HUP0203546A2 - Irrigation of a hollow body - Google Patents

Abstract

The subject of the invention is a catheter for irrigating and flushing the internal hollow parts of the body with an irrigating fluid. The essence of the invention is that it contains a passage (2 or 3) for the intake of the irrigant and a passage (3 or 2) for the removal of the irrigant and waste from the body. The invention is further discussed as a method for irrigating the internal cavities of the body, the essence of which is that the 1-17. Any of the catheters according to the claims is inserted into the body, the distal end of the catheter is placed at a given distance from the inner lining of the given organ, the irrigating agent is introduced into the body from a given source along one course of the catheter, while the irrigating agent is led out of the body, e.g. from the bladder, along another course of the catheter and the waste or polluting material brought with it. HE

Description

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PROCEDURE FOR BODY cavitation irrigation

The invention relates to a method for irrigating a body cavity, such as wound irrigation, surgical irrigation or irrigation of internal organs, and in particular to the irrigation of various internal body cavities. The invention also relates to a catheter and an irrigation system. Irrigation itself is hereinafter generally understood to mean that its task is to wash out various wastes and residual products from the body cavity to be irrigated.

Internal cavity lavage and irrigation are often used to remove debris or waste from a body cavity in order to reduce the impact of debris, such as calculi or plaque, that could lead to obstruction of the organ.

Catheterization is usually used for urinary dysfunction, and the number of these patients is very large. In institutional care and treatment, 4% of patients are required to undergo so-called long-term catheterization (LTC), while 10% of patients, mainly in hospitals, are required to use a bladder catheter. Another form of bladder catheterization is short-term catheterization (STC), which includes post-operative urinary drainage, monitoring of urinary flow in acute illness, or relieving urinary retention in cases of urinary retention. Long-term catheterization (LTC) is usually used for long-term urinary dysfunction, such as urinary incontinence, various neurological disorders, or a separate outlet in a body cavity.

Some of the complications associated with long-term catheterization (LTC) are related to decreased comfort, but the

File number: 96992-3516 KK/Ho with the risk of infection, 8 urine leakage, trauma, improper functioning or blockage of the catheter, which can occur, for example, by a stone or other debris or coating getting into the catheter. The role of inguinal catheterization is primarily to alleviate or improve the complications associated with bladder catheterization, including various infections. Various residues, stones and deposits formed in the catheter can eventually lead to the catheter becoming blocked, but remaining in place. The most common cause of catheter blockage is the formation of deposits and a coating in the catheter tube. Among the components of deposits and stones, struvite is primarily mentioned, and the densest, therefore highest density component of stones is brucite (its density is 2500 kg/m ³ ).

Internal organ lavage and irrigation are primarily performed via a bladder catheter. Internal cavity lavage usually involves the introduction of a specific amount of lavage solution through a catheter into the internal cavity, often from a bag or syringe connected to the catheter, followed by the withdrawal of fluid from the body cavity, allowing the solution to drain the sediment into the bag. Internal cavity lavage essentially consists of two simultaneous steps: introducing fluid into the cavity and draining it. During these two processes (irrigation and lavage), a wide variety of flow rates are used. Today, irrigation itself most often serves the purpose of flushing blood and light contaminants from the internal cavity after surgery.

In current practice, deposits and blockages occur to some extent as a result of cavity washing, but they also tend to occur when the catheter is changed, although different diets, fluid intake, etc. may also be relevant. Despite the regular cavity washing and washing used in 40% of LTC patients, we have found that the removal of various debris and wastes during these washings and rinsings is not achieved with a consumer-friendly efficiency. Surgical irrigation uses higher flow rates to remove debris and waste materials, including smaller stones, but the stones often grow to a size that requires endoscopic or surgical removal from the given internal cavity. Another serious risk associated with organ washing and washing is damage to the cavity mucosa.

The invention aims to eliminate the aforementioned shortcomings and to develop a rinsing and irrigation method that has lower risks.

The invention relates to a catheter for irrigating cavities of internal body organs with a given irrigating fluid, which catheter comprises a passage for introducing the irrigating fluid and a passage for removing the fluid and other waste products generated after irrigation from the given organ.

The invention also relates to a method for irrigating internal hollow organs, which method comprises first introducing a catheter into the given organ, then positioning the distal end of the catheter at a given distance from the inner wall of the organ, then introducing the irrigating fluid from a given source into the organ through a passage, which passage forms one passage of a catheter, and then removing the resulting fluid and waste from the organ through another passage.

If necessary, the irrigating fluid can also be introduced into the organ under the influence of gravity.

According to another embodiment, the irrigating fluid can be introduced into the organ using suitable means, e.g. pumps.

The invention also relates to a system adapted for irrigating the cavity of internal organs, comprising a catheter and a source containing an irrigating fluid.

The channels optionally also have an opening at the distal end of the catheter, which allows for very good efficiency and ease of application.

The opening may be formed by an opening at the distal end of one of the passages at the distal end of the catheter. This allows for a simple structure.

Optionally, an opening can be formed at a given distance from the distal end, namely towards the other passage, and the openings of the corresponding passages can be placed adjacent to each other. This allows for the introduction of the irrigating fluid and its drainage after irrigation with a very high efficiency.

One of the passages may be the passage that is designed to introduce the irrigating fluid into or drain it from the given organ.

This solution allows for the use of a relatively simple construction, which is also extremely flexible in terms of where the liquid is introduced or discharged.

The other passage may be a passage that serves to discharge the irrigating fluid or, if appropriate, to introduce it into a specific organ. This again allows for very flexible application.

The two passages may optionally be parallel, with the corresponding openings at the open end of the catheter. This relatively simple construction, especially when two passages are used, is advantageous because these passages can be arranged on the same axis.

The two passages can optionally be arranged so that they are axially offset in the longitudinal direction.

The openings spaced a given distance from the distal end may optionally be formed from a series of openings spaced along the length of the catheter and directed into either one or the other passageway.

This solution provides a relatively unobstructed flow of the irrigating fluid.

The openings should optionally be positioned at a substantially 90° angle to the length of the catheter, but optionally these openings may also be positioned at a 60° angle to the length of the catheter.

When the openings are angled, the openings in the catheter may be oriented to form a given angular opening toward the distal end of the catheter.

If necessary, a spacer can be used to keep the distal end of the catheter at a given distance from the wall of the internal organ during use. This allows for very efficient removal of fluid and various contaminants after irrigation, and also prevents the mucosa of the organ in question from being damaged or even being sucked into the drainage openings.

The spacer may optionally be formed as an extension of the side walls of the catheter. This is a relatively simple construction, or another construction may be formed such that the spacer consists of separate spacer elements which are attached to the distal end of the catheter.

The catheter may also be formed in a single piece, forming a unit.

During the method according to the invention, the angle of entry of the irrigating fluid into the organ may be in the range of 0-25° vertically.

The opening of the other pipe is 0-20 mm away from the dirt. This allows for a good rinsing efficiency.

The distance is in this case approximately 8 mm.

The inlet flow rate of the irrigating fluid can be as high as 650 ml/min, but 150 ml/min is preferred. This again improves the efficiency of the procedure.

In the system according to the invention, the source of the irrigating fluid is connected to the inlet pipe.

The catheter, method and system according to the invention, which is used for flushing and irrigating the cavities of internal organs, will be described in more detail below with the help of exemplary embodiments in the accompanying drawings. The

Figure 1 shows a three-dimensional drawing of the distal end of the catheter according to the invention, with the aid of

Figure 1A is an enlarged three-dimensional view of the distal end of the catheter shown in Figure 1, with

Figure 2 shows a further enlargement of the distal end of the catheter shown in Figures 1 and 1A,

Figures 3a and 3b, 4a and 4b, 5a and 5b and 6a and 6b schematically show four different embodiments of the catheter according to the invention in cross-section, Figures A always showing one flow path, Figures B always showing the other flow path,

Figure 7 shows a bladder irrigation system constructed in accordance with the invention,

Figures 7a and 7b show the different usage and implementation forms of the system shown in Figure 7, the

Figure 8 shows the percentage of debris and contamination removed on the Y axis (average of two measurements) versus time (t) for the tube shown in Figures 3a - 6b, held vertically 5 mm from the bottom of the bladder for embodiment A, and the flow rate was 150 ml/min, for the

Figure 9 also shows the % of debris and waste removed on the Y axis as a function of time (t), for the tubes shown in Figures 3a - 6b, which were kept 5 mm from the bladder wall in the case of the bladder catheter system designed as system B, and the flow rate was 150 ml/min, for the

Figure 10 also shows the % of waste removed on the Y axis for model A 4 minutes after it was put into operation, as a function of the distance, which is the distance from the tip of tube 1A to the bladder wall, the distance is shown on the X axis, and the flow rate was 150 ml/min, the

In Figure 11, the vertical axis also shows the % of debris removed for model A after 4 minutes, as a function of the insertion angle (Φ), the flow rate was also 150 ml/min, the

In Figure 12, again only the % of waste removed is shown on the Y axis for system A after 4 minutes as a function of the angle/linear arrangement (Θ), where the flow rate was also 150 ml/min, the

Figure 13 shows the % of waste removed on the Y axis for model A for pipe 1A after 4 minutes, as a function of the flow rate, which is shown on the X axis, and finally

Figure 14 shows the irrigation, flushing, and flushing process for fluidized particles near the distal end of the catheter.

Returning to the figures, Figure 1 shows a catheter 1 for irrigating and flushing the internal hollow body of the body, which includes a passage 2 through which the irrigating fluid enters and a passage 3 through which the irrigating fluid and waste 4 exit the organ. Figure 1 shows a catheter 1 provided with two passages 2 and 3, in other words, a two-passage system, one of the passages 2 having an opening 5 at the distal end 6 of the catheter 1, which catheter 1 is an open distal end catheter, where the distal end 6 of the catheter 1 has an open opening 5. The other passage 3 is also provided with an opening 7, and the openings 5 and 7 are formed in close proximity to each other at the corresponding passages 2 and 3.

It is important to note that all embodiments are designed in such a way that one of the passages, e.g. passage 2, is used to introduce the irrigating fluid into the hollow organ, in the exemplary embodiment, this is the bladder, or to drain the irrigating fluid and waste therefrom, while the other passage 3 can also be used, but always in reverse, i.e. always depending on how the first, here passage 2, was used.

As mentioned above, one of the passages, here 2 or 3, is always used to introduce the irrigating agent into the bladder or to drain the irrigating agent and waste from the bladder, and the other 3 or 2 passages are used to drain the irrigating agent and waste from the bladder, or to introduce the irrigating agent into the bladder, to flush it or wash it out. In the figures, the flow direction I shows when the liquid is introduced (inlet), and the flow direction R shows the liquid outlet as viewed from the irrigating agent.

1, 1A and 2 show a typical exemplary embodiment of a catheter 1 which is formed as a unitary unit from a polymer or other suitable material, e.g. stainless steel, by a suitable molding process, e.g. injection molding and/or extrusion, or the like. The catheter 1 is a dual-lumen catheter having a larger diameter lumen 3 through which irrigant and waste exit, and a smaller diameter lumen 2 through which irrigant enters. The catheter 1 has a gripper 8 having an inlet 9 and an outlet 10 formed at a given distance from the distal end 6 for connection to a bladder management system. The outlet of the lumen 2 is cut off or has an open opening at the distal end, while the inlet of the lumen 3 is where the irrigant and waste exit.

The passage 3 is provided with 11 holes for better efficiency. In the exemplary embodiment, the internal cross-section of the passage 2 is 2.85 mm ² , while that of the passage 3 is 8.095 mm ² .

Figures 3a-6b show two hollow catheters 30, 40, 50, 60, which are constructed according to the invention. In Figures 3a and 3b, the two passages 2 and 3 are arranged co-axially, i.e. coaxially, and the inlet and outlet are formed by cutting off the open end of the catheter.

Figures 4a and 4b show an embodiment in which the passage 2 is open at the distal end towards the bladder, namely in the embodiment shown in Figure 4a the flow direction I towards the bladder forms the inlet, while in the embodiment shown in Figure 4b the flow direction R towards the bladder forms the outlet. The passage 2 is implemented in Figure 4a with outlet openings 41 which are formed perpendicular to the axis of the catheter. This means that in Figure 4a the flow direction R at the openings 41 forms the outlet from the bladder, while in Figure 4b the flow direction I forms the inlet towards the bladder.

Figures 5a and 5b show an embodiment similar to the embodiment shown in Figures 6a and 6b, where the inlet or outlet to the passages is formed by openings 51 and 61, respectively. In Figure 5, the openings 51 form a given angle with the longitudinal axis of the catheter 50. The angle of the axis of the openings 51 with the longitudinal axis of the catheter 50 is approximately 60°. In the embodiment shown in Figures 4a and 4b, the distance S between the openings 41 is approximately 10 mm, and in the embodiment shown in Figure 1, the length X is 130 mm.

In Figure 6, similarly to Figure 5, the axis of the openings 61 forms an acute angle with the longitudinal axis of the catheter 60, and this angle is also around 60.

Turning to Figures 7a and 7b, there is shown an exemplary embodiment that constitutes an experimental system 70 that simulates bladder lavage or irrigation. The bladder is represented by a spherical, transparent bag 71, which allows us to visually observe, as shown in Figure 14, the flow of waste. Only one device is shown, but the experiments were performed with several models, in the case of Model A, the diameter of the bag 71 was 80 mm, which corresponds to a volume of about 270 ml, while in the case of Model B, the diameter of the bag 71 was 60 mm, which corresponds to a volume of about 110 ml. In Figures 7a and 7b, Model A is shown, where the bag 71 has an outlet 72 and two transparent outlets 73 and 74. The central outlet 72 is used for a tube 75 that simulates a catheter, which has two paths, and one outlet 74 is closed. In the case of model B, which is not shown separately in the figure, the bag has only one outlet from the central part.

In both models A and B, the outlet 73 was used to accommodate a suitably calibrated pressure transmitter 76 (0 - 0.35 bar g) in order to monitor the internal pressure and pressure changes during the experiments. A general arrangement is shown in Figure 7. In both cases, well water was used as the fluid medium or irrigating agent in the pouch 71, since its density (993 kg/ ^m3 at 37 °C) does not differ significantly from the density of urine (1016 - 1022 kg/ ^m3 ). The flow rate through the irrigating tube 75 into the bladder, here into the pouch 71, was controlled by a suitable pressure head and an adjustable restriction, and monitored by a suitable flow meter. The pressure head corresponded to approximately 1.6 m of water column, thus achieving the desired flow rate, and the change in pressure during the tests was approximately 60 mm of water column, which is a very small value, meaning that the flow rate was achieved with a change of approximately 3% during each test.

The post-irrigation fluid and any suspended particles were drained from the irrigation tube onto a filter paper at the outlet side, which was designed as three vacuum-coupled filter elements 77. All tests were performed at room temperature (18 - 24 °C). In some tests, the pouch 71 was immersed in a rectangular container containing water to reduce optical distortion.

The embodiments shown in Figures 3a-6b were tested. Each was constructed as a catheter made of stainless steel tubing with an internal diameter of 5.84 mm and a coaxial stainless steel inner tube with a diameter of 3.2 mm and a wall thickness of 0.5 mm was used for both tubes. The inner and outer tubes were connected to each other to form a T-shaped end. In each exemplary embodiment, the inner tube (3a, 4a, 5a, 6a), i.e., the 2nd passage, was used for inflow, i.e., the I-flow inlet to the bladder, while in the embodiment shown in Figures 3b, 4b, 5b, 6b, it was used for outflow, i.e., the R-flow outlet from the bladder. A three-way continuous irrigation 20 CH catheter (Rusch Simplastic) made of PVC was used as a control for the studies. Glass beads with a diameter of 0.212 - 0.300 mm and a density of 2500 kg/m ³ were used to simulate the harder and heavier debris in the bladder. The collection system was a vacuum lancet, one of which is shown in Figure 7, which was successively lined with Whatman 1 filter paper (qualitative medium speed).

In each test, the bladder bag 71 was filled with water and 5 gm of dry glass beads were added. The irrigation/irrigation tube and the bladder model bag 71 were arranged in the appropriate position and orientation. The irrigation fluid flow was controlled by gravity by opening a valve not shown and the irrigation fluid was introduced for 12 minutes. The R flow outlet from the bag 71 was directed to the different filters at 4 minute intervals, using all three for 12 minutes (maximum). After each test, the bladder model bag 71 was emptied, rinsed thoroughly and the glass beads were removed. The three filter papers were removed from the filter apparatus, dried in an oven at 150 C for 30 minutes, and the amount of dried glass beads was then determined. (Preliminary tests showed that constant mass was achieved during a 30-minute drying process.)

We performed the following experiments and tests:

(i) 12-minute tests were performed to determine which tube configurations were most effective in removing contamination from bladder models A and B. All five irrigation/irrigation tubes or catheters were positioned vertically with their distal end or tip d=5 mm from the bottom of the bladder.

The following tests were performed to properly determine the efficacy:

(ii) Variation in the proximity of the tip of the tube to the bladder wall. The range of 5 - 10 mm was examined;

(iii) The angle of the pipe (Φ) was examined for the waste (Figure 9);

(iv) We tilted the tube and bladder models relative to each other by an angle Θ from the vertical, thus creating a combined angle of attack and displacement, as shown in Figure 7b; and (v) we examined different flow velocities.

Unless otherwise stated, the tube shown in Figure 3a was used, held vertically and directed so that it ended 5 mm from the bottom of the bladder forming Model A, the flow rate was 150 ml/min, and the duration was 4 min.

In models A and B, the pressure was maintained at approximately ambient atmospheric pressure (0.05 bar, i.e. 1 kPa) during the initial tests, which were performed with the embodiments shown in Figures 3a to 6b, and the flow rate was 150 ml/min; these pressures were found to be sufficiently low to allow for the recording of successive measurements. The flow rate was adjusted so that its variation during the initial tests remained within approximately 3%. These variations were considered to be acceptably low.

In the (i) tests, the different design tubes were compared (Figures 8, 9, 10 and 11). The tests were performed in two runs for each model A. Significant dirt and residue removal was observed for the tube shown in Figure 3a (87%, 91%), the tube shown in Figure 3b (45%, 59%) and the tube shown in Figure 4b (13%, 12%). In each case, the removal of the main part of the contaminant occurred in the first 4 minutes. The other tubes removed less than 5% of the waste and contaminant during the 12-minute period (Figure 8). When we examined the removal rates for models A and B, we found that the size of the bladder had very little or no effect on the tests in the range studied.

The rate of contaminant removal was much higher and more reproducible in the embodiment shown in Figure 3a than in the other embodiments shown in the figures. For this reason, only the tube corresponding to the embodiment shown in Figure 3a was used in the following tests.

The aforementioned 80% contaminant removal in the first 4 minutes was observed when the tube was 8 mm from the bottom of the bladder model (Figure 8). If this distance was greater than 8 mm, the contaminant removal efficiency decreased sharply, and at a distance of 10 mm it was less than 20%. Visual observations and photographs suggested that the distance-dependent contaminant removal was as observed because a local contaminant volume, a so-called fluidized region, had developed, extending upward by approximately 8 mm, and was created by the inflowing liquid jet between the jet, the bladder, and the glass particles (Figure 14). The fluidized particle region was observed in Figures 3a, 4a, 5a and 6a, and in the embodiments shown in Figures 3b and 4b, but not in the others. Cases 1 and 2 showed high contaminant removal rates, and the fact that the embodiment shown in Figure 4b performed better than the embodiment shown in Figure 4a is assumed to be due to the fact that the presence of the outflow tube in the fluidized particle region was a key factor in effective contaminant and debris removal. It was also found that the contaminant and debris removal rate was relatively sensitive to the angle Φ ((test (iii)) and the combined angles mentioned in test (iv) up to 25° and 20°, respectively (Figures 11 and 12). Note here that the range of θ around 20° corresponds to a displacement of about 14 mm and an additional 2 mm distance from the contaminant or debris, and the reduction in debris removal efficiency is most likely a function of the given angle and the vertical distance, not simply the given angle.

Finally, tests (v) showed that the removal of the contaminant was greatly accelerated when the flow rate was increased up to 150 ml/min. Thereafter, the removal rate was practically unaffected by the flow rate up to 650 ml/min (the maximum rate used, shown in Figure 13).

Although the flow rate typically used in the experiments was 150 ml/min, which is relatively high compared to the values used in the irrigation process, primary studies show that these are much lower than the maximum and average flow rates that occur when the vagina is douched or emptied (1180 ± 250 ml/min and 540 ± 200 ml/min, mean ± standard deviation). These values were measured with a urine flow meter in 8 cases. It is also noted that for the irrigation tube designs studied (tubes 1-4), flows continued at approximately 150 ml/min without significant hydrostatic overpressure in the bladder model. In addition, an upper limit can be set for the normal stress (σ) that occurs at the bottom of the bladder model due to the inflow of the irrigating fluid in the tube shown in Figure 1a; for a flow rate of 150 ml/min, σ < 0.5 p ² can be used, where pa is the density of water and v is the average velocity in the inlet tube, and then σ is 50 Pa or less.

The experiments showed that the region of fluidized contaminant is close to where the incoming irrigating fluid jet impinges on the lower part of the bladder model, and when the part of the outlet flow in the irrigating tube was within the fluidized region, the removal of contaminant and debris occurred at a high rate (Fig. 14). In contrast, the removal of debris was very poor when the outflow tube was not within the fluidized region. Therefore, for steady flow catheters for flushing waste, it is desirable to have the inlet port exiting the catheter and the outlet port entrance close to each other. Furthermore, assuming that the incoming irrigating fluid impinges on the settled debris and contaminant at an angle of about 25° to the vertical, an acceptable removal rate is obtained.

In each exemplary embodiment, it is ensured that the distal end of the catheter 1, 30, 40, 50, 60 is at a distance from the bladder wall that is optimal for irrigation and flushing, and that the outlet passage is in the fluidized contaminant created by the impact of the incoming irrigation jet. At the distal end of the catheter, a spacer may optionally be provided, which may be, for example, an extension of the spacer itself, or, for example, a cut-off portion that is at the end of the catheter and, for example, cut off as a semicircular portion, or, for example, a separate spacer that is removably attached to the distal end of the catheter before it is used for flushing or flushing. In each exemplary embodiment, the process has been carried out under the influence of gravity, but it is also obvious that suitable means, e.g. Pumps can also be used without relying solely on gravity. It is also possible to use existing flushing or flushing solutions in the catheter or system of the invention.

In all embodiments, the ratio of the diameters of the passages is such as to optimize the removal of waste material from the bladder.

The invention has been presented by way of example embodiments, however, the solution according to the invention can also be used for cleaning the body, such as a storage tank, but can also be used in swimming pools or in elements that contain a fluid medium and whose interior needs to be cleaned with a relatively high efficiency.

Claims (26)

PATENT CLAIMS 1 Catheter for irrigating and flushing the internal hollow parts of the body with an irrigating fluid, characterized in that it comprises a passage (2 or 3) for introducing the irrigating agent and a passage (3 or 2) for removing the irrigating agent and waste from the body. 2. A catheter according to claim 1, characterized in that at least one of the passages (2 or 3) has an opening (5 or 7) at the distal end (6) of the catheter (1). 3. A catheter according to claim 2, characterized in that at least one passage (2) at the distal end (6) of the catheter (1) has an open distal end. 4. A catheter according to claim 2 or 3, characterized in that at a given distance from the distal end (6) there is an opening which opens into the other passage, and the openings (5, 7) of the respective passages are arranged close to each other, adjacent to each other. 5. The catheter of claim 4, wherein one of the passages is configured as a passage configured for introducing irrigating agent or for removing irrigating agent and waste from the body. 6. The catheter of claim 4, wherein the other passage is configured as a passage configured for the removal of irrigant or for the introduction of irrigant into the body. 7. A catheter according to claim 5 or 6, characterized in that it has two passages (2, 3) which are substantially parallel and whose openings (5, 7) are formed open at the distal end (6) of the catheter (1). 8. Catheter according to claim 7, characterized in that the passages (2, 3) are coaxial. 9. The catheter of claim 7, wherein the passages are offset along the longitudinal axis. 10. A catheter according to claim 8 or 9, characterized in that the openings formed at a given distance from the distal end consist essentially of a series of openings (41, 51, 54) formed one after the other along the longitudinal axis of the catheter (50, 60, 70) in one or the other passage. 11. A catheter according to claim 10, characterized in that the openings (41) are formed substantially perpendicular to the longitudinal axis of the catheter (40). 12. A catheter according to claim 10, characterized in that the openings (51) are formed at an angle of approximately 60° to the longitudinal axis of the catheter (50). 13. A catheter according to claim 12, characterized in that the direction of the openings (61) is formed at an angle towards the distal end of the catheter (60). 14. A catheter according to any one of claims 1-13, characterized in that a spacer is formed at the distal end of the catheter, which is designed to protrude from the wall of the catheter and to provide a distance for the distal end of the catheter from the wall of the internal organ during use. 15. The catheter of claim 14, wherein the spacer is a projection of the surface wall of the catheter. 16. The catheter of claim 14, wherein the spacer is formed as a separate element and is adapted to be mounted on the distal end of the catheter. 17. A catheter according to any one of claims 1-16, characterized in that it is formed in one piece. 18. A method for irrigating the internal cavities of the body, characterized in that any one of the catheters according to claims 1-17 is inserted into the body, the distal end of the catheter is placed at a given distance from the inner lining of a given organ, the irrigating agent is introduced into the body from a given source along one path of the catheter, while the irrigating agent and the waste or contaminants brought with it are drained from the body, e.g. from the bladder, along another path of the catheter. 19. The method of claim 18, wherein the irrigating agent is introduced into the body by gravity. 20. The method according to claim 19, characterized in that the direction of introduction of the irrigating agent towards the waste is selected to be 0 - 25° from the vertical. 21. The method according to claim 20, characterized in that the distance of the opening of the other passage from the waste and contaminant is placed at 0-20 mm. 22. The method of claim 21, wherein the distance is selected to be 10 mm or less. 23. The method of any one of claims 18-22, wherein the flow rate of the irrigating agent is a maximum of about 650 ml/min. 24. The method of claim 23, wherein the flow rate is approximately 150 ml/min. 25. A system for irrigating internal body cavities, comprising a catheter according to any one of claims 1-17 and a source containing the irrigating agent connected thereto. 26. The system of claim 25, wherein the source containing the irrigating agent is connected to the inlet passage. 7_ /C The authorized person: Patent and Trademark Office Ltd. Blacksmith's Patent Brain