Background: Peritoneal catheter displacement appears to be related to vario
us causes including omental attachment, bower contractions, peritoneal adhe
sions, and the catheter floating in the dialysis fluid. In order to prevent
this complication,which can impair peritoneal dialysis efficacy, Di Paolo
et al. designed a "self-locating catheter" (SLC) that is similar to the Ten
ckhoff catheter (TC) and includes a small tungsten cylinder (weight 12 g) a
t the distal end (Di Paolo N, et al. The self positioning catheter. Proceed
ings of the VII Italian Congress on Peritoneal Dialysis. Milan: Wichtig Edi
tore, 1993:539-42). The weight of the tip prevents the catheter from floati
ng and migrating by gravitation toward the Douglas cavity.
Objective: Starting in 1996, we implanted SLC in 15 continuous ambulatory p
eritoneal dialysis patients. The aim of our study was to compare the ratio
of migration and other catheter-related complications between patients with
SLC (196 patient-months) and 13 patients with conventional straight TC (29
5 patient-months).
Results: Peritonitis ratio, catheter complication rate, dialysate inflow an
d outflow, and weekly creatinine clearance were similar in the two groups o
f patients. The incidence of catheter displacement was significantly higher
(p = 0.0349) in the TC group than in the SLC group (4 vs 0).
Conclusion: In our experience, the SLC seems to be useful in preventing cat
heter migration by continuous gravitation of its extremity toward the pelvi
c cavity.