Catheter Selection
When navigating intermittent catheter selection for patients, finding a product that will help them stay compliant to their prescribed cathing regimen is key. To ensure optimised patient outcomes, you'll want to consider:
- Comfort during insertion and removal
- UTI Prevention
- Maintaining activity levels and quality of life
Let's dive into some catheter details to consider when selecting product from the cabinet to send home with new IC users.
Catheter diameter is measured in millimeters - multiply this by three and we have what is more commonly known as the French or Charriere size. Catheter French sizes generally start small at 5 or 6 and progress upward in size, some as large as 24 French. Most commonly, patients use a catheter between 8 and 18 French or Charriere.
Most intermittent catheter manufacturers use a universal funnel color coding system to identify catheter size. This can be a helpful tip when instructing patients how to order from their retailer as it may be easier to recall the color of the funnel rather than the number associated with their preferred product.
Intermittent catheters come with two tip style option - straight or coudé. Straight tip is the most common tip style with most patients having success in passing this type of intermittent catheter. For patients with difficulty passing a straight tip catheter, a coudé tip may be needed. Coudé, which is French for 'elbow' or 'bend', features a slight bend or curve at the insertion tip. A coudé tip is designed to maneuver around obstructions in the urethra such as blockage from scar tissue or BPH.
It is important to educate patients on the proper insertion of a catheter with coudé tip. The curved tip of a coudé catheter is inserted pointing up. Patients can ensure proper orientation one of two ways:
- Most manufacturers include a notch or bump on the funnel of the catheter. If this is facing up, the coudé tip is too. This is beneficial for users with vision limitations and/or those who prefer tactile cues.
- Some manufacturers have a blue stripe along top of the catheter. If the blue stripe is in view on top of the
catheter, the catheter is oriented correctly.
Correctly inserting coudé tip catheters ensures a reduced risk in trauma to the urethra. Cure™ coudé catheters feature both a funnel notch and blue guide strip to give patients both options to confirm correct coudé tip orientation while they adjust to intermittent catheterisation.
Intermittent catheter lengths fall into three lengths: 16 inches or longer, 8 inches or shorter, and 10 inches.
- 16” or longer: Longer length catheters are generally used by patients with male anatomy, those cathing from a chair directly into a toilet, or those who are voiding into a separate receptacle. If there is a caregiver assisting in the cathing process, they may prefer a longer length to help void into a urinal or direct into the toilet.
- 8” or shorter: Shorter catheters are generally used by patients with female anatomy as the urethra is shorter and does not require as much length to reach the bladder.
- 10” length: This length is usually referred to as a pediatric length catheter and can sometimes come in a smaller french sizes than longer, universal catheters.
Patients may occasionally notice blood in their urine when using intermittent catheters and even a small amount can make patients fearful. In addition to alleviating this concern, it is important to address the cause of bleeding. One possibility is eyelet quality.
Opting for a catheter that features smooth, polished eyelets may help reduce urethral trauma. Polished eyelets are designed to aid in smooth insertion and enable a comfortable cathing experience.
Catheter technology has evolved over the years and there are many options to suit your patients needs. It's important to talk to your patients about their lifestyle, where they will need to use catheters to maintain compliance and then recommend a product that can meet those needs.
Uncoated: Uncoated catheters require lubrication for comfortable use. For some patients, the process of applying lubricant can be a challenge while those who have been using catheters for years have integrated this step into their routine.
Hydrophilic PVP coating: Hydrophilic catheters have a separate layer of coating that is activated by water or saline that is included in the catheter packaging, sometimes in a sachet. Your patients level of dexterity will help determine the best way to instruct them on how to break these water or saline packets. Some common methods include folding the sachet in half and applying pressure or placing the package on a flat surface and pushing down. Typically, it takes less than 30 seconds for liquid to activate the coating to create a slippery surface. Once activated, the hydrophilic coating reduces friction and eliminates the need for additional lubrication. Most hydrophilic catheters have a sleeve or gripper to prevent contact directly with the catheter.
Hydrophilic PVP free additive: Unlike traditional hydrophilic catheters, FeelClean Technology™ embeds the hydrophilic properties in the catheter material. Benefits include instant activation and no sticky residue for clean, comfortable cathing.
Pre-lubricated: A ready to use, pre-lubricated catheter offers a convenient option when water sachets present a barrier to use. No activation time is needed as patients can simply open the package and the catheter is already coated with lubrication. Some pre-lubricated products include a gripper to aid with insertion and prevent direct contact with the catheter.
Your training and ability to connect with your patient to determine their requirements and preferences will enable you to select the catheter that is easiest and best for them to use to ensure compliance, bladder health and quality of life.
As always, our me+™ team of product specialists and WOC nurses are here to support you and your patients. Call and talk to a member of the me+™ support team today. Call 1-800-422-8811 (M-F, 8:30 AM – 7:00 PM ET).
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