UNDERSTANDING INTERMITTENT CATHETERS
Intermittent Catheter Indications
Intermittent catheterization has become the preferred treatment for patients with acute or chronic bladder dysfunction as a result of injury, medical condition or surgery. Studies show that intermittent catheter (IC) use leads to fewer complications than the formerly preferred, long-term indwelling catheters. Common conditions associated with IC use include:
- Neurogenic Bladder - A name given to urinary conditions resulting from brain, spinal cord or nerve damage. These neurological conditions include injuries and diseases like Multiple Sclerosis (MS), Parkinson's disease, Spina Bifida, and spinal cord injuries.
- Urethral Stricture - The narrowing of the tube that transports urine out of the bladder due to scarring. Left untreated, strictures will result in serious urinary tract problems including inflammation and infection.
- Urinary Incontinence - A general term to describe the loss of bladder control resulting in involuntary leakage. Depending on the underlying reason for incontinence, IC may be indicated.
- Vesicoureteral Reflux - Most commonly associated with young children and infants, this condition occurs when the flow of urine is reversed from the bladder into the ureter or kidneys.
- Other medical reasons such as enlarged prostate and stroke or bladder surgery.
Intermittent Catheter Risks
Risks associated with the clean catheterization process can be mitigated by employing proper insertion and hygiene protocols. If the intermittent catheter is the wrong size or inserted improperly, trauma to the urethra or bladder can cause scarring, resulting in urethral stricture. More commonly, however, Catheter-Associated Urinary Tract Infections, or CAUTIs, occur when bacteria is introduced to the bladder as a result of a poor sanitation process. Following a few simple preventative measures will help mitigate that risk.
- Wash your hands before handling your intermittent catheter as most will come in sterile packaging.
- Clean the area surrounding your urethra with an antibacterial cleanser prior to self-catheterization.
- If it is necessary to reuse your intermittent catheter, be sure to disinfect it thoroughly before insertion.
* Image source: cdc.gov
Intermittent Catheter Sizing
Intermittent Catheters, also referred to as 'in and out' catheters, are available in many sizes to accommodate anatomical differences, gender, and age. The diameter is measured in French Gauge and will be clearly indicated by the funnel color and on the catheter's packaging. The most common adult size is 14 French; however, the best catheter diameter will be large enough to permit a steady urine flow and small enough to slide through the urethra without causing damage.
The length of intermittent catheters is different for men, women, and children. The following information is based on industry averages. Your unique needs may vary.
Please consult your physician to determine the correct intermittent catheter size.
- Intermittent Catheters for Males average 14 to 18 inches in length & 14 to 22 French in diameter.
- Intermittent Catheters for Females average 6 to 10 inches in length & 12 to 16 French in diameter.
- Pediatric Catheters average 6 to 13 inches in length & 6 to 10 French in diameter.
PARTS OF AN INTERMITTENT CATHETER
The narrow end of an intermittent catheter is referred to as the insertion tip. This tip leads the way through the urethra and into the bladder during all urinary catheterization processes, whether using a Foley catheter, closed-system catheter, or intermittent catheter. Despite the manufacturer, all catheters are designed with either a straight tip or a coudé tip. Straight intermittent catheters are the most commonly used, however, those with urethral strictures or blockages, atrophic vaginas, or enlarged prostates may find comfort in cathing with a curved insertion tip like the Magic 3 Intermittent Catheter Coudé Tip Catheter or Cure's Ultra® Coude Catheter.
The Importance of Eyelets
Catheter eyelets are small holes near the insertion tip end of the catheter tube used to drain the urine from the bladder. As inconsequential and simple as these holes may seem, manufacturers continuously strive for design advancements to make the process of self-catheterization more comfortable, efficient and safe. Innovations include placement, shape and number of eyelets on the catheter for efficient drainage as well as polishing and recessing the holes for smooth insertion. Industry leading brands, like Cure Medical uses an ultrasonic process to ensure that all eyelets are exceptionally smooth, one of the many quality features of the Hydrophilic Cure Catheter® for Men.
Also known as catheter funnels, connectors are typically colored in accordance with the universally-accepted French Size Chart used to identify the diameter of a catheter tube. The funnel is also a functional part of the catheter as it can be connected with a urinary leg bag or other drainage receptacle. Not all intermittent catheters are designed with a funnel end. Luer end catheters, or whistle tip catheters, are open on one end. Coloplast, an industry innovator, offers many variations of intermittent catheters including the Self-Cath Straight Tip Intermittent Catheter available with a funnel or a luer end. Choosing one style over the other is a matter of personal preference.
To avoid CAUTIs, urethral strictures or other painful damage to the urethra’s delicate tissue, a lubricant of some sort is imperative when inserting a catheter. To prevent these and other issues, it’s important to use a lubricant. Options include over-the-counter products like Surgilube® are readily available and even available in discrete foil packs like McKesson Lubricating Jelly. For ultimate convenience, pre-lubricated catheters are often the preferred choice. Hydrophilic catheters like Cure Medical’s Straight Intermittent Catheter with a hydrophilic coating (pictured to the left) are coated with a plastic substance that becomes slick and smooth for easy insertion when immersed in the included purified water. Closed urinary catheter systems often include hydrophilic-coated catheters.
FREQUENTLY ASKED QUESTIONS
What is a hydrophilic catheter?
A hydrophilic catheter is an intermittent catheter coated with polymer that becomes slick when submersed in water. The polymer runs the length of the tube and remains intact through the insertion process reducing pain and potential injury to urethral tissue. Most hydrophilic catheters are either prepackaged with sterile water or come with a sterile water pouch built into the packaging that the user breaks before catheterization. Many experts believe hydrophilic catheters are more sterile as they do not require manual lubrication and are therefore less likely to cause infection.
What is intermittent self-catheterization?
Intermittent self-catheterization, also called clean intermittent catheterization, is the process of inserting a catheter into the bladder through the urethra for the purpose of draining urine. This process can become necessary when an individual cannot urinate independently. Unlike indwelling catheters, intermittent catheters are inserted as needed and removed when the bladder has been emptied either into a catheter bag or directly into the toilet. While other forms of catheterization remain in place for extended periods of time, intermittent catheterization is prescribed when a patient can either maintain a regular cathing schedule or is able to identify when the urge to urinate strikes.
Are straight and intermittent catheters the same?
Straight catheters are one of the most common catheter styles used for both male and female intermittent catheterization. Although the catheter itself is typically one straight length of soft PVC plastic or rubber material, the name actually refers to the catheter's tip, as it is simply a continuation of the insertion tube. Other catheter tip shapes, like the tapered or bent coude tip, may be prescribed in certain circumstances.
Can I insert a catheter too far?
Many people who are self-catheterizing for the first time worry about insertion. Fortunately, it’s very difficult to insert a catheter too far. If the catheter is inserted too deeply into the bladder, it will just coil up onto itself.
Some men may feel like they’re inserting their catheter too far because they’ve hit a muscle known as the external sphincter. Most of the time, this resistance can be overcome if the patient pushes or strains against the catheter tip. It may feel uncomfortable, but shouldn’t feel painful.
How long can an intermittent catheter remain in place?
An intermittent catheter is not designed for long-term use. It should only remain in place for the length of time that you’re using it. After completely voiding your bladder of urine, it should be carefully removed.
If any type of catheter is left in place for too long or exposed to bacteria while in place, it can lead to painful and dangerous urinary tract infections (UTIs). Symptoms of this include burning around the urethra and bladder and pain or even spasms along the lower back and stomach. If you suspect you have an infection or any other complication, consult a physician immediately.
How do I clean my intermittent catheter?
Most frequently, doctors recommend single-use catheters for intermittent self-catheterization to avoid contamination. However, if you do have a reusable catheter, it should be gently rinsed and sterilized after every use to prevent bacterial contamination that can cause UTIs.
How often should I use an intermittent urinary catheter?
When first starting out, most doctors recommend inserting an intermittent catheter between four and six times a day including once first thing in the morning and again before you go to bed at night. In between, try to space your self-catheterization sessions every few hours or at regular intervals.
Once you’ve become more accustomed to the catheterization process, you will learn how to track your fluid intake and self-cath after you’ve had roughly 500 mL of liquid. This can help you avoid any leaks in between sessions.
MEDICAL ADVICE DISCLAIMER
The information, including but not limited to text, graphics, images, charts, and any other material on this site, is intended for informational purposes only and does not take the place of medical guidance provided by your physician. No information on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Please consult a qualified medical professional about your condition or circumstances before undertaking a new healthcare regimen.