title: In-flight urine collection device: efficacy, maintenance, and complications in U-2 pilots.
abstract: BACKGROUND
  Urine collection systems for in-flight use have gradually improved over the past 50 yr; however, current management of urine evacuation remains suboptimal. This is a cross-sectional survey-based study on the current urine collection device employed in the U.S. Air Force's U-2S airframe, examining efficacy, problems with wear, device maintenance, and complaint reporting.
  
  
  METHODS
  An anonymous survey consisting of 18 questions was generated inquiring about problems with wear of the urine collection system, care of the device, and education. The survey was offered at Beale AFB and overseas U-2 locations to pilots with at least 180 h of flying experience with the airframe.
  
  
  RESULTS
  There were 57 subjects who completed the survey with 62.5% reporting complications, including mechanical dysfunction, pain and poor fit, skin irritation, allergic reaction, embarrassment, and urethral issues. Variation was seen in the degree of problem reporting and care of the device. Discussion and literature review is provided on in-flight and space urine collection and evacuation systems, sheath catheters, urine and contact dermatitis, urethritis, external catheter sizing methods, and psychological aspects of catheter use.
  
  
  CONCLUSIONS
  The majority of surveyed pilots experienced various problems associated with wear of their urine collection device. Also, variation in reporting and care of the device exists. Potential improvements include standardization of fitting procedures and device maintenance, increased catheter draining capacity, use of skin barriers to urine, enhanced privacy measures, and incorporation of less injurious structural materials such as silicone.
authors.affiliation: Department of Flight Medicine, Beale Air Force Base, CA, USA. gvonthes@hotmail.com
authors.forename: Genevieve H
authors.initials: GH
authors.lastname: Von Thesling
authors.forename: Charles B
authors.initials: CB
authors.lastname: Coffman
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Hundemer
authors.forename: Rory P
authors.initials: RP
authors.lastname: Stuart
mesh_terms: D000337:Aerospace Medicine / Q000295:instrumentation*; D000401:Aircraft; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008889:Military Personnel; D011795:Surveys and Questionnaires; D014481:United States; D014546:Urinary Catheterization / Q000009:adverse effects / Q000295:instrumentation*