Intermittent Catheters by Hollister- Mary Anne Wasner and Meryl Dillon

Mary Anne Wasner and Meryl Dillon discuss the intermittent catheters offered by Hollister Incorporated with Diane Newman.  They review the features of the VaPro catheter products including the hydrophilic coating, protective sleeve, and tip along with the Coude tip feature.  They also discuss the Onli catheter which has the same hydrophilic coating as the VaPro and is intended to be easy to teach and for the patient to learn. 
Biographies:

Mary-Anne Wasner, RN BSN CURN, Manager of Clinical Education, Clinical Research Manager, US Continence & Critical Care, Hollister Incorporated

Meryl Dillon, Secure Start at Hollister Incorporated

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. I'm a Urology Nurse Practitioner and I specialize in pelvic floor dysfunction. I see patients with incontinence, overactive bladder, but I also see many patients who cannot empty their bladder, they have an incomplete bladder emptying syndrome or urinary retention and they need catheterization. I'm also the editor of the Pelvic Health Center on UroToday and we have a resource center for indwelling urinary catheters and intermittent catheterization that I know patients and clinicians have found to be very informative. So I'm bringing you a series of recordings on the different catheters we use for draining the bladder. And I have with me today two individuals from Hollister Corporation, which is here in Illinois in Libertyville. We're actually in Chicago filming this, and one is actually an old friend, Mary Anne Wasner, who's a nurse who was involved very much in the Society of Urologic Nurses Associates who's now at Hollister, and I also have Meryl Dillon here who's also from Hollister. I'm going to ask them to provide us with a little bit of information about what they do. Mary Anne?

Mary Anne Wasner: Sure. Diane, thank you so much for having us. UroToday has been a wonderful resource to me as a clinician in my everyday practice. With Hollister, I am the Clinical Resource Manager and I have the opportunity to create, manage and deliver educational programs that are customized for key opinion leaders, for clinicians, patients as well as our Hollister Associates. As you know, I am a certified urology nurse as well for many years and my passion is really about the patient and making sure that they have great outcomes. So thank you for this opportunity to share some things with you today.

Diane Newman: Mary Anne brought up and it's true, I've done a lot of stuff with Hollister. You've really been at the forefront of patient education in this area, so we really thank you. Meryl.

Meryl Dillion: I'm a marketing manager with our US Continence Care business and I'm responsible for vapor catheters and prior to this, I was a marketing manager with our patient support service.

Diane Newman: Well, thank you. Now, what we have here today is actually some of your products and I'd like them to go through exactly what the product is, kind of show us how you open it and what's the characteristics of it. Because I have found in my field, even though I'm in urology that even many of my colleagues within our practice at the University of Pennsylvania are not aware of the specifics of the catheters that may be more appropriate for an individual patient. So why don't you go through some of these here?

Mary Anne Wasner: Sure. I'd like to start with our VaPro Plus Pocket product. It provides 100% no-touch protection, and it is in a pocket packaging so that we have a nice discretion for our users. It has a ring pull which makes it easy to open.

Diane Newman: And that was really easy to open and you bring this up, patients really like the smallness of these. They don't want people to know they have a product say in their purse and they bring out a big catheter, right. This is very convenient, very discreet.

Mary Anne Wasner: Children have said, "This looks like a pop tart."

Diane Newman: Oh really?

Mary Anne Wasner: They said that it could be a juice box. Some of our adults have said this looks like a protein pack. So it's not something that you would immediately think of a medical product.

Diane Newman: That's really nice.

Mary Anne Wasner: So when you go to open the packaging, hydrophilic catheters can be slippery when wet. They can have a lot of fluid in there, but if you take a look at our packaging, it's pre-hydrated, ready to go. There's no pledget that needs to be burst. There's some water in here, but nothing that's going to cause a mess or a lot of spillage.

Diane Newman: That's a big issue, as far as water getting over their clothes and that. And the hydrophilic, that's a coating, correct?

Mary Anne Wasner: Yes. Yes.

Diane Newman: Talk a little bit about the coating because your product is very, very unique as far as, well, of course, the cost of cover. I want you to go through that. But also as far as the coating on the catheter.

Mary Anne Wasner: So, the coating, the way it is manufactured, is something that is pre-hydrated ready to use. And it is a patented type of processing that Hollister has directed our attention to so that when we're passing the catheter, it's continuously lubricated down the entire length of the catheter and makes for easy insertion as well as removal. So the catheter itself has a ring cap to it and we always look at dexterity issues, very easy to remove. It has a protective tip and, the importance of the protective tip is that it bypasses the first 15 millimeters of the distal urethra where so much of the bacteria reside.

Diane Newman: So you want the patient to insert that into their urethra, this tip right here, right?

Mary Anne Wasner: Yeah, so you want the catheter behind the tip. Once you've placed this into the urethra, you're not pushing the bacteria in that bacterial loaded area-

Diane Newman: Just bypassing that.

Mary Anne Wasner: ... area up into the bladder. The protective sleeve protects a sterile catheter, so no matter where you touch along the shaft of the catheter, you're never touching the catheter itself. It's always protected by the sleeve. So regardless of the pathogen that may be on your hands or along the environment as you're passing the catheter, the catheter itself always stays protected.

Diane Newman: Yeah. And this, for our viewers, is what's very important in what she just said is we call that a no-touch technique and the patients are just much more active, right? They're at work, they're out maybe at the restaurant having dinner and they really need to catheterize themselves. You're right about the hand hygiene, we would hope that, of course, you wash your hands before you do the catheterization, but you don't. They may not be able to do that because they may be in a place where they don't have the water to wash their hands. They can use maybe one of the alcohol-based cleaners but still, you're right, that no-touch technique I think is very important.

Mary Anne Wasner: And it's more important to catheterize on your schedule.

Diane Newman: Yes, that's right.

Mary Anne Wasner: Regardless of where you're going to need to empty your bladder. So protective tip bypasses that first 15 millimeters of the distal urethra; protective sleeve, you're never touching the catheter. The catheter remains sterile. So once you've advanced the catheter, very smooth eyelets.

Diane Newman: Yeah, I know. That's actually what I really love about your catheter is actually the smoothness and you're right the eyelets. There's no rough edges, which is important because, of course, the eyelets are where the urine, of course, drains out of the catheter. But you don't want any kind of roughness on the catheter because-

Mary Anne Wasner: You don't want to cause any trauma to the urethra.

Diane Newman: No, what I've seen and I know you were in practice a long time, Mary Anne, is we've seen patients cathing for years and years and years, right? So putting that catheter in four or five, six times a day, traumatizes the urethra, especially males who have long urethra. So the smoothness is very important.

Diane Newman: And then answer one more, Mary.

Mary Anne Wasner: Sure.

Diane Newman: So I teach patients this, so what's really neat is as they pass a catheter, this protective sleeve, look, it just very, is very thin. I mean I don't know how you guys design this but really nice, just kind of just flows back there, it's no big deal. And you can see how the catheter really is really nice, really very, very smooth, nice catheter.

Mary Anne Wasner: And even those who have some limited dexterity and don't have a good pinch. Even utilizing the side of your leg and being able to just advance the catheter through.

Diane Newman: That's a good idea.

Mary Anne Wasner: So it just makes it so simple.

Diane Newman: Right, right, right, yeah.

Mary Anne Wasner: And being protected, always that 100% no-touch protection. That's what's key. We talked about cathing on schedule. You're not always going to be in this easiest place to do catheterization. You may be in a public bathroom, you may not even be able to get into a toilet area. You might be catheterizing in your car, on the plane.

Diane Newman: I just got to say, one of my patients catheterizes in his car, he's a salesperson. You're right. And he drives many miles, four times a week and he has to catheterize himself. And actually, what I really got on him as far as switching to this type of a system, and we call this a closed-system, right, where the bag is attached. 

Mary Anne Wasner: Mm-hmm 

Diane Newman: Is the fact that you need to catheterize yourself. So how do we make it convenient for them wherever right?

Mary Anne Wasner: Correct. Correct. And you still want to maintain that good technique, and make it easy. With the bag, this is a full-size 1,000-mililiter bag. You would never know that from the way it's packaged. You remove the ring pull and now when you unfold the bag ...

Diane Newman: Oh, that's a nice bag, isn't it?

Mary Anne Wasner: I'm not doing a good job at this, you guys.

Diane Newman: Well. Oh, it's a large bag too, look at that. Yeah, that's a really nice, huh?

Mary Anne Wasner: A great handle. Very similar to a urinal. It's something that we all use every day in healthcare. If you take a look at the markings, this will allow you to look at your residual urine. If you're doing any of your bladder diaries for a nice calculation. Anti-reflux valve, so if for some reason I needed to do this in my car or on the plane and I have to put the bag down, you're not going to have the backflow of urine and have leakage all over the place. Same thing too if I'm catheterizing and I pull the bag up, I'm not going to have reflux.

Diane Newman: So you really want to have a valve in here so that your urine isn't going to go back up.

Mary Anne Wasner: Yes, and if that is this portion right in here. Right here.

Diane Newman: That's important because I have patients do a lot of different things. Like you say, hang them on a doorknob while they're doing the catheterization or something, a hook and you're right, you don't want it to have to go back or have any kind of impedance as far as the flow.

Mary Anne Wasner: The other thing too is the handle really has a nice control, so as patients are filling their bags, they get heavy, they get bulky and you don't want this pulling out before they're completed with their emptying of the bladder as well.

Diane Newman: That's really nice.

Mary Anne Wasner: And then when it's the convenient time to empty, it has a nice tear, you're able to dispose of the urine into the toilet and then the rest of this is just regular trash so you can even put your cap back on, and put this back into our bag.

Diane Newman: This back into the bag, huh?

Mary Anne Wasner: Yep, for a discreet disposal of your product.

Diane Newman: So it's really a pocket kind of, huh? What I had shared with them was the fact that one of the patients that when this product came out about six months after, I had a patient who came into me see me because he had recurring retention infections. The cause of his urinary retention, it was kind of was idiopathic, we weren't quite sure why. But he'd been cathing for almost two years, would have an infection every almost every 10 weeks, sometimes even more frequent. And they've tried everything. He was starting to develop a lot of very much resistance to antibiotics, which I'm sure you understand the more and more of these infections go on the more antibiotics we give, the resistance is a major problem. So I watched his technique and he was using single-use hydrophilic, another type of catheter, but not a no-touch. Actually, I switched him to VaPro and has not had an infection now for I think 18 months.

Mary Anne Wasner: That's amazing. 

Diane Newman: I know it is. It really is because I think male patients, we tend to see more infections in women because of the anatomy and that, but he just really, I don't know what, we watched him in the office but we really don't know how they're catheterizing outside. Right?

Mary Anne Wasner: Correct.

Diane Newman: So I just felt that a no-touch system and this worked perfectly. He loves the system, so, very active man.

Mary Anne Wasner: Awesome.

Diane Newman: Well, tell us a little bit about what you're doing, Meryl, as far as with your role in Hollister?

Meryl Dillon: So, my role with Hollister, I'm in charge of all of the VaPro catheters in the United States and I wanted to show you our Coude product.

Diane Newman: Oh, okay. Yes.

Meryl Dillon: If you liked the protective tip and sleeve features of VaPro and that easy to open package, we have it available in a Coude tip. And this is again with the protective tip and sleeve, and there's just water in the package so it won't stain, of course. And again, you can take the cap off with the Coude, it's designed to help maneuver the bends in a narrow urethra and it's also suitable for a male with an enlarged prostate.

Diane Newman: So the Coude is a curved tip right at the end?

Meryl Dillon: It is.

Diane Newman: Sometimes it's referred to a Tiemann catheter.

Meryl Dillon: Yes.

Diane Newman: And you can see how that curve and when you put it in exactly as you're holding it, you want the curve up towards the head as you insert it.

Mary Anne Wasner: Yes, and our catheters have a notch on the funnel.

Diane Newman: Oh, okay, great.

Mary Anne Wasner: And that's the indicator that lets you know that direction of that curved tip.

Diane Newman: Yeah, that's very important. We also see this with indwelling urinary catheters, that notch at the end, we tell nurses and patients when they are cathing that they should see that as they insert it, so that we know the tip is in the correct position as it goes in the urethra.

Meryl Dillon: Exactly, so that's our Coude tip product. The packaging also has an adhesive tab on it so you can adhere the package to a surface and the product, it's a 16-inch catheter and it's available in French sizes 12 through 16.

Diane Newman: Oh, that's nice, huh? Oh yeah. I guess I didn't realize that you had the Coude tip in the VaPro. That is very nice. It's really the same design, isn't it?

Mary Anne Wasner: Yes.

Meryl Dillon: Mm-hmm.

Diane Newman: Excellent. Both out the bag, which is nice to have though also because people can, of course, use it at home and that, and I prescribed a lot of Coude tips in male patients, those say with strictures. Even if you don't have a male patient with a stricture over time, that's one of the risk factors, right, of continuing catheterizing yourself, you can develop a stricture, which is like a narrowing scar tissue in the urethra So using Coude helps. Also, I think it's also very helpful in preventing false passages, get tunneling in another part of the urethra. That's a nice catheter. Thank you.

Meryl Dillon: Yes.

Diane Newman: All right. And I see you have a shorter one here also, huh?

Mary Anne Wasner: We do, so not every patient will need all of the protective benefits of our VaPro product. Onli is a great alternative. It's a wonderful way to start patients for their very first time of intermittent catheterization. Onli is intended to be easy to teach as well as easy to learn. It has the ring pull. Again, we've kept that with all of our product line and our female product is a shorter length catheter.

Diane Newman: Oh, that's a nice catheter, yeah.

Mary Anne Wasner: So, it's a seven-inch. It has a flexible funnel so it makes for easy handling of the product itself. And again, the smooth eyelets.

Diane Newman: It's the nicest.

Mary Anne Wasner: It's a hydrophilic coating, the same coating as of our VaPro line of products.

Diane Newman: Yeah. This is a nice grip. Yeah, this is a nice product, Onli. Onli and show that because when I first heard that I was saying, "Hey, that's an interesting name," so this is the VaPro and that is the Onli. But I have to tell you that with female patients, shorter catheters work so much better as far as the manipulation of the catheter and the urethra. Women will complain that in a longer catheter if they use it, it kind of flips around and that, and this is so much better to manage when catheterization. So this is really a nice catheter and you have the same coating that you have on the other.

Mary Anne Wasner: It says the same coating as VaPro.

Diane Newman: It's a nice catheter.

Mary Anne Wasner: For our gentleman though, if we want to have the 16-inch length, again, the ring pull for open. And if you take a look at the male catheter itself, it's pre-hydrated, ready to use. And it has an ergonomic gripper because when we talk about hydrophilic's one of the things people say, "It's slippery when wet, so how do I manage holding onto the catheter and being able to advance the catheter without actually touching it as well?" So if you're using the ergonomic gripper, you're able to catheterize without touching the catheter itself.

Diane Newman: Yeah. This is an interesting technology that's not that old is it, Mary Anne?

Mary Anne Wasner: No.

Diane Newman: And the thing is that these are like grippers, and you see what this is basically to hold the catheter as you advance it. And this is again is a nice one. I keep asking about as far as, "How can you grip it," and that? For some people that also may have issues with dexterity but also with sensation, this is nice. It's a little bit more firm in that and again with using this you have that non-touch, right?

Mary Anne Wasner: Correct. Correct.

Diane Newman: And this is a straight tip here?

Mary Anne Wasner: This is straight.

Diane Newman: So that's the Onli, right? Onli?

Mary Anne Wasner: That is.

Diane Newman: And this is a for a male longer catheter and what size is that?

Mary Anne Wasner: This is a 16-inch and the French sizes go from 8 to 16.

Diane Newman: I see, so then you can use it. A lot of times with the younger patients, especially with pediatrics, we use a smaller French size. Well, thank you very much. This has been very helpful. I know this is going to be helpful to our audience because I'm all about education and we have so many different types of products and I think Hollister has some of the newest and the most innovative technology, so I thank you for coming.

Mary Anne Wasner: Thank you for having us.

Meryl Dillon: If you'd like to learn more about Hollister Incorporated its products and services, you can visit hollister.com.

Diane Newman: Thanks very much.

Meryl Dillon: Thank you, Diane.
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