Advancements in Catheter Technology: Exploring the Role of Lubrication and Proper Utilization for Urethral Health - Diane Newman & Don Darais
May 18, 2023
In this discussion, Diane Newman, a Urologic Nurse Practitioner and Don Darais, the Associate Director of US Marketing for ConvaTec, explore the vital role of lubricating catheters in preventing damage to the urethra and delve into the significance of appropriate catheter utilization. Darais introduces ConvaTec's self-lubricating Cure® catheters, which simplify the process for users. They also discuss the drawbacks of traditional hydrophilic coatings and introduce the new GentleCath™ catheter with FeelClean™ Technology, where the hydrophilic properties are embedded in the catheter surface. This eliminates the issue of drying and sticking during catheterization. The conversation emphasizes the benefits of the new technology in providing a smoother and more comfortable catheterization experience.
Biographies:
Don Darais, Associate Director of U.S Marketing, Continence Care, ConvaTec, Oklahoma City, OK
Diane K Newman, DNP, ANP-BC, BCB-PMD, FAAN, Urologic Nurse Practitioner, Adjunct Professor of Urology in Surgery, Research Investigator Senior, Perelman School of Medicine, University of Pennsylvania, and Former Co-Director of the Penn Center for Continence and Pelvic Health, Philadelphia, PA
Biographies:
Don Darais, Associate Director of U.S Marketing, Continence Care, ConvaTec, Oklahoma City, OK
Diane K Newman, DNP, ANP-BC, BCB-PMD, FAAN, Urologic Nurse Practitioner, Adjunct Professor of Urology in Surgery, Research Investigator Senior, Perelman School of Medicine, University of Pennsylvania, and Former Co-Director of the Penn Center for Continence and Pelvic Health, Philadelphia, PA
Read the Full Video Transcript
Diane Newman: It's very important that you lubricate your catheter before you put it into your bladder, into your urethra. I hear lots of stories from patients and I just cringe sometimes. I've had people say to me that they lubricate just the tip or they don't do enough lubrication, and that's, that's not good. You want the entire length of the catheter to be lubricated. Most catheters, now that we use the technology is self lubricating. We're going to show you those, but I want to show you what we call an uncoated catheter that needs you to apply lubrication or what we call gel. So this is actually uncoated catheter. You can see that it opens at either side on the back again, we got this as a 14 French catheter. It's a Cure catheter. It's the name of it. And you open it up and let's look at this.
This is a shorter length, so this would be for women. You can see it's not lubricated. Okay, what would you do? Well then you have to have a packet of lubrication or maybe a tube. And you want to make sure that when you lubricate, you lubricate the entire catheter. What I tell patients to do is I have them open up the catheter like this, you're in the bathroom, put it on the counter, you tore open your packet and you lubricate the entire catheter. The length of the catheter is very important. You see, you want lubrication. You see that gel of the entire length. That's very important to do. It's just going to prevent trauma to your urethra. And I can't stress this enough. I don't think that sometimes when we educate patients, we put the emphasis on lubrication. I tend to like self lubricated catheters. We're going to show you that in a minute. But again, lubrication is extremely important, especially if you have an uncoated catheter. And uncoated would mean it's not hydrophilic. It has no actual coating at all. So I showed you one that was uncoated that we lubricated. So we're going to have Don demonstrate for us these self lubricated catheters. And that's what these are, correct?
Don Darais: Yeah. So this is the Cure Ultra®. So Diane was talking a little bit ago about the products, you know you lubricate the catheter yourself. This actually takes that step out of the way for you. So it's much more convenient. So you just pull the tab open there and this catheter is ready to go. So just like Diane was showing in the previous one.
Diane Newman: See all that nice lubrication there, huh?
Don Darais: Exactly. And what's great about this is that, so this product, the packaging is the least amount of packaging that's really needed for this, which was very intentional. And sometimes when patients open it, they talk about how they feel this little pull and this tug. And that's actually intentional. We call it our coverall technology. So whenever these catheters are made, we actually vacuum seal the package so that way when they go to pull the catheter out, the entire catheter is lubricated and ready to go.
So we talked about this catheter. So this is our Cure Ultra®. This is our female length. And as you could tell it is quite a bit more compact or much shorter.
Diane Newman: So this is for women, correct?
Don Darais: Correct, yes.
Diane Newman: A guy does not use a shorter length catheter.
Don Darais: You are absolutely right. One of the things we heard a lot of feedback on was that a lot of patients really liked this product, however, they just said it's a little too small. So we listened to the market, we listened to what end users were saying, and we developed this one. So this is called the Cure Ultra Plus®. So same package, same product. It's actually just a little bit longer. So that way patients that need that little extra length, and we've got a different funnel color here, they can use a little bit longer of a product. But again, still that coverall technology that's used in every Ultra® product and the packaging, they would just open up the top there like I did. And then you can see that lubrication from tip to funnel.
Diane Newman: Wow, that's really nice. So let's look at these together, you can see the differences in those lengths. And that's a really great idea. So if you're really concerned, again, you're a woman about, maybe this is too short, you have this, but it's not the length of a male catheter. And then that white funnel is a 12 French. So again, you see this is a 14 French, and this is a 12 French. And you can see the differences in the diameter there. And again, remember that funnel top is color coded per size.
We talked about the coating, we talked about uncoated, we talked about the fact of the new GentleCath™ and the new FeelClean™ Technology where you have the embedded hydrophilic coating. A lot of the, historically, the hydrophilic coating has been where it's placed on the actual surface of the catheter, correct?
Don Darais: Right, exactly.
Diane Newman: And you can feel this is very slippery. Okay. And that's really nice for going through the urethra. The problem is though, is that this coating is adhered to the surface of catheter. And what happens is it dries, and it dries fairly quickly. One of the things that we're interested in is clinicians, and of course as patients is how much time it takes for you to catheterize and to drain your bladder. I've heard times like 14 minutes, maybe 10 minutes. Well, the problem is you're passing this into the urethra, very nice coated for the hydrophilic coating, but it's drying as that urine is draining. And what patients complain about is that it gets stuck. It may get stuck at the base of the bladder, in the urethra, and I've had patients tell me that I, Diane, I have to pull it out to get it out. It's stuck so badly. So we're really interested in new technology where it's not placed... The hydrophilic coating is placed on the surface, but it's actually embedded into the actual catheter surface. Right Don? I think that's the next type of technology. So talk to us a little bit about the catheter you have here.
Don Darais: Yeah, so you're absolutely right. So the previous hydrophilic or the second generation catheters of the coated hydrophilics, they used a chemical called PVP, which PVP is actually in glue as well because they had to have an item that is going to make the hydrophilic properties adhere to the catheter. But you're absolutely right, very lubricious. And what we actually have data that shows is that it's both our glide catheter and coated hydrophilic are just as lubricious going into the urethra. However, where the big difference is it's actually coming out. So it actually takes almost 40% less effort to start removing our GentleCath™ catheters with FeelClean™ Technology compared to a coated hydrophilic. So just like you were saying, this one actually doesn't have a coating. The hydrophilic properties are integrated or embedded into the product itself. So this one bursts the water sachet and it's immediately ready to go.
Diane Newman: So what happens when he did that is the water activates that embedded coating. Okay. So it's not like this one where actually it's on the surface, it's actually activating inside the surface. It's kind of embedded in there. So that's why you need that fluid to actually activate the actual coating.
Don Darais: Exactly. You're exactly right. And what's great about this is that fluid that we're talking about here. This is just purified water. It's just sterile water where, and some other products, they use saline. So a lot of times it can stain your clothes if it gets on your clothes or your shoes. If this gets on onto you, I always like to demonstrate just putting it on my clothing. It's not going to stain anything at all. It's just going to be water. So that's also a big advantage as well. But to your point, this catheter's going to stay very slippery. And then that PVP, if you touch a coated catheter, you can kind of tell over time that your fingers start to get a little sticky because that's that PVP actually coming off of the product. Where on the GentleCath™ catheters with FeelClean™ Technology, it's not going to be any stickiness. So if you get it on your hands, if you get it on your clothes, it's just water.
Diane Newman: And I was showing you before about this, this is now starting to get sticky. So it's been what? A couple minutes. And I mean that is a concern. So I do think that with new technology, we're probably going to maybe see less problems with removing that catheter and maybe less complaints as far as the catheter sticking to your urethra as you remove it.
Diane Newman: It's very important that you lubricate your catheter before you put it into your bladder, into your urethra. I hear lots of stories from patients and I just cringe sometimes. I've had people say to me that they lubricate just the tip or they don't do enough lubrication, and that's, that's not good. You want the entire length of the catheter to be lubricated. Most catheters, now that we use the technology is self lubricating. We're going to show you those, but I want to show you what we call an uncoated catheter that needs you to apply lubrication or what we call gel. So this is actually uncoated catheter. You can see that it opens at either side on the back again, we got this as a 14 French catheter. It's a Cure catheter. It's the name of it. And you open it up and let's look at this.
This is a shorter length, so this would be for women. You can see it's not lubricated. Okay, what would you do? Well then you have to have a packet of lubrication or maybe a tube. And you want to make sure that when you lubricate, you lubricate the entire catheter. What I tell patients to do is I have them open up the catheter like this, you're in the bathroom, put it on the counter, you tore open your packet and you lubricate the entire catheter. The length of the catheter is very important. You see, you want lubrication. You see that gel of the entire length. That's very important to do. It's just going to prevent trauma to your urethra. And I can't stress this enough. I don't think that sometimes when we educate patients, we put the emphasis on lubrication. I tend to like self lubricated catheters. We're going to show you that in a minute. But again, lubrication is extremely important, especially if you have an uncoated catheter. And uncoated would mean it's not hydrophilic. It has no actual coating at all. So I showed you one that was uncoated that we lubricated. So we're going to have Don demonstrate for us these self lubricated catheters. And that's what these are, correct?
Don Darais: Yeah. So this is the Cure Ultra®. So Diane was talking a little bit ago about the products, you know you lubricate the catheter yourself. This actually takes that step out of the way for you. So it's much more convenient. So you just pull the tab open there and this catheter is ready to go. So just like Diane was showing in the previous one.
Diane Newman: See all that nice lubrication there, huh?
Don Darais: Exactly. And what's great about this is that, so this product, the packaging is the least amount of packaging that's really needed for this, which was very intentional. And sometimes when patients open it, they talk about how they feel this little pull and this tug. And that's actually intentional. We call it our coverall technology. So whenever these catheters are made, we actually vacuum seal the package so that way when they go to pull the catheter out, the entire catheter is lubricated and ready to go.
So we talked about this catheter. So this is our Cure Ultra®. This is our female length. And as you could tell it is quite a bit more compact or much shorter.
Diane Newman: So this is for women, correct?
Don Darais: Correct, yes.
Diane Newman: A guy does not use a shorter length catheter.
Don Darais: You are absolutely right. One of the things we heard a lot of feedback on was that a lot of patients really liked this product, however, they just said it's a little too small. So we listened to the market, we listened to what end users were saying, and we developed this one. So this is called the Cure Ultra Plus®. So same package, same product. It's actually just a little bit longer. So that way patients that need that little extra length, and we've got a different funnel color here, they can use a little bit longer of a product. But again, still that coverall technology that's used in every Ultra® product and the packaging, they would just open up the top there like I did. And then you can see that lubrication from tip to funnel.
Diane Newman: Wow, that's really nice. So let's look at these together, you can see the differences in those lengths. And that's a really great idea. So if you're really concerned, again, you're a woman about, maybe this is too short, you have this, but it's not the length of a male catheter. And then that white funnel is a 12 French. So again, you see this is a 14 French, and this is a 12 French. And you can see the differences in the diameter there. And again, remember that funnel top is color coded per size.
We talked about the coating, we talked about uncoated, we talked about the fact of the new GentleCath™ and the new FeelClean™ Technology where you have the embedded hydrophilic coating. A lot of the, historically, the hydrophilic coating has been where it's placed on the actual surface of the catheter, correct?
Don Darais: Right, exactly.
Diane Newman: And you can feel this is very slippery. Okay. And that's really nice for going through the urethra. The problem is though, is that this coating is adhered to the surface of catheter. And what happens is it dries, and it dries fairly quickly. One of the things that we're interested in is clinicians, and of course as patients is how much time it takes for you to catheterize and to drain your bladder. I've heard times like 14 minutes, maybe 10 minutes. Well, the problem is you're passing this into the urethra, very nice coated for the hydrophilic coating, but it's drying as that urine is draining. And what patients complain about is that it gets stuck. It may get stuck at the base of the bladder, in the urethra, and I've had patients tell me that I, Diane, I have to pull it out to get it out. It's stuck so badly. So we're really interested in new technology where it's not placed... The hydrophilic coating is placed on the surface, but it's actually embedded into the actual catheter surface. Right Don? I think that's the next type of technology. So talk to us a little bit about the catheter you have here.
Don Darais: Yeah, so you're absolutely right. So the previous hydrophilic or the second generation catheters of the coated hydrophilics, they used a chemical called PVP, which PVP is actually in glue as well because they had to have an item that is going to make the hydrophilic properties adhere to the catheter. But you're absolutely right, very lubricious. And what we actually have data that shows is that it's both our glide catheter and coated hydrophilic are just as lubricious going into the urethra. However, where the big difference is it's actually coming out. So it actually takes almost 40% less effort to start removing our GentleCath™ catheters with FeelClean™ Technology compared to a coated hydrophilic. So just like you were saying, this one actually doesn't have a coating. The hydrophilic properties are integrated or embedded into the product itself. So this one bursts the water sachet and it's immediately ready to go.
Diane Newman: So what happens when he did that is the water activates that embedded coating. Okay. So it's not like this one where actually it's on the surface, it's actually activating inside the surface. It's kind of embedded in there. So that's why you need that fluid to actually activate the actual coating.
Don Darais: Exactly. You're exactly right. And what's great about this is that fluid that we're talking about here. This is just purified water. It's just sterile water where, and some other products, they use saline. So a lot of times it can stain your clothes if it gets on your clothes or your shoes. If this gets on onto you, I always like to demonstrate just putting it on my clothing. It's not going to stain anything at all. It's just going to be water. So that's also a big advantage as well. But to your point, this catheter's going to stay very slippery. And then that PVP, if you touch a coated catheter, you can kind of tell over time that your fingers start to get a little sticky because that's that PVP actually coming off of the product. Where on the GentleCath™ catheters with FeelClean™ Technology, it's not going to be any stickiness. So if you get it on your hands, if you get it on your clothes, it's just water.
Diane Newman: And I was showing you before about this, this is now starting to get sticky. So it's been what? A couple minutes. And I mean that is a concern. So I do think that with new technology, we're probably going to maybe see less problems with removing that catheter and maybe less complaints as far as the catheter sticking to your urethra as you remove it.
