The Unique Features of Wellspect Urinary Catheters- A Discussion with Diane Newman, Susanne Lindholm and Anna Malmborg

Diane Newman discusses, in a “show and tell” style, catheter options for patients with lower urinary tract dysfunction with Susanne Lindholm and Anna Malmborg from Wellspect HealthCare, a provider of LoFric® urinary catheters and the Navina bowel management system.  The two catheters reviewed are the LoFric® Sense™ for female catheterization and the LoFric® Origo™ for males.  A third product reviewed was the kit which contains both the catheter and a bag for urine collection.  Common to each of the Wellspect catheter products are their unique surface technology referred to as the Urotonic™ Surface.  This surface coating is on the outside of the PVC free catheters which is hydrophilic and isotonic to urine, making self-catheterization easier and more comfortable for patients.  The representatives from Wellspect demonstrate the unique features of each of the catheter products.

Biographies:

Anna Malmborg, Wellspect HealthCare Head of Global Platform Enterology

Susanne Lindholm, Global Product Manager, Urology Platform, Wellspect HealthCare

Diane K. Newman, DNP, ANP-BC, FAAN, Associate Professor of Medicine in the Division of Hematology/Oncology at the Northwestern University Feinberg School of Medicine in Chicago, Illinois.

Read the Full Video Transcript

Diane Newman: Welcome. I'm Diane Newman, a Nurse Practitioner, and a Continence Nurse Specialist at the University of Pennsylvania, Division of Urology. I'm also the Editor of UroToday's Pelvic Health Center. Today we're going to do a show and tell. By that I mean I have two guests with me from Wellspect, which is a catheter company in Gothenburg, Sweden. And I'm going to have them show some of the really high-quality catheters that they have. 

So, it's kind of to educate you about what's available for patients who have bladder dysfunction. These, of course, are patients who have lower urinary tract dysfunction, incomplete bladder emptying or urinary retention. So I want to welcome Susanne Lindholm, Project Manager.

Susanne Lindholm: Thank you.

Diane Newman: And Anna Malmborg, who is the Head of Global Endourology platform for Wellspect.

Anna Malmborg: Yes, thank you.

Diane Newman: Now, I'm going to ask both of them to give us a little bit of information about your background.

Anna Malmborg: Okay. I'm Anna. I'm heading our global endourology platform, which is the product side where we work with the bladder and bowel. So it's the product for transanal irrigation, because, as we know, many of our customer, users, have problems with both bladder and bowel. So that's my main area.

Diane Newman: So you're using transanal irrigation for ... Of course, a lot of these patients have bladder and bowel.

Anna Malmborg: Yes.

Diane Newman: Neurogenic bladder and bowel, right?

Anna Malmborg: Yes. Those patients, that's a big group, and a group that we know well from all our years of experience with LoFric®, but then there is also a big group of patients with functional disorders.

Diane Newman: Okay. Susanne, tell us a little bit about yourself.

Susanne Lindholm: Yes. I work as the product manager within the urology platform. The role is to work with the product life cycle management, but also within the product development processes.

Diane Newman: So you're both based in the main company, right, in Sweden?

Anna Malmborg: Yeah.

Susanne Lindholm: I used to work in medical affairs as a clinical research manager.

Diane Newman: Well, one thing I've been practicing in pelvic floor dysfunction, pelvic health, for many, many years. I have to tell you that I have a memory of coming to European meetings and seeing LoFric®, and we do not have that in the United States, and I always thought, "What is this?" So I'm really glad that you're here today, because I want you to talk about your catheter products that you use for human catheterization, for patients, men, and women, but also I think the uniqueness of the coating of your catheters, which I hope my audience will find just as intriguing as I do.

Anna Malmborg: Yeah.

Diane Newman: So how about you start, Anna, and just give us some idea about what's here on the table. You have your catheters here, right?

Anna Malmborg: Yes. So, this is our three prioritized products, so to speak. We have a big assortment, but these are the ones that sort of cover most needs. So we have the female catheter, called LoFric® Sense™. We have the male catheter, called LoFric® Origo™, and we have the kit product, which is a catheter and a bag all ready to use, available in different length and sizes. All with the Urotonic surface technology, which is our unique surface.

Diane Newman: Yeah, so LoFric® is Urotonic surface, right? 

Anna Malmborg: Yes.

Diane Newman: What does that mean? Is it the coating is within the catheter, outside of the catheter? Explain that to me.

Anna Malmborg: So, the catheter itself, it's a PVC free tube. On the outside of that tube, it has a unique coating. It's a hydrophilic catheter, which means that it reacts with water. It's isotonic to urine, which means that it has the same level of particles, or amount of particles, on the catheter as you would find in the urethra. 

Diane Newman: So it's urethra friendly, right?

Anna Malmborg: Yes.

Diane Newman: So we're talking about that it's similar to what the lining of the urethra would be?

Anna Malmborg: Yes. That means that when you activate all these products with the water sachet that's inside, and then they're ready to use. What happens when you insert a catheter, if there is an imbalance in the amount of particles or the salt content of the urethra or the catheter, you will have a migration in either direction. But since this is isotonic to urine, so it's got the same ... It's in balance with each other. It means it's slippery going in, and even if a catheterization might take some time, it's slippery when going out, which minimizes the risk for urethral damage and trauma, because, as we know, this is a long term therapy for many people. So we know that it works overtime, and it's a product with long-term studies showing that.

Diane Newman: Thank you very much. Now, let's start with your catheter for women.

Anna Malmborg: Yes.

Diane Newman: Because we have this in the United States, and I have to tell you that I've used this product quite a bit, and women love this product. So why don't you show us about this product? It's called the Sense, right?

Anna Malmborg: Yes. So LoFric® Sense™, it's the sensible choice.

Diane Newman: Oh, sensible choice. 

Anna Malmborg: We worked with the five senses when we introduced it. We've recently done an upgrade with it where we've looked at things that we could improve. So, basically, we have a long sleeve here to make it easier to open. It has a separate water sachet on the inside. So, before opening it, you squeeze it open. You have a large loop here or a large opening here. When you take it out, it's 15 centimeters in total. Insertable length is about 10 centimeters. 

When we did the improvement of this product, we worked a lot with the handle. We had, actually, a group of about 10 women with different problems, all using a catheter. It was everything from someone who had a surgery that went wrong, to someone with traumatic MS, to spinal cord injury, and they all had different difficulties. So, basically, what we wanted was to have the pronounced ridges. We wanted to have an ergonomic shape. We want the pronounced ridges to show ... To make it easier, so that even if you had problems with your eyesight, or if you had problems with numbness in your hands, that it would be easy to feel where the handle starts and where it finishes. Also, to make the ridges pronounced, but not too pronounced to make it uncomfortable for someone who has their sensation intact. So, the handle is designed to be long enough to make sure that you can grab it and hold on to it properly.

Diane Newman: I had to tell you, I wasn't aware that you improved, but that was probably why women ... And I've had some women, younger women, who've had neurologic disorders, who have real problems with manual hand dexterity. This is a nice funnel. It's interesting you called it a handle because it is kind of a handle. But the issue is, you can see with the design, is it's really easy to grip. So if someone has problems with that, this is firm enough and actually large enough. And you can see the coating there. It's really nice, smooth coating. How can I say it? It's not all this water. 

Anna Malmborg: No.

Diane Newman: Sometimes patients will complain there's water all over the place, dripping down. But you don't have that with this catheter.

Anna Malmborg: No. Actually, the water's still in the package. So you'd have the slipperiness. It's really very slippery. It doesn't stain. I've tried it myself, so I can say that I know that it stays slippery during use and after use.

Diane Newman: So it slides in and out?

Anna Malmborg: Yeah.

Diane Newman: Very little trauma to that urethra for women.

Anna Malmborg: Yeah. I think that there is one way of holding it for every person who's holding it because it all depends. But if you have good dexterity, this is a good way of holding it, and then you can have one hand free, so to speak, to ensure that you can find the urethra.

Diane Newman: And it doesn't collapse when you hold it.

Anna Malmborg: No, no.

Diane Newman: I think that's important. Because sometimes, the funnel, if you squeeze it ... Because you don't want it to drop. It actually obstructs the urine from coming out. But that's very nice.

Anna Malmborg: Also, since there's water in the package, we needed to have a surface that wouldn't make it slippery.

Diane Newman: Yeah, that's a good point.

Anna Malmborg: We had some rounds when it was slippery before. But, actually, the actual funnel is on the inside, so this is something that's mounted on the outside to the catheter, to have a proper handle of that and a good length.

Diane Newman: Show, though, the camera a little bit, this way. Show us the feel of pack in there and how you broke that because I think that would be really of interest.

Anna Malmborg: So looking at this, there is a water sachet down here. So when you press it, you can either, depending on your dexterity, you can squeeze it like this, or you can press it like that. You can use your elbow, whatever. Then, when you open it, you will see that you have quite a large opening here to make it easy to take it out, even if you don't have very good dexterity, but also to put it back in. So we made the hole a bit larger than we had before. Then, on the back of the package, you have a sticker, so that you can place it ...

Diane Newman: Yeah, on the wall or something. Right.

Anna Malmborg: ... On the wall. Yeah. It actually stays, it doesn't fall down.

Diane Newman: So what you're saying is the patient doesn't have to hold that while they're trying to cath?

Anna Malmborg: No. Any surface that's close and convenient for you when getting ready. It works really well. Then, once you're done, you can either pour the water out, again, and then seal it, so that you can have a discrete seal, so no one else has to know, unless you want anyone else to know, or you can keep it like this. But then I would keep it in an upright position, and just throw it away, or you can put it in your bag and throw it when it's convenient for you.

Diane Newman: The other thing, and I think that ... Let me put this down here ... Is the audience should know, too, is that if you have to, women could do a connecting tube to this.

Anna Malmborg: Yes, yes. Exactly.

Diane Newman: As far as if they're worried that urine may not get right into a receptacle. They could put a small tubing, which would connect very easily with this.

Anna Malmborg: Yes, it's a universal connector.

Diane Newman: Right. So I think that's very nice. Thank you very much.

Anna Malmborg: Thank you.

Diane Newman: This is a really neat product, and I was really glad to see it like this, because I have many patients that go to work, or when they're out, and they tell me that they don't catheterize because they can't carry around a long catheter. And this is mostly men. But it's nice that this next product, I want you to talk about Anna, is that we can really fold it up, and somebody could just put it in their pocket, go in the bathroom to cath, right? So tell us about this product here.

Anna Malmborg: Yeah. Well, this is our male catheter. It's available in two lengths. It's 30 and 40 centimeters. It's designed to be able so that you can fold it into pocket size.

Diane Newman: Yeah. That's what I do. It's easy.

Anna Malmborg: You can make it very small if you want to, and you can tie it, and it straightens out in a nice way. It's also PVC free like all our LoFric® catheters. It also has the Urotonic surface technology.

Diane Newman: And then behind here, is that that packet again to lubricate the surface, right?

Anna Malmborg: Yes. So you have the water sachet on the back. Then you squeeze that, and then surface is activated.

Diane Newman: I don't want to interrupt you, but the LoFric® really is ... The coating is such that it's Urotonic, right?

Anna Malmborg: Yes.

Diane Newman: And whenever you activate it, the water that comes out of the sachet travels down, and that activates the coating. Correct?

Anna Malmborg: Yes. It's activated and ready immediately. The surface, as such, has been on our catheters since 1983, and it's been developed to make it really ready to use, no waiting time required. And the inventor of our products, of the coating, is actually still working in the office. He still looks almost the same as he did when he was 27.

Diane Newman: You've been around since 1983. That long, huh?

Anna Malmborg: Yeah.

Diane Newman: You were the first catheter out there that was hydrophilic, though, correct?

Anna Malmborg: Yes.

Diane Newman: With that coating, right?

Anna Malmborg: Yes. This is really the starting point for the hydrophilic urinary catheters. We have had continuous development. But the surface is, actually ... It's been very good. Since then, since the '80s, and now it's developed even further to ensure that it keeps being the high-quality product.

Diane Newman: Right. Show us how you would do that. I see you have instructions here on the front, right?

Anna Malmborg: Yeah. So you have that squeezing and the removal instructions to make it easy to understand. The water pocket on the back. And you have a label here so that you can stick it on any surface close to you, to make it convenient for your hands.

Diane Newman: And that way you free your hands because you can attach it somewhere that you could easily access to cath.

Anna Malmborg: Also, this one, it can be folded to activate it. It's done easily, like this.

Diane Newman: So just folding that. So what you did is you broke, basically, the water pouch, and satchel in there, and then the water comes down. Right?

Anna Malmborg: Yeah. So, now this is filled with water, and it's ready to be used. So you open this one from the top, like this, and you can actually see the water, the water pocket on the inside here. So, taking the catheter out. I'll just place it here. You have an insertion grip or an insertion-

Diane Newman: Oh, that's an insertion grip. Huh? That's really nice, isn't that?

Anna Malmborg: So this is to ensure a non-touch technique, to have improved hygiene. So when you insert it, you push the insertion grip back, and you can actually have the full length of the catheter that you need, and then you empty your bladder, and you withdraw it. With the surface that we have, which is isotonic to urine, so the same level of particles in the urethra as on the catheter, it will ensure that it's slippery both going in but also coming out. So it's very comfortable.

Diane Newman: This, again, is very nicely, as far as gripping. Right? As you cath, you basically can hold that as you pass it. Huh?

Anna Malmborg: Yeah.

Diane Newman: That's very nice. The other thing that's nice, I hope the audience, our viewers, see, it's not flopping around.

Anna Malmborg: No.

Diane Newman: And it's not dripping all over the place. Because a lot of people say, “Well, there's water, it gets all over my pants,” or whatever. Men will say that, right? But that this is very nice, and you could see that you could easily cath with this, especially males could, as far as, because of course, the other hand would be holding the penis. But, again, they could easily direct that right into the urethra. It's a very nice design.

Anna Malmborg: Thank you.

Diane Newman: How long have you had ... Now, this has been here ...

Anna Malmborg: This has been on the market since 2013.

Diane Newman: Not with the insertion grip, right?

Anna Malmborg: Yeah.

Diane Newman: Oh wow.

Anna Malmborg: This was sort of the male response to the success with LoFric® Sense, and obviously the needs are different for a man.

Diane Newman: You need a longer length.

Anna Malmborg: So you need a longer length, and we wanted to have a design that was attractive for a male audience, and also the functionality. That's what we were looking for. 

Susanne Lindholm: And foldability.

Anna Malmborg: And foldability, to make ...

Diane Newman: It really helps making independent.

Anna Malmborg: Yeah.

Diane Newman: I do have some women that like the longer catheter, too, but it's nice that that could easily go in a purse.

Anna Malmborg: Yeah, it can.

Diane Newman: It can go in a pocket. I hate to say it, but I have some men who cath themselves in their car, and they drain it into a container. And you're right. So the compact of this is very nice.

Anna Malmborg: Yeah. Basically, when you're done, you can either pour it out into the toilet or wherever you are. Maybe not in the car. And then you can close it. So it's resealable, and then you can throw it away in a discreet way, and hygienic way. So, yeah.

Diane Newman: Thank you very much.

Anna Malmborg: Thank you.

Diane Newman: Well, I have with me here two young ladies here from Wellspect. Wellspect has known for their LoFric® coated catheters. And they've brought some here for us today to do a show and tell. So I'm going to ask Susanne to tell us about this product right here.

Susanne Lindholm: Yes. This is LoFric® Hydro-Kit, which is our kit product.

Diane Newman: What do you mean by kit? What does that have?

Susanne Lindholm: That you have everything in the same ... It goes with a urine bag.

Diane Newman: Oh, so it has a drainage bag? I don't need to worry about finding the toilet or a container?

Susanne Lindholm: No, no. And everything is included here. It also, our Urotonic surface, in this. And you activate it in this bag.

Diane Newman: So the pouch, the satchel we call it, is up here, right?

Susanne Lindholm: Yeah.

Diane Newman: So that is what? That has the water? Yes, I see.

Susanne Lindholm: Yeah. It has sterile water included.

Diane Newman: It's one continuous ...

Susanne Lindholm: Yes. And it's also easy to go if you are on travel or in car, or whatever.

Diane Newman: Or at work. Right. You put that in your pocket or purse.

Susanne Lindholm: Yeah. Yes. Of course. Yes.

Diane Newman: It's nice material, too, huh?

Anna Malmborg: And it's quiet.

Diane Newman: Oh, that's a good point. It's quiet. That's important.

Susanne Lindholm: Yeah, quiet. And this neck is really popular, for you can have it over your leg.

Diane Newman: Oh, I see that, and you could cath yourself and just have it drain like that. Then when your catheters in, you can put it down to drain.

Susanne Lindholm: Exactly. If you have a need to hang it up, you can do that, and you can easily empty the bag, just here.

Diane Newman: Tears right easily.

Susanne Lindholm: Yep. And you activate it.

Diane Newman: Same way you do your other products.

Susanne Lindholm: Yeah.

Diane Newman: It's very easy, you just fold it and let it ...

Susanne Lindholm: You can see it here. The water coming down.

Diane Newman: Yeah, it's coming all the way down, huh? So the water's activating the LoFric® coating. The isotonic LoFric® coating. And you need that water to activate it, right?

Susanne Lindholm: Exactly.

Diane Newman: Because the coating is on the outside of the catheter, correct?

Susanne Lindholm: Exactly. And here is actually some loops, if you need to, if you have bad or reduced dexterity, you can use this one. But you easily take it apart here. And you have to take it apart, and this you will remove.

Diane Newman: Oh, really?

Susanne Lindholm: Yeah. 

Diane Newman: So that's the insertion grip there, huh?

Susanne Lindholm: Yeah, exactly. So you do it just like this, and this will be the insertion aid. Also, with a better grip. You can use this one.

Diane Newman: This is very popular now, these insertion aids we call them. This is called a no touch method. Catheterization is putting catheter in the bladder. We want to minimize the introduction of bacteria, because one of the complications of catheterization, especially repeated doing, is UTIs, urinary tract infections. So these insertion grips, or guides, are really very popular with patients, aren't they?

Susanne Lindholm: Yeah. It is. It's the non-touch technique that we want to ...

Diane Newman: And of course, if someone else is catheterizing that person.

Susanne Lindholm: Exactly.

Diane Newman: Say with children, their parents, or say it's a caregiver that's catheterizing. You would not want them touching. You know, in the past, we don't use gloves anymore. I mean, first of all, it's another product that you have to carry. But, also, if you don't touch the catheter, you should be fine with washing your hands before you start the catheterization. Then with these insertion grips, you're not touching. So no touch.

Susanne Lindholm: Exactly. Yeah, sorry?

Anna Malmborg: I do want to say that if you make sure to pull the catheter out just enough, then you can ensure that you don't have any leakage of urine during catheterization either. Then it will be sealed.

Susanne Lindholm: It will be sealed. Yes.

Diane Newman: It will be sealed, huh?

Susanne Lindholm: Yeah. Now, when you are ready when you are finished, you just put it back in. And then you can empty the bag if you want to. You just easily do the bag, or you can ...

Diane Newman: And just throw the whole thing away like that.

Susanne Lindholm: Yeah. And now you're finished. Yeah.

Diane Newman: That's a nice system. That really is. And you can see it's very easy to use. Like you say, it's kind of soft. You don't hear it, which is ... We don't think a lot about that, but, you know, patients would tell you they don't want anybody to know what they're doing, so the sound is important to them. But then, of course, too, how compact it is, and how easily then it can be discarded.

Susanne Lindholm: Yeah, exactly.

Anna Malmborg: One nice thing, I think, with these new updated loops, is that even if you have poor dexterity, you can actually put your hand in, then have you put your thumbs in-

Diane Newman: And use that to do some-

Anna Malmborg: ... And then you can remove the top.

Diane Newman: Oh, I see.

Anna Malmborg: And also separate it from the bottom to make use of the insertion grip.

Susanne Lindholm: You also have a scale here, if you want to know quantity.

Diane Newman: You have a measurement here on the side of the bag, huh? How much does this bag hold?

Anna Malmborg: One liter.

Diane Newman: Oh, that's a lot of urine. So hopefully no one's cathing a liter. We tell patients that they should cath at least under 500 mLs, so we don't want that bladder to get too big and overdistended. So that's a more than adequate amount.

Susanne Lindholm: It could be good if you want to have ... To see how much urine, if you have to.

Anna Malmborg: Also, that's also the transparency of the bag, and also so that you can see.

Diane Newman: You've shown us three really great products, and I really appreciate your coming. I think that in our show and tell portion of the Pelvic Health Center on UroToday, is for providers who really ... Even urology, new nurses coming there, not aware that this is available. So this is very informative. We have a lot of patients and consumers that come to the pelvic health center on UroToday, and they like to understand this. I think that showing this and some specifics about the female one, the more compact male one, and then one where you have a drainage bag so it's all inclusive, I think really can be helpful. So I really appreciate you spending time with me.

Susanne Lindholm: Well, thank you for having us.

Anna Malmborg: Thanks for having us.

Diane Newman: Providing all this information, so thank you.

Anna Malmborg: Thank you so much.

Susanne Lindholm: Thank you.