Advances in technology have offered a lot to intermittent catheters but have at the same time complicated what healthcare professionals and patients need to know. There are now several types of catheters, designed according to the injury, the condition, special circumstances and the needs of the user.
If you are or have recently started using intermittent catheters, it is almost certain that you may be missing out on important features that can make daily catheterization easier and faster. Traumacare follows the modern standards of urological care and presents you with a complete update and practical instructions for all types of intermittent catheters.
What is an intermittent catheter?
Like any urinary catheter, disposable intermittent catheters are thin, flexible tubes used to help people who cannot empty the bladder on their own by intermittent catheterization, a very simple technique that can be taught by the nursing staff to the patient and perform it completely alone, about 4-6 times a day, as if they were going to the toilet normally.
The intermittent catheter is disposable and is inserted through the urethra, reaching the bladder and then removed as soon as it is emptied. In the past, there were intermittent reusable catheters, but they have been abandoned as they show an increased risk of urinary tract infections (UTIs) and also hinder the user’s mobility for no reason. Today, intermittent self-catheterization is a simple daily habit for people with incontinence, urine retention, diabetes and a number of diseases that cause bladder dysfunction.
Technical Characteristics of Disposable Intermittent Catheters
Disposable catheter types are now specially designed for each sex to meet the anatomical differences between men and women, but there are also special designs for children.
This difference in length is extremely important, as the shorter length of the intermittent catheters for women and children allows easy use and placement without folding or creasing while the longer length of men ensures complete drainage of the bladder.
Although some companies produce pediatric catheters, the length is essentially the same as that of women and so, most of the time female intermittent catheters are used for children without any problems at all.
The only ONE-USE catheters that are READY TO USE
SPONSORED BY EOPYY
180 catheters/month for paraplegics
REQUEST NOW YOUR FREE SAMPLE
Since the intermittent catheter is a tube designed to allow the free flow of urine without damaging the urethra, the choice of the appropriate size is determined by the outer diameter of the tube.
The diameter of all catheters is measured in millimeters according to the French scale or the French measuring system and is most often symbolized by Fr or CH (in honor of Joseph-Frédéric-Benoît Charrière, who created the French scale). Other times it is also symbolized as F, FG, Ch.
Sizes range from 6 to 24Fr where for women it is usually 10-14Fr and for men 12-14Fr. Larger than usual sizes are used to treat narrowing and other complications.
For immediate distinction and recognition of the intermittent catheter’s size, its tip is coded with specific colors.
There are usually two eyelets at the end of intermittent urine catheters, placed laterally or opposite each other. Larger catheters don’t necessarily have larger drainage holes than smaller ones.
The Nelaton catheter is the most common. Absolutely straight and flexible with a soft rounded tip. Most of the time it has two side eyelets.
Tiemann catheters (also known as Coudé catheters) are more rigid than nelaton catheters and are slightly bent at the edge, allowing the tube to bypass problematic areas while usually having three urine drainage eyelets.
They are often preferred when the user feels discomfort using a Nelaton catheter but is the appropriate choice in people with urethral stricture, prostate hyperplasia, prostate surgery, pelvic irradiation, urethral trauma, etc.
The material from which an intermittent catheter is made can play a role in whether or not it fits your needs. Beyond that, the two factors that you should definitely pay attention to are catheters that contain latex and plasticizers as they are not only unsuitable for people with allergies but long-term exposure to these materials has an increased chance of causing these allergies.
Vinyl, also known as PVC (polyvinyl chloride), remains the most popular disposable catheter material. They are generally clean, stable and flexible but their flexibility depends on the manufacturer and the composition (which most often contains latex). Of course, most manufacturers use plasticizers to make vinyl catheters more flexible.
- Stable and flexible
- Transparent so you can see the output
- Compatible with the French scale
- Some disposable vinyl catheters don’t have a funnel
- Only a few vinyl catheters don’t contain latex
Red Rubber Latex
Red rubber latex is heat sensitive, ie the disposable catheter is easily heated by the ambient temperature and becomes flexible. Unfortunately, many people face difficulties during insertion.
- We find them in red, brown or orange, depending on the manufacturer
- They are opaque so you can’t see the output
- There is no color coding according to the French scale
- They are prohibited for people with allergies or sensitivity to latex
Silicone catheters are becoming increasingly popular over time.
- Extremely smooth material
- The flexibility of silicone catheters lies between latex and vinyl
- Often without latex and less often without plasticizers (DEHP)
- Transparent for easy observation of urine output
- Several manufacturers use French-scale color coding
Of course, there are even more modern catheter materials such as thermoplastic polyolefin with clearly better properties than all the above.
The purpose of lubrication is to reduce friction during insertion and removal of the disposable intermittent catheter, thus protecting the sensitive urethra from irritation and injury.
There are simple catheters, usually made of latex, vinyl (PVC) or silicone, which are available with a separate gel or other lubricant and are usually used in the hospital. Non-lubricated latex catheters are not suitable for everyone and are prohibited for those who are allergic to latex. It is worth noting once again that even if one is not allergic to latex, there is a good chance of getting it when exposed to it often.
These are the combinations of lubricants used in one-use intermittent catheters.
• Lubricants without anesthetic (lignocaine, lidocaine and / or chlorhexidine)
• Lubricants with chlorhexidine (antiseptic)
• Lubricants with anesthetic lignocaine / lidocaine
• Lubricants with anesthetic lignocaine / lidocaine and chlorhexidine
• Lubricants with water and glycerin
Hydrophilic and self-lubricating catheters
Hydrophilic catheters are characterized by having a layer of polymer coating, which absorbs and traps water on the surface of the catheter up to ten times its weight. This results in a really thick, smooth and slippery surface that causes minimal friction between the catheter surface and the urethral mucosa during insertion. The hydrophilic coating layer remains intact during insertion and ensures lubrication of the urethra along its entire length.
Today there is a wide variety of catheters with hydrophilic coating. Some products require the addition of water for 30 seconds to activate the catheter overlay while others are sold pre-packaged with water or saline. There are also self-lubricating catheters where an inert transparent water-soluble gel is used that automatically lubricates the catheter as it comes out by the package containing it. The only problem with all of these disposable hydrophilic catheters is that they “drip” which means you are more likely to get dirty.
But there is an even better solution that doesn’t get messy and doesn’t create clutter with ready-for-use pre -lubricated catheters. So, you don’t need to do anything but follow the instructions for use of the product you choose. A typical example of disposable advanced pre-lubricated catheter technology is the B Braun Actreen series.