Activation of Complement Kallikrein‐kinin, Fibrinolysis and Coagulation Systems by Urinary Catheters. Effect of Time and Temperature in Biocompatibility Studies

Abstract

Urethral strictures induced by the use of latex catheters and combined silicone/latex catheters following open-heart surgery have been reported. These strictures differ from the post-catheterisation type in affecting a greater length of urethra. Recently it was shown that complement was activated by catheters which cause inflammation, in contrast to clinically silent catheters. The present study was designed to investigate a possible association between catheter-induced inflammation and activation of another mediator of inflammation, the contact system. We also investigated various in vitro conditions to optimise biocompatibility studies. Our data indicate that both the complement and the kallikrein-kinin system are activated by potentially harmful silicone/latex catheters and may be involved in the pathophysiology of catheter-induced urethral strictures. In vitro biocompatibility tests may be performed at both 20 and 37 degrees C. Glass test tubes may be used for in vitro complement but not for kallikrein-kinin investigations.