as representative of breaching the internal urethral sphincter. Once the catheter advances past the valve, water drains through the catheter; the operator then inflates the Foley balloon, which seats against the bladder neck. A 1/8 inch (3.2 mm) acrylic front window lets learners and instructors confirm catheter advancement, balloon inflation, and seating position visually. The Smooth-On 00-30 silicone external genitalia are deformable enough to be gripped, retracted, and angulated during insertion. The printed base supports future swap-in of pathologic geometries such as a urethral stricture or enlarged prostate.[1]
Current Development Status Built and tested via a face-validity workshop with 64 pre-clerkship medical students; the source authors explicitly state no construct-validity claim, no comparator group, and no objective performance measure.[1]
Estimated Build Time and Cost Not stated in source.[1], ~US$25.[1]
Specialized Tools and Equipment Ultimaker 3 fused-deposition-modelling (FDM) 3D printer for the PLA components (20 per cent infill, 0.2 mm layer height). Formlabs Form 2 stereolithography (SLA) 3D printer for the Grey Pro resin components.[1]
Version Second-generation iteration.[1]
Development Team Contact Information Charlie J. Gillis (corresponding author; charliejgillis@gmail.com), Department of Urology, Dalhousie University, Halifax, Canada. Co-authors at Medical Education and Simulation, Memorial University of Newfoundland and the MUN Med 3d Laboratory, St. John's, Canada.[1]

Tissues

Tissue Qty Material Cost Notes
Bladder PLA-printed bladder body and base (1; reusable) Polylactic acid filament at 20 per cent infill and 0.2 mm layer height; 1/8 inch (3.2 mm) acrylic front window sealed with silicone caulking ~US$5 Holds water during catheter passage; the acrylic front window lets learners and instructors confirm catheter advancement past the valve, balloon inflation, and seating position visually.[1]
Urethra Silicon urethral tube (1 length; reusable until perforation) Silicon tubing, approximately 178 mm length × 7 mm internal diameter; proximal end seats onto a curved barbed FDM-printed PLA connector at the Grey Pro valve ~US$5 178 mm length and 7 mm internal diameter are within adult-male urethral parameters; the proximal seal to the valve is the path along which the catheter encounters the mechanical sphincter feedback.[1]
Penis Smooth-On 00-30 silicone cast (1; reusable) Smooth-On 00-30 platinum-cure silicone, cast for the external genitalia ~US$10 Shore 00-30 durometer is soft enough for the operator to grip, retract, and angulate the penile shaft during insertion; cast geometry is not parameter-quantified in the source.[1]


Structural Parts

Part Name Qty Material Cost Notes
Ultimaker 3 3D printer 1 (institutional equipment; reusable) Fused-deposition-modelling (FDM) 3D printer for the PLA bladder body, base, and curved barbed urethral connector at 20 per cent infill and 0.2 mm layer height Equipment (not part of per-unit consumable cost) The FDM platform for all PLA components of the simulator; per-component print time is not stated in source.[1]
Formlabs Form 2 SLA 3D printer 1 (institutional equipment; reusable) Stereolithography (SLA) 3D printer for the Grey Pro resin threaded insert and one-way valve body Equipment (not part of per-unit consumable cost) The SLA platform for the Grey Pro resin components; layer height and resin print parameters are not stated in source.[1]
Grey Pro resin Print volume per unit not stated in source Formlabs Grey Pro photopolymer resin for the SLA threaded fitting at the bladder base and the screw-in one-way valve body at the bladder neck ~US$5 Produces the SLA structural components that form the one-way bladder-neck valve; the valve body gives the mechanical sphincter feedback during catheter passage.[1]
Acrylic sheet (1/8 inch / 3.2 mm) 1 piece per unit, cut to the bladder frontal aspect 1/8 inch (3.2 mm) clear acrylic sheet ~US$3 Forms the transparent front window of the bladder for visual confirmation of catheter advancement and balloon inflation; brand or manufacturer not stated in source.[1]
Silicone caulking Quantity not stated in source Standard silicone caulking ~US$2 Provides the watertight seal between the acrylic front window and the PLA bladder body.[1]
Adhesive Quantity not stated in source Adhesive (type and brand not stated in source) ~US$1 Holds the SLA threaded fitting in the PLA bladder base and the FDM curved barbed connector in the Grey Pro valve body; type, brand, and quantity not stated in source.[1]


Build Instructions

The source paper describes the fabrication and assembly workflow at Gillis 2020 p.3 columns 1 to 2 (Materials And Methods).[1] Before beginning, gather the PLA filament, Smooth-On 00-30 silicone, Grey Pro SLA resin, silicon urethral tube of approximately 178 mm length and 7 mm internal diameter, 1/8 inch (3.2 mm) acrylic sheet, silicone caulking, and adhesive.

Phase 1: Print the PLA components on the Ultimaker 3

  1. Print the bladder body and integrated base on the Ultimaker 3 in PLA at 20 per cent infill and 0.2 mm layer height per the source-stated parameters.
  2. Print the small curved barbed urethral connector tube on the same FDM platform in PLA. This connector mediates the join between the screw-in Grey Pro valve body and the silicon urethral tube.

Phase 2: Print the SLA components on the Formlabs Form 2

  1. Print the threaded insert (the SLA-grade fitting that will be glued into the bottom of the PLA bladder) in Grey Pro resin on the Formlabs Form 2.
  2. Print the one-way valve body (the SLA-grade screw-in component that seats into the threaded insert and provides the mechanical sphincter resistance) in Grey Pro resin on the same platform.

Phase 3: Cast the external genitalia in Smooth-On 00-30 silicone

  1. Cast the external genitalia in Smooth-On 00-30 platinum-cure silicone over a prepared mould to produce the soft external structure of the simulator.

Phase 4: Cut and seal the bladder front window

  1. Cut the 1/8 inch (3.2 mm) acrylic sheet to the dimensions of the bladder frontal aspect.
  2. Place the cut acrylic sheet in the frontal aspect of the bladder so that catheter advancement and balloon inflation will be observable from outside the simulator.
  3. Apply silicone caulking around the acrylic-to-bladder interface to create a watertight seal.

Phase 5: Assemble the bladder valve, urethra, and external genitalia

  1. Glue the SLA-printed threaded insert into the bottom of the PLA bladder using the assembly adhesive.
  2. Screw the SLA-printed valve body into the threaded insert. The valve body now seats at the bladder neck and provides the mechanical resistance the operator will encounter when advancing a catheter from the urethra into the bladder.
  3. Glue the small curved barbed FDM-printed PLA connector into the bottom of the valve body using the assembly adhesive.
  4. Slide one end of the silicon urethral tube over the barbed connector. The barbed geometry secures the urethral tube to the valve body without an additional clamp.
  5. Integrate the Smooth-On 00-30 silicone external-genitalia cast with the urethral tube so that the meatus end of the silicon tube emerges through the external genital structure for learner access during catheter insertion.

For learner-facing setup, water-fill protocol, operation between learners, reset procedure, and stepwise procedural instruction (sterile-technique preparation, meatus identification and lubrication, Foley catheter passage along the urethra, valve resistance recognition, intravesical balloon inflation, urine-flow confirmation through the acrylic window), refer to the corresponding SELF Module for urinary catheterization training and to Gillis and colleagues 2020.[1]



References

[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 Gillis CJ, Bishop N, Walsh G, Harvey D (2020). "Evaluation of a Novel 3D-Printed Urinary Catheterization Simulation Model in Undergraduate Medical Teaching." Cureus 12(5):e8377. DOI: 10.7759/cureus.8377. PMID: 32626621. PMC: PMC7328704. Published 31 May 2020 (received 31 March 2020, accepted 30 May 2020). License: CC BY 4.0. Department of Urology, Dalhousie University (Halifax, Canada); Medical Education and Simulation, Memorial University of Newfoundland (St. John's, Canada); Memorial University of Newfoundland MUN Med 3D Laboratory (St. John's, Canada); Department of Urology, Memorial University of Newfoundland and Labrador (St. John's, Canada).
  2. 2.0 2.1 Gillis C, Dubrowski A, Bishop N, Walsh G, Harvey D (2019). "Male catheter insertion simulation using a low-fidelity 3D-printed model in undergraduate medical learners." Dalhousie Medical Journal 45(2):19–22. DOI: 10.15273/dmj.Vol45No2.8998. Regional journal (not PubMed-indexed); first-generation predecessor design.
  3. Thomas AZ, Giri SK, Meagher D, Creagh T (2009). "Avoidable iatrogenic complications of urethral catheterization and inadequate intern training in a tertiary-care teaching hospital." BJU International 104(8):1109–1112. DOI: 10.1111/j.1464-410X.2009.08494.x. PMID: 19338562.
  4. Wyndaele JJ (2002). "Complications of intermittent catheterization: their prevention and treatment." Spinal Cord 40(10):536–541. DOI: 10.1038/sj.sc.3101348. PMID: 12235537.
  5. Mittal MK, Morris JB, Kelz RR (2011). "Germ simulation: a novel approach for raising medical students awareness toward asepsis." Simulation in Healthcare 6(2):65–70. DOI: 10.1097/SIH.0b013e318206953a. PMID: 21487344.
  6. Clayton JL (2017). "Indwelling Urinary Catheters: A Pathway to Health Care-Associated Infections." AORN Journal 105(5):446–452. DOI: 10.1016/j.aorn.2017.02.013. PMID: 28454610.
  7. Sullivan JF, Forde JC, Thomas AZ, Creagh TA (2015). "Avoidable iatrogenic complications of male urethral catheterisation and inadequate intern training: a 4-year follow-up post implementation of an intern training programme." Surgeon 13(1):15–18. DOI: 10.1016/j.surge.2014.02.001. PMID: 24613184.
  8. Brewin J, Ahmed K, Challacombe B (2014). "An update and review of simulation in urological training." International Journal of Surgery 12(2):103–108. DOI: 10.1016/j.ijsu.2013.11.012. PMID: 24316286.
  9. Dawe SR, Pena GN, Windsor JA, Broeders JA, Cregan PC, Hewett PJ, Maddern GJ (2014). "Systematic review of skills transfer after surgical simulation-based training." British Journal of Surgery 101(9):1063–1076. DOI: 10.1002/bjs.9482. PMID: 24827930.
  10. Waters PS, McVeigh T, Kelly BD, Flaherty GT, Devitt D, Barry K, Kerin MJ (2014). "The acquisition and retention of urinary catheterisation skills using surgical simulator devices: teaching method or student traits." BMC Medical Education 14:264. DOI: 10.1186/s12909-014-0264-3. PMID: 25527869. PMC: PMC4323138.
  11. Rodríguez-Díez MC, Díez N, Merino I, Velis JM, Tienza A, Robles-García JE (2014). "Simulators help improve student confidence to acquire skills in urology." Actas Urológicas Españolas 38(6):367–372 [Article in Spanish]. DOI: 10.1016/j.acuro.2013.10.007. PMID: 24332529.
  12. Nayahangan LJ, Bølling Hansen R, Gilboe Lindorff-Larsen K, Paltved C, Nielsen BU, Konge L (2017). "Identifying content for simulation-based curricula in urology: a national needs assessment." Scandinavian Journal of Urology 51(6):484–490. DOI: 10.1080/21681805.2017.1352618. PMID: 28743217.
  13. Zhong X, Wang P, Feng J, Hu W, Huang C (2015). "Novel Transparent Urinary Tract Simulator Improves Teaching of Urological Operation Skills at a Single Institution." Urologia Internationalis 95(1):38–43. DOI: 10.1159/000375129. PMID: 25720440.
  14. Aydin A, Shafi AM, Shamim Khan M, Dasgupta P, Ahmed K (2016). "Current Status of Simulation and Training Models in Urological Surgery: A Systematic Review." Journal of Urology 196(2):312–320. DOI: 10.1016/j.juro.2016.01.131. PMID: 27016463.
  15. Kusaka M, Sugimoto M, Fukami N, Sasaki H, Takenaka M, Anraku T, et al. (2015). "Initial experience with a tailor-made simulation and navigation program using a 3-D printer model of kidney transplantation surgery." Transplantation Proceedings 47(3):596–599. DOI: 10.1016/j.transproceed.2014.12.045. PMID: 25891694.
  16. Doucet G, Ryan S, Bartellas M, Parsons M, Dubrowski A, Renouf T (2017). "Modelling and Manufacturing of a 3D Printed Trachea for Cricothyroidotomy Simulation." Cureus 9(8):e1575. DOI: 10.7759/cureus.1575. PMID: 29057187. PMC: PMC5647136.
  17. Lichtenberger JP, Tatum PS, Gada S, Wyn M, Ho VB, Liacouras P (2018). "Using 3D Printing (Additive Manufacturing) to Produce Low-Cost Simulation Models for Medical Training." Military Medicine 183(suppl 1):73–77. DOI: 10.1093/milmed/usx142. PMID: 29635555.
  18. Grober ED, Hamstra SJ, Wanzel KR, Reznick RK, Matsumoto ED, Sidhu RS, Jarvi KA (2004). "The educational impact of bench model fidelity on the acquisition of technical skill: the use of clinically relevant outcome measures." Annals of Surgery 240(2):374–381. DOI: 10.1097/01.sla.0000133346.07434.30. PMID: 15273564. PMC: PMC1356416.
  19. Cohen A, Nottingham C, Packiam V, Jaskowiak N, Gundeti M (2016). "Attitudes and knowledge of urethral catheters: a targeted educational intervention." BJU International 118(4):654–659. DOI: 10.1111/bju.13506. PMID: 27104479.
  20. Yang RL, Reinke CE, Mittal MK, Kean CR, Diaz E, Fishman NO, et al. (2012). "The surgery clerkship: an opportunity for preclinical credentialing in urinary catheterization." American Journal of Surgery 204(4):535–539. DOI: 10.1016/j.amjsurg.2012.01.015. PMID: 22591699.
  21. Bigot P, Rouprêt M, Orsat M, Benoist N, Larré S, Chautard D, et al. (2008). "Evaluation of the practical skills of final year medical students: example of bladder catheterization." Progrès en Urologie 18(2):125–131 [Article in French]. DOI: 10.1016/j.purol.2007.10.003. PMID: 18396241.
  22. Sultan I, Kilic A, Arnaoutakis G, Kilic A (2018). "Impact of Foley Catheter Placement by Medical Students on Rates of Postoperative Urinary Tract Infection." Journal of the American College of Surgeons 227(5):496–501. DOI: 10.1016/j.jamcollsurg.2018.08.182. PMID: 30145285.
  23. Carrasco J, Gómez E, García JH, Valero J, Sánchez A, Salamanca JJ, et al. (2018). "Impact of the use of simulators on the mental workload and confidence in a digital rectal examination and bladder catheterization workshop." Archivos Españoles de Urología 71(6):537–542 [Article in Spanish]. PMID: 29991662.
  24. Todsen T, Henriksen MV, Kromann CB, Konge L, Eldrup J, Ringsted C (2013). "Short- and long-term transfer of urethral catheterization skills from simulation training to performance on patients." BMC Medical Education 13:29. DOI: 10.1186/1472-6920-13-29. PMID: 23433258. PMC: PMC3598217.




Simulator data
Alternative names Urinary catheterization simulator
Foley catheter trainer
MunMed3D urinary catheterization simulator

Property "SimulatorProcedure" (as page type) with input value "Urinary catheterization. The simulator supports undergraduate medical training in passage of a Foley catheter through the external urethral meatus, along the penile and bulbous urethra, past the external urethral sphincter, and into the bladder, with balloon inflation and stabilization once intravesical position is achieved.'"`UNIQ--ref-00000002-QINU`"' The mechanical valve at the bladder neck provides a modest resistance gradient that the source authors describe as "representative of breaching the internal urethral sphincter on a real patient."'"`UNIQ--ref-00000003-QINU`"'" contains invalid characters or is incomplete and therefore can cause unexpected results during a query or annotation process.


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