Intermittent Catheter Features - Diane Newman
June 20, 2022
Diane K. Newman, DNP, ANP-BC, FAAN, Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania, and Former Co-Director of the Penn Center for Continence and Pelvic Health. She is the author of several books. The most recent is as lead editor of the 1st edition of the SUNA Core Curriculum for Urologic Nursing and of Clinical Application of Urologic Catheters, Devices, and Products.
Diane Newman: I'm Diane Newman. I'm a nurse practitioner and I specialize in urology. Urology is a medical specialty that treats men and women who have bladder dysfunctions. And those dysfunctions could be a problem where you cannot empty your bladder adequately and urine stays in the bladder. And in those cases you may need catheterization. I've been practicing for over 35 years, and I've been teaching men and women how to place a catheter in their bladder to drain the urine out if they can. And you sometimes see that in individuals who have diabetes, who have a spinal cord injury, who may have multiple sclerosis. So, there's a lot of conditions that can cause a person not to be able to empty their bladder adequately. What I want to do now is show you some of the catheters that we use to drain the bladder.
These are called intermittent catheters, and I'm showing two different companies here, Cure Medical, they make intermittent catheters, as well as Convatec. And I want to show you some different components of these catheters. Let's first start with this one. So, this basically is what I call a straight catheter. And by that, I mean, we say we straight catheterize someone, which means that we just put the catheter in, we drain it and then we take it out. So, it is removed after the bladder is drained. This is what we call a long catheter. The funnel at the end tells you what type of size it is. This is a 14 French because green is 14 French. The length of this is what we sometime say is a standard length, but it is a long length catheter for men because men have long urethras, so that's the tube that goes to the bladder to the outside.
So, you got to make sure that there's an adequate length to get that catheter into the bladder. So, this we tend to use with men. We also have another type of catheter that we use for women. And these tend to be shorter length catheters. Women just find these a little bit easier to kind of grasp and use. And it's almost like a pencil. I'm right handed, so to catheterize, I would hold it like this. Us, women have short urethras and I actually have a model here to show you kind of what women's bladders looks like. So, this is basically the uterus and this is the bladder. And this is looking at kind of the woman's bottom. This down here is a vagina and this is the urethra.
So, whenever you would catheterize yourself, you would actually hold it like this and place the catheter right into the urethra and it would pass. And as you can see here, it's in that bladder. Because our urethras are much shorter, so that length is good for us. And I find that these catheters are great because women can manipulate them. They don't flop around. And because we have shorter urethras, we don't need that long length catheters that men use. What else you'll notice about this catheter is it actually is pre-lubricated. That's an important point. You don't want to put a dry catheter in your bladder. That can cause trauma to that tube that goes from the outside into the bladder. It can cause bleeding. It can cause some disruption in the lining of the urethra, that tube, so you want to make sure it's well-lubricated, as you can see with this catheter.
Now, I talked with you about the shortness. Here's another one. This is by Cure Medical, and it's called the Twist. See how easy that was to open. And as you can see, it has a nice type of container it sits in. Okay, so you could put this in your pocket if you have to go to work or you're going out or on vacation, you have to catheterize yourself, because you're going to be doing it several times a day. Remember, if the bladder's not empty, you will have to catheterize yourself several times a day. And you can see again how easy this is to take out. Again, it's very similar to the one I just showed you, and it has lubrication on it also. But this is really a nice compact catheter that you can use and easily place in your purse or in your pocket.
Now, we talked about the tip and this is a straight tip. You see that? It's straight. However, men are made differently than women. I think you probably kind of... Most of us understand that. And by that, I mean, is that men have longer urethras. What that means is that... Okay, here's the guy's scrotum. Here's his penis. And this is kind of cutting him in half, you can see the bladder. Men have longer urethras, but they also have what we call curve. Sometimes we call them s-curves, which mean they curve to get into that bladder. You, number one, need a longer length catheter, but sometimes you may need a different type of tip. So, I want to show you a different kind of catheter with a different tip. Remember, we talked about a straight catheter. Well, this is basically one that has a curve tip and that's called a coudé tip catheter.
This is actually by Cure Medical. And basically what you have here... There's a couple things we have with this catheter, a couple features that I think are important. Number one, look at that coudé tip, that curve tip. It curves up. Okay? It's very different than this, which is a straight catheter. This is pre-lubricated also. This one was not pre-lubricated, but this one is. And it has something else really interesting. It has a blue stripe there that kind of guides you to tell you how the catheter should be placed into the urethra when you're catheterizing yourself. And this also is another feature that I'm going to talk about also later. And that's what I call a finger grip or a guide, a slider. And what that means is you don't have to really touch the catheter. When you catheterize, you can just use this to slide it along.
So, let's catheterize this patient. Okay. What you would do is, number one, with men, you want to straighten out those curves as much as you can, because again, when you catheterize, you don't want to traumatize that tube that comes from the bladder. So, with a male patient, what I teach them is they should always pull their penis up. Okay, so I'm trying to straighten out that curve and that tip is always up towards the head. So, it's curved upwards when it goes in. And by watching that blue guide stripe, I know that I'm not twisting it. So, what you would do is put that in like that. Okay. And you see here, I'm holding it here. All right. So, I'm not touching the surface of it. And then you would pass it and you want to keep the penis up, straighten out that curve. And as you can see, I'll turn this around, that catheter is already in the bladder to drain.
Now, what I teach patients to do though, because men's penises are different lengths, so that urethra's a different length, that I have them pass that catheter almost to, what we call the hub. I pass it to the funnel of the catheter, the end of the catheter, and what'll happen in the bladder is it will just curl around in the bladder, which is fine. Okay. It goes up against the bladder wall. It's a soft type of product. It's a soft catheter, it'll curve and then it'll drain the urine out. And then what I have them do is once the catheter's in, they don't have to hold their penis up, it can go down. And then once the bladders drain, you slowly remove it. So, that's actually how you would catheterize with a coudé tip catheter.