Coiled catheter for recurrent migration

Sir, Double-cuffed Tenckhoff's catheters has been widely used for continuous ambulatory peritoneal dialysis (CAPD). Various techniques of insertion have been described with placement of catheter tip downwards into the pelvis for maximal drainage. One of the well-known complications of CAPD is migration of the catheter tip out of the pelvis which leads to inadequate drainage and dialysis. The incidence of this problem varies considerably from center to center (5–35%), depending on the surgical technique, the patient's body habitus, the presence of adhesions from previous surgeries, excessive omentum and the type of the peritoneal dialysis catheter [1]. Swan-neck coiled catheters were found to have advantages of coiled intraperitoneal segments in reducing the probability of infusion or tip pressure pain [2]. But only one study demonstrated that the double-cuff, swan-neck coiled-end configuration was associated with a considerably lower incidence of migration [3]. In that study, there was catheter tip migration in three patients with the straight catheters compared to one patient with the swan-neck coiled catheter [3]. We present a 28-year-old non-diabetic gentleman with hypertensive end-stage renal disease, who was initiated on CAPD in January 2010. He had no history of previous abdominal surgery. He underwent double-cuff swan-neck 142 NDT Plus (2011)