Patent Publication Number: US-2005124978-A1

Title: Indwelling urinary catheter

Description:
TECHNICAL FIELD  
      The present invention relates to an indwelling urinary catheter, and more particularly to the indwelling urinary catheter that can easily eliminate human urine from a patient&#39;s bladder, especially a person who has incontinence as a result of a problem with the sphincter based on a vertebra injury resulting in the bladder to leak urine continuously. In more detail, the present invention overcomes related complications such as the difficulty to insert the catheter into the urethra each time due to the high stiffness of the sphincter or adhesion of the urethra, the severely limited storage capacity of the bladder due to the adhesion of the bladder, and/or the difficulty to utilize the urethral catheterization frequently due to the injury of the urethra.  
     BACKGROUND OF THE INVENTION  
      The urethra catheter for eliminating the urine from the bladder that is most frequently used, is the Foley catheter that has a structure in which a urine inlet hole and fixing device are installed in one side of the body, and urine outlet tube in the center of the body is connected to the urine outlet hole situated in the other side of the body in order to discharge the urine in the patient&#39;s bladder.  
      A urinary catheter based of the above mentioned Foley catheter was disclosed in the Korean patent application No. 2000-22511 entitled ‘the fixing system and method for the urinary catheter’ and Korean patent application No. 2001-29052 entitled ‘Urinary catheter’.  
      The cross section of the urinary catheter in 2000-29052 is illustrated in the  FIG. 1 , and  FIG. 2  illustrates ‘A’ part in the  FIG. 1 .  
      Referring to the  FIG. 1  and  FIG. 2 , an inlet hole  20  through which the urine flows in the catheter, and fixing device  25  to fix the urinary catheter inside of the bladder are installed on the center of one side that is inserted into the bladder. The fixing device  25  has a balloon shape that expands when the liquid for controlling the diameter of the fixing device flows in from the liquid injection device  30  installed in the other side of the urinary catheter. That is, if the liquid for controlling the diameter of the fixing device flows in the fixing device  25  from the liquid injection device  30  via flow tube  35  after inserting one side of the catheter into the bladder, the fixing device  25  expands in the shape of the balloon, and then the urinary catheter become fixed inside of the bladder.  
      The body of the urinary catheter has a double tube shape, and a urine discharging tube  10  to be connected to the inlet hole  20  is installed at the center of the cross section, and an exudation discharging tube  40  that has plural exudation inlet and outlet holes  45  is installed outside of the urine discharging tube  10 . The exudations produced in the urethra flow in the exudation discharging tube  50  through the exudation inlet and outlet holes  45  in the urethra, and then discharged through the exudation inlet and outlet holes  45  outside of the urethra.  
      Meanwhile, a urine outlet hole  15  to be connected to the urine discharging tube  10  is formed in the other side of the urinary catheter, and urine inside of the bladder is discharged to the outside.  
      However, although the above mentioned urinary catheter can discharge the urine and exudations simultaneously by the double structure, the urinary catheter can still move from its desired position because the balloon-shaped fixing device is made of soft materials, and even more problematical the overall structure is too complicated because it needs additional devices such as the liquid injection device to expand the balloon. That is, the balloon-shaped fixing device is made of the soft materials for repeated expansion and contraction, so rupturing can easily occur along with shifting from its original position. Moreover there is a danger of foreign particles remaining in the bladder when it ruptures.  
      Furthermore, there is another danger that the urine might flow backward to the kidneys by excessive pressure caused during the process of injecting the liquid to affix the catheter in the bladder. Also an additional device is required to inject the liquid to expand the balloon, which complicates the production procedures and reduces the inner diameter of the urine discharging tube thus causing decreased effectiveness of the catheter. Finally, the balloon in the end of the urine discharging tube enlarges the outer diameter, which might damage the urethra mucosa and urethra sphincter when inserting the urine discharging tube into the bladder.  
      An urination controller is also disclosed in Korean Patent Publication No. 97-6099 that prevents the catheter from shifting from its original fixed position.  FIG. 3  shows a perspective view of the urination controller, and  FIG. 4  shows a cross section illustrating when the urination controller is inserted into the bladder in  FIG. 3 .  
      Referring to the  FIG. 3  and  FIG. 4 , the urination controller includes the urine discharging tube  65  connected to the valve  60  at one side. An external outlet  70  is formed in one end, and plural sidewall openings  75  are formed at the other end.  
      An air tube  105  extends facing to the inlet  80  to the inside of the valve  60  and is arranged along to the longitudinal direction of the urine discharging tube  65 . At the both ends of the air tube  105 , an outlet  90  positioned inside of the device  85  forming a part of the sidewall of the urine discharging tube  65 , and inlet  115  are formed. If the air is injected to the device  85  on the sidewall of the urine discharging tube  65  via the air tube  105 , the device  85  expands to form a balloon shaped chamber  100 . To make this possible, an opening  120  is formed on one side of the air tube  105 .  
      To prevent the urination controller from shifting from its fixed position, a fixing collar  95  is formed outside of the bladder corresponding to the chamber  100  inside of the bladder. Thus, the urination controller can remain in its original fixed position due to both the chamber  100  inside of the bladder and the fixing collar  95  outside of the bladder.  
      However, because the urination controller is affixed by inserting air into the balloon-shaped chamber made of the soft material, additional devices are required such as the air tube for inserting air, which still leaves the same problem when a rupture of the balloon-shaped chamber occurs.  
     SUMMARY OF THE INVENTION  
      Therefore, it is an object of the present invention to provide an indwelling urinary catheter that can be easily fixed inside of the bladder of the patient without the balloon shaped fixing device by making the body of the indwelling urinary catheter expand partially.  
      To accomplish the objects of the present invention, there is provided a indwelling urinary catheter including an inserted part to be inserted into the bladder, a body that includes the inserted part and non-inserted part is formed in one body with the inserted part and exposed to the outside of the bladder of the patient, a discharging tube installed inside of the body to discharge the urine, the first fixing member formed inside of the inserted part, and an expander fixed to the first fixing member at its one end. In this case, the first fixing member has the opened-ring or closed-ring shape, and plural inlet holes are formed in its circumference of one end through which the urine flows in from the bladder.  
      Preferably the plural openings are shaped like a running track, lozenge, oval or polygon that can be formed in the inserted part. Accordingly, the expander can be formed from wire selected from steel wire, piano wire, or typical fishing-type line.  
      According to one aspect of the present invention, a part of the inserted part expands in the lateral direction of the body with the opening as the center by pulling the free end of the expander, and then the indwelling urinary catheter is fixed inside of the bladder of the patient. An indicator that is an area or points having a different color from the rest of the expander, can be included to indicate the expanding state of the inserted part.  
      Also, an inlet hole can be formed in one end of the discharging tube positioned inside of the body, and an outlet hole can be formed in the other end of the discharging tube positioned outside of the body. The second fixing member that consists of a protrusion, a recess, or a combination of the protrusion and the recess is formed at one end of the discharging tube to fix the one end of the expander.  
      According to another aspect of the present invention, a contacting member is formed next to the openings of the inserted part, and a ring shaped mounting recess is formed between the inserted part and non-inserted part.  
      According to still another aspect of the present invention, a central hole through which the expander passes is formed in the center of one end of the discharging tube positioned inside of the body, and the end has a cone shape, in the circumference of which plural inlet holes are formed, and the outlet hole is formed on other end of the discharging tube.  
      Also, the first thread is formed on the inner face of the non-inserted part, the second thread corresponding to the first thread is formed on the outer face of the discharging tube, and the second fixing member which is one among protrusion, a recess or combination of the protrusion and recess, is formed in the other side of the discharging tube on which the other side of the expander is rolled and fixed. Thus, as the discharging tube is withdrawn to the outside by rotation, the inserted part expands partially in the lateral direction of the body with the opening as the center. In this case, an indicator is formed on the outer face of the other side of the discharging tube, by which the expanding state of the inserted part can be indicated.  
      Also, according to still another aspect of the present invention, a indwelling urinary catheter is provided that includes a body comprising an inserted part for being inserted into the bladder and non-inserted part for being positioned outside of the bladder, a expanding part between the inserted part and the non-inserted part, a discharging tube installed inside of the body and discharging the urine, a fixing member formed inside of the one end of the inserted part and an expander fixed to the fixing member at one side.  
      Preferably, the expanding part has a ring shape, on the outer face of which plural openings are formed, and to prevent the expanding part from being separated, the first protrusion that is inserted into the one end of the expanding part is formed on one end of the inserted part and the second protrusion that is inserted into the other end of the expanding part is formed on one end of the non-inserted part.  
      According to the present invention, because a part of the body expands to fix the indwelling urinary catheter inside of the bladder of the patient, typical problems associated with the conventional balloon shaped fixing device can be solved. Also, because the indwelling urinary catheter can be easily affixed by the expander without additional devices such as air pump or liquid pump, the overall structure is simple and the urine in the bladder can be effectively discharged by enlarging the inner diameter of the discharging tube. Moreover, the indwelling urinary catheter has a longer life and can be manufactured inexpensively and quickly due to the simple and effective structure. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
      The above objects and other advantages of the present invention will become more apparent by detailed describing preferred embodiments thereof with reference to the attached drawings in which:  
       FIG. 1  is the cross sectional view of a conventional urethra catheter;  
       FIG. 2  is the cross sectional view of the part ‘A’ in the Fig.;  
       FIG. 3  is the perspective view of the conventional urination controller;  
       FIG. 4  is the cross sectional view of the urination controller in  FIG. 3  to illustrate the state that the urination controller is inserted into the bladder;  
       FIG. 5  is the perspective view of the first embodiment of the present invention;  
       FIG. 6  is the cross sectional view according to the line B 1 -B 2  in  FIG. 5 ;  
       FIG. 7  is the partially projected view of the first embodiment of the present invention to show the operation of the indwelling urinary catheter;  
       FIG. 8  is the plane view of the expander in the first embodiment of the present invention;  
       FIG. 9  is the perspective view of the second embodiment of the present invention;  
       FIG. 10  is the enlarged cross sectional view of the contacting member in  FIG. 9 ;  
       FIG. 11  is the perspective view of the third embodiment of the present invention;  
       FIG. 12  is the cross sectional view according to the line D 1 -D 2  in  FIG. 11 ;  
       FIG. 13  is the front view of the discharging tube in the  FIG. 12 ;  
       FIG. 14  is the perspective view of the fourth embodiment of the present invention;  
       FIG. 15  is the cross sectional view according to the line E 1 -E 2  in  FIG. 14 ;  
       FIG. 16  is the perspective view of the fifth embodiment of the present invention;  
       FIG. 17  is the cross sectional view according to the line F 1 -F 2  in  FIG. 16 ;  
       FIG. 18  is the partially projected view of the fifth embodiment of the present invention to show the operation of the indwelling urinary catheter;  
       FIG. 19  is the perspective view of the sixth embodiment of the present invention;  
       FIG. 20  is the cross sectional view according to the line G 1 -G 2  in  FIG. 19 ;  
       FIG. 21  is the partially projected view of the sixth embodiment of the present invention to show the operation of the indwelling urinary catheter;  
       FIG. 22  is the side view of the sixth embodiment of the present invention in  FIG. 19 ; and  
       FIG. 23  is the partially cut cross sectional view of the one end of the non-inserted part  720 . 
    
    
     EMBODIMENTS  
      Hereinafter, preferred embodiments of the present invention will be described in more detail with reference to the accompanying drawings, but it is understood that the present invention should not be limited to the following embodiments.  
     Embodiment 1  
       FIG. 5  is the perspective view of the first embodiment of the present invention, and  FIG. 6  is the cross sectional view according to the line B 1 -B 2  in  FIG. 5 .  
      Referring to the  FIG. 5  and  FIG. 6 , the indwelling urinary catheter  200  of the first embodiment includes an inserted part  215  to be inserted into the bladder, a body  210  that includes the inserted part  215  and non-inserted part  220  is formed in one body with the inserted part and exposed to the outside of the bladder of the patient, a discharging tube  230  installed inside of the body  210  to discharge the urine, and an expander  235  fixed to the one end of the body  210  and penetrating the discharging tube  230 .  
      The inner end of the inserted part  215  that forms one side of the body  210  has the first fixing member  245  to affix the expander  235 . To the first fixing member  245  the one end of the expander  235  is connected, and the other end of the expander  235  is exposed to the outside of the outlet hole  255  through the discharging tube  203 . The first fixing member  245  can have the shape of an opened ring or closed ring for easy connection to the one end of the expander  235 .  
      The inserted part  215  can have a pre-determined radius at its one end for easy insertion, and plural openings  240  that are track shaped holes are formed in the inserted part along to the circumference of the body with same interval and size in the longitudinal direction of the body in the adjacent area to the non-inserted part. For the extraction and contraction of the body  210 , the body  210  is made of the synthetic rubber, silicon resin or polyurethane resin. Also, the body  210  can be made of the synthetic rubber that is manufactured by applying the N-halamine to the polystyrene to eliminate the pathogen such as the virus or mycota. This alternative structure is very useful to a patient who has weak immunity due to “AIDS”, cancer, or organ transplantation.  
      As described above, by forming plural openings  240  in a part of the body  210 , and upon pulling the free end of the expander  235  connected to the first fixing member  245 , a longitudinal force is generated in the body  210  of the indwelling urinary catheter  200 , and then the part in which the openings  240  are formed expands laterally by the force. This operation will be discussed later.  
      And, the openings  240  perform the same function as the inlet holes of the conventional urethra catheter. Thus, the indwelling urinary catheter of the present invention  200  can discharge the urine in the bladder of the patient through the openings  240  without forming additional inlets.  
      Moreover, because the indwelling urinary catheter of the present invention  200  needs no additional fixing devices such as the balloon shaped fixing device, a simple structure will suffice and the inner diameter of the discharging tube  230  of the body  210  is enlarged. Thus urine in the bladder of the patient is discharged in a very short time. To assist such function, plural inlet holes can be formed in one end of the inserted part  215  of the body  210  like the conventional catheter.  
      The non-inserted part  220  of the body  210  is the part that will be positioned outside of the bladder of the patient, when the inserted part  215  is inserted into the bladder of the patient and the openings  240  expands. The discharging tube  230  is installed in the non-inserted part  220  that has an inlet hole  250  in one end through which the urine flows in from the bladder, and an outlet hole  255  in the other end through which the urine is discharged to the outside. The one end of the discharging tube  230  extends beyond the non-inserted part  220  and is arranged adjacent to the openings  240  of the inserted part  215 , and the other end of the discharging tube  230  extends to the outside of the non-inserted part  220  of the body.  
      The expander  235  made of a wire such as the piano wire, steel wire or fishing-type line is connected to the first fixing member  245  formed in the inserted part  215  in its one end, and the other end is exposed to the outside through the discharging tube  230 .  
      In the same way, the second fixing member  260  is formed on the outer face of the end of the exposed discharging tube  230  on which the other end of the expander  235  is rolled and fixed. In  FIG. 5  and  FIG. 6 , the second fixing member  260  is illustrated as the protrusion shape, but it can be formed as a recess. And the end of the expander  235  can be fixed more tightly by forming the protrusion and recess together. The second fixing member  260  maintains the body  210  in the expanded state by rolling the end of the expander  235  on the second fixing member  260  after expanding the part in which the openings  240  are formed among the body  210  by pulling the end of the expander  235 .  
      In the first embodiment, the openings are formed like an extended track shape, but they can also be formed in a different shape such as an extended lozenge, an oval, or a rectangle according to the optimal expanding height. In particular, when the openings have the lozenge shape that is extended to the non-inserted part, leakage of the urine is effectively prevented from the bladder due to the increased degree of contact because the expanding height of the non-inserted part become higher than that of the inserted part.  
      Hereafter, the operations of the first embodiment will be described referring to the  FIG. 7 .  
       FIG. 7  is the partially projected view of the first embodiment of the present invention to show the operation of the indwelling urinary catheter.  
      Referring to the  FIG. 7 , by pulling the exposed end of the expander  235  after inserting the inserted part  215  of the body  210  into the bladder of the patient, a part of the inserted part  215  folds along to the lateral direction of the body  210  with the openings  240  formed in the extended track shape in the longitudinal direction of the body as a center, and then the indwelling urinary catheter is fixed in the bladder of the patient. In this case, the urine in the bladder of the patient flows in the discharging tube  230  through the plural openings  240  formed in the inserted part  215  and inlet hole  250  of the discharging tube  230 , and thereafter is discharged to the outside through the outlet hole  255  of the discharging tube  230 . Forming additional openings on the outer face of the inserted part  215  can accelerate the discharging of the urine.  
      Therefore, because the indwelling urinary catheter of the present invention can be fixed in the bladder of the patient by the partial expanding of its body  210  without additional fixing device, the problem with a conventional urethra catheter using a balloon-shaped fixing device that is a required additional device and has the potential to rupture resulting in further health complications can be resolved.  
       FIG. 8  is the plane view of the expander  235  in the first embodiment of the present invention. As shown in  FIG. 8 , the expander  235  can include an indicator located in the range of C 1 ˜C 2 . The indicator has a different color in contrast to the entire color of the expander  235 ; for example, the indicator has a yellow color whereas the entire expander  235  has a black color, or the indicator has a red or blue color whereas the entire expander  235  has a white color.  
      The indicator indicates the degree to which a part of the body  210  expands when partially expanding the body  210  by pulling the expander  235 . It is difficult to know the degree to which a part of the body  210  expands outside, because the inserted part  215  expands inside of the bladder of patient with the openings  240  as a center. Thus, by using the expander  235  having the indicator, whether the part of the inserted part  215  expands optimally can be readily checked.  
      In  FIG. 8 , the indicator is an area in the range of C 1 -C 2 , but the indicator can be the points arranged in the range of C 1 ˜C 2  with a different color to the entire expander  235 .  
     Embodiment 2  
       FIG. 9  is the perspective view of the second embodiment of the present invention, and  FIG. 10  is the enlarged cross sectional view of the contacting member in  FIG. 9 .  
      Referring to the  FIG. 9  and  FIG. 10 , the indwelling urinary catheter  300  in the second embodiment has same structure as in the first embodiment except that a contacting member  270  having a ring shape is further included in the inserted part  315  next to the openings  340  of the body  310 .  
      The contacting member  270  is made of elastic material such as silicon rubber, supports the expanded part when a part of the inserted part  315  expands in the lateral direction of the body  310 , and prevents leakage of the urine between the expanded part and bladder. To fix the contacting member  270  to the body  310 , a ring-shaped recess  275  is formed in the outer circumference of the body  310  between the inserted part  315  and the non-inserted part  320 .  
      Thus, the indwelling urinary catheter  300  in the second embodiment can maintain partial expansion of the inserted part  315  by the expander  335 , and still prevent leakage of the urine from the bladder of the patient.  
     Embodiment 3  
       FIG. 11  is the perspective view of the third embodiment of the present invention, and  FIG. 12  is the cross sectional view according to the line D 1 -D 2  in  FIG. 11 .  
      Referring to the  FIG. 11  and  FIG. 12 , the indwelling urinary catheter  400  in the third embodiment includes a body  410  comprising an inserted part  415  and non-inserted part  420 , a discharging tube  430  installed in the body  410 , and an expander  435  to expands a part of the body  410 . Because it is the same as in the first embodiment that the first fixing member  445  is formed inside of the one end of the inserted part  415  and plural openings  440  are formed in outer face of the inserted part  415 , the detailed description will be omitted.  
      Plural inlet holes  450  are formed in one end of the discharging tube  430 , and the outlet hole  455  to discharge the urine in the bladder of the patient is formed in the other end of the discharging tube  430 . The part of the discharging tube  430  in which the inlet holes  450  are formed is in a cone shape, and center hole  485  through which the expander  435  penetrate is formed in the center of the cone.  
      Also, the first thread  480  is formed on the inner face of the non-inserted part  420  to be positioned outside of the bladder of the patient, and the second thread  470  corresponding to the first thread  480  is formed on the outer face of the discharging tube  430  that is the path of the urine to be discharged. Thus, if rotating the discharging tube  430  with the second thread  470 , the second thread  470  of the discharging tube  430  will rotate engaged with the first thread  480  of the non-inserted part  420 , and then the discharging tube  430  will be withdrawn to the outside of the non-inserted part  420 . As the discharging tube  430  is withdrawn to the outside of the non-inserted part  420 , the longitudinal force will be exerted on the inserted part  415  by the expander  435  that is fixed to the first fixing member  445  in one end, and then the part in which the openings  440  are formed will expand in the longitudinal direction. In this situation, the second fixing member can be formed in one end of the discharging tube  430  and be one among a protrusion, recess or a combination of the protrusion and recess.  
      To check whether the inserted part  415  expanded optimally, an indicator can be included in a predetermined position of the expander  435  or one end of the discharging tube  430  that is in the non-inserted part  420 . That is, to check whether the discharging tube exited optimally beyond the body  410 , the indicator comprising an area or points that has a contrasting color with the color of the entire body can be included in the one end of the discharging tube  430 .  
       FIG. 13  is the front view of the discharging tube in the  FIG. 12 . As shown in the  FIG. 13 , the one end of the discharging tube  430  is formed in a cone shape, the center hole  485  is formed in the center of the cone, and plural inlet holes  450  are formed in the circumference of the center. The expander  435  penetrates through the center hole  485  to be fixed to the first fixing member  445 , and the urine flows into the discharging tube  430  through the inlet holes  450 . When the discharging tube  430  is withdrawn outside of the body  410  via rotation, the expander  435  will pull the inserted part  415  out accurately in a direction corresponding to the lateral direction of the body  410 , and then the part in which the openings  440  are formed can expand in the longitudinal direction optimally.  
     Embodiment 4  
       FIG. 14  is the perspective view of the fourth embodiment of the present invention, and  FIG. 15  is the cross sectional view according to the line E 1 -E 2  in  FIG. 14 .  
      Since the fourth embodiment has the same structure as in the above-described embodiments except that the expanding part is installed between the inserted part and non-inserted part, the description for the same structure will be omitted.  
      Referring to the  FIG. 14  and  FIG. 15 , the indwelling urinary catheter  500  of the fourth embodiment includes a body  510  that comprises an inserted part  515  and non-inserted part  520 , a discharging tube  530  positioned in the body  510 , and a ring shaped expanding part  590  formed between the inserted part  515  and non-inserted part  520 .  
      The expanding part  590  with plural openings  540  is made of the soft and elastic material such as the silicon rubber, and installed between the inserted part  515  and non-inserted part  520  of the body  510 . As shown in the  FIG. 6  and  FIG. 12 , the indwelling urinary catheter  500  of the fourth embodiment can also include the same expander as in the first embodiment to expand the expanding part  590  in the longitudinal direction of the body  510 , and the threads in the discharging tube  530  and non-inserted part  520 . Since the expander and threads were fully described above, their detailed description will be omitted.  
      To prevent the expanding part from separating while fixing the indwelling urinary catheter  500  of the fourth embodiment by expanding the expanding part after inserting into the bladder of the patient, the first and second protrusions  595 ,  596  are formed in the inserted part  515  and non-inserted part  520  respectively. The first and second protrusions  595 ,  596  extend into the expanding part  590  individually to prevent the expanding part from separating from the body  510 . Also, the indwelling urinary catheter  500  of the fourth embodiment can include plural inlet holes on the outer face of the inserted part.  515  to effectively discharge the urine of the bladder through the discharging tube  530  via inlet hole  550  and outlet hole  555  at each end.  
     Embodiment 5  
       FIG. 16  is the perspective view of the fifth embodiment of the present invention, and  FIG. 17  is the cross sectional view according to the line F 1 -F 2  in  FIG. 16 .  
      As shown in the  FIG. 16  and  FIG. 17 , the indwelling urinary catheter  600  of the fifth embodiment includes a body  610  comprising an inserted part  615  and a non-inserted part  620 , a discharging tube  630  positioned in the body  610 , and an expander  635  to expand a part of the body  610 . Since the first fixing member  645  and the inserted part  615  with plural openings  640  in the circumference are the same as in the first embodiment, their detailed description will be omitted.  
      Plural inlet holes  650  are formed in one end of the discharging tube  630 , and the outlet hole  655  is formed in the other end of the discharging tube  630  to discharge the urine from the bladder. The part of the discharging tube  630  in which the inlet holes  650  are formed has a cone shape, and the expander  635  is fixed in the center of the cone. Also a contacting member  660  is installed next to the inlet holes  650 . To easily insert and withdraw the discharging tube  630  assembled in the contacting member  660 , preferably the contacting member  660  is made of material such as plastic that has certain degree of rigidity.  
      An external fixing member  670  is installed in the other end of the discharging tube  630 . The one end of the external fixing member  670  is fixed to one end of the discharging tube  630 , and the other end of the external fixing member  670  is received in the non-inserted part  620 . That is, the one end of the external fixing member  670  operates as a hinge, and the free end of the external fixing member  670  can be bent towards the discharging tube  630  to be inserted into the non-inserted part  630 . If the discharging tube  630  is withdrawn to the outside, the free end of the external fixing member  670  will return to its original position parallel to the outer face of the discharging tube  630  or bent toward outside to engage in the recess  625  in the end of the non-inserted part  620 .  
      Also, a membrane  680  to prevent leakage of the urine is installed in one end of the discharging tube  630 . By using the membrane  680 , typical leakage of urine that occurs while inserting the indwelling urinary catheter can be effectively prevented. If the indwelling urinary catheter  600  is inserted into the bladder, the urine that flows into the discharging tube  630  through the inlet holes  650  will be discharged through the outlet hole  655 . Meanwhile the membrane  680  closes the outlet hole, and then a urine collecting tube  800  is inserted into the discharging tube  630  through the membrane  680 . Thus, preliminary action such as closing the discharging tube using a clamp before insertion into the bladder is not necessary.  
      As the discharging tube  630  is withdrawn to the outside of the non-inserted part  620  of the body  610 , the longitudinal force will be exerted on the inserted part  615  by the expander  635  that is fixed to the first fixing member  445  in one end, and then the part in which the openings  640  are formed will expand in the longitudinal direction of the body  610 .  
      Hereafter, the operation state will be described with reference to the drawings.  
       FIG. 18  is the partially projected view of the fifth embodiment of the present invention to show the operation of the indwelling urinary catheter.  
      Referring to the  FIG. 18 , by pulling the one end of the discharging tube  630  after inserting the inserted part  615  of the body  610  of the indwelling urinary catheter into the bladder of the patient, a part of the inserted part  615  folds along to the lateral direction of the body  610  with the openings  640  forming an extended track shape in the longitudinal direction of the body  610  as a center, and then the indwelling urinary catheter  600  is fixed in the bladder of the patient. In this case, the urine in the bladder of the patient flows in the discharging tube  630  through the plural openings  640  formed in the inserted part  615  and inlet hole  650  of the discharging tube  630 , and then discharges outside through the outlet hole  655  of the discharging tube  630 . Forming additional openings on the outer face of the inserted part  615  can accelerate the discharging of the urine. The discharging tube  630  the one end of which is withdrawn to the outside maintain the indwelling urinary catheter  600  fixed by engaging the external fixing member  670  in the recess  625 .  
      When the indwelling urinary catheter  600  is fixed, the urine discharged from the bladder is collected by connecting the urine collecting tube  800  to the outlet hole  655 . The urine collecting tube  800  is inserted into the outlet hole  655  penetrating through the membrane  800  to be fixed in the indwelling urinary catheter  600 .  
     Embodiment 6  
       FIG. 19  is the perspective view of the sixth embodiment of the present invention, and  FIG. 20  is the cross sectional view according to the line G 1 -G 2  in  FIG. 19 .  
      Since the indwelling urinary catheter in the sixth embodiment has the same structure as in the fifth embodiment except that a fixing protrusion is formed in one end of the discharging tube and the first and second recess are formed in the one end of the non-inserted part, their detailed description will be omitted.  
      Referring to the  FIG. 19  and  FIG. 20 , the indwelling urinary catheter  700  in the sixth embodiment includes a body  710  comprising an inserted part  715  and a non-inserted part  720 , a discharging tube  730  positioned in the body  710 , and an expander  735  to expand a part of the body  710 . To easily insert and withdraw the discharging tube  730  assembled in the contacting member  760 , preferably, the contacting member  760  is made of the material such as the plastic that has certain degree of rigidity. Also, since the contacting member  760  is pressed to a certain degree while fixing the discharging tube  730  in the second fixing recess  775  by withdrawing the discharging tube  730  to fix the indwelling urinary catheter  700 , preferably, the contacting member is made of elastic material.  
      At least one protrusion  770  that is an external fixing member is formed on the outer face of the end of the discharging tube  730 . If plural protrusions are formed, the angle between each protrusion is preferably the same for all the protrusions. The protrusion, the first recess, and second recess will be described with reference to the  FIG. 22  and  FIG. 23 .  FIG. 22  is the side view of the sixth embodiment of the present invention in  FIG. 19 , and  FIG. 23  is the partially cut cross-sectional view of the one end of the non-inserted part  720 .  
      If the discharging tube  730  is received in the non-inserted part  720 , the protrusions  770  are positioned in the first recess  725 . The first recesses  725  are formed on the inner face of the end of the non-inserted part  720 , the number of the first recesses  725  are the same as the number of the protrusions  770 , and it is preferred to form two protrusions  770  symmetrically. Also, it is preferred to form the first recesses  725  in such a depth as a part of the inserted part  715  that cannot expand in the longitudinal direction of the body  710  by the expander  735 .  
      If the discharging tube  730  is withdrawn to the outside of the non-inserted part  720 , the protrusions  770  are positioned in the second recesses  775 . The second recesses  775  are formed on the inner face of the end of the non-inserted part  720 , the number of the second recesses  775  are the same as the number of the protrusions  770 , and it is preferred to form two protrusions  770  symmetrically. Also, it is preferred to form the second recesses  775  in such a depth as a part of the inserted part  715  that cannot expand in the longitudinal direction of the body  710  by the expander  735 .  
      And, it is also preferred to form the first recessed  725  deeper than the second recessed  775 , so that the part in which the openings  740  are formed will remain in an expanded state in the longitudinal direction of the body  710  by the discharging tube  730  with the protrusions fixed to the second recessed  775 .  
      Hereafter, the operation state will be described with reference to the drawings.  
       FIG. 21  is the partially projected view of the sixth embodiment of the present invention to show the operation of the indwelling urinary catheter.  
      Referring to the  FIG. 21 , by pulling the one end of the discharging tube  730  after inserting the inserted part  715  of the body  710  of the indwelling urinary catheter into the bladder of the patient, a part of the inserted part  715  folds along to the longitudinal direction of the body  710  with the openings  740  forming an extended track shape in the longitudinal direction of the body  710  as a center, and then the indwelling urinary catheter  700  is fixed in the bladder of the patient. In this situation, the urine in the bladder of the patient flows in the discharging tube  730  through the plural openings  740  formed in the inserted part  715  and inlet hole  750  of the discharging tube  730 , and then discharges outside through the outlet hole  755  of the discharging tube  730 . Forming additional openings on the outer face of the inserted part  715  can accelerate the discharging of the urine. The discharging tube  730  one end of which is exposed to the outside maintains the indwelling urinary catheter  700  in a fixed position by engaging the protrusions  770  in the second recesses  775  due to the clockwise or counter clockwise rotation of the discharging tube  730 .  
      When the indwelling urinary catheter  700  is fixed, the urine discharged from the bladder is collected by connecting the urine collecting tube  800  to the outlet hole. The urine collecting tube  800  is inserted into the outlet hole penetrating through the membrane  800  to be fixed in the indwelling urinary catheter  700 .  
      In the above embodiments, the openings are formed having an extended track shape, but they can be also formed in the different shape such as an extended lozenge, oval, or rectangle according to the optimal expanding height. In particular, when the openings have the lozenge shape that is extended to the non-inserted part, there is no need to include an additional contacting member to prevent leakage of the urine due to the increased degree of contact because the expanding height of the non-inserted part becomes higher than that the inserted part.  
     INDUSTRIAL UTILIZABILITY  
      According to the present invention, problems with the conventional balloon shaped fixing member can be resolved because the indwelling urinary catheter can be fixed in a desirable position by expanding a part of the body. Furthermore, the indwelling urinary catheter of the present invention needs no additional fixing devices such as the balloon-shaped fixing device but instead can be fixed by the expander. Also the indwelling urinary catheter has a simple structure and enlarges the inner diameter of the discharging tube, thus discharging the urine in the bladder effectively.  
      Also, because the conventional urethra catheter includes the balloon to fix the catheter inside of the bladder and consequently the inlet at the end of the inserted part should be apart from the entrance of the bladder, the urine can start to flow into the inlet of the inserted part after the level of the urine rises to a certain level. Thus, the possibility of infection increases due to the remaining urine in the bladder. However, according to the present invention, the expanding part that fixes the indwelling urinary catheter in the bladder acts as an inlet. In turn the inlet is positioned adjacent to the entrance of the bladder. Consequently, no remaining urine collects. Finally, the indwelling urinary catheter has a long life and can be manufactured economically and quickly due to the simple and effective structure.  
      While the present invention has been particularly shown and described with reference to the preferred embodiments thereof, it will be appreciated that many variations, modifications, and other applications of the present invention may be made without affecting the spirit and scope.