Types of Catheters
Straight catheters, also known as intermittent catheters, are inserted through the urethra and into the bladder. Equipped with openings called eyelets, urine flows out of the bladder, through the catheter, until empty. Once emptied, the catheter is removed and discarded.
Coudé catheters, are similar to straight catheters with the only difference being a slightly bent or curved tip. This aids in navigating arounds obstructions in the urethra like an enlarged prostate.
Closed-kit catheter systems are self-contained all-in-one sterile kits with a self-contained collection bag. The closed-kit system is considered the safest and most sterile catheterization option, often resolving repeated UTIs by preventing the catheter from contacting bacteria before entering the bladder.
External catheters, also known as condom catheters, are used by men to address urinary incontinence. These catheters, like condoms, contain a sheath that roll over the penis and connect to a urinary retention bag. Some men find external catheters to be more convenient as they do not require insertion through the urethra while continually offering protection from urinary incontinence.
Indwelling catheters, also known as “Foley” catheters are inserted by a medical professional and remain in the bladder for a period of time instructed by a physician or personalized catheterization care plan. Urine empties from the bladder through the catheter and drains into a collection bag outside of the body.
Why perform self-catheterization?
The bladder’s function is to collect, retain and empty urine created by the body. The need for catheterization arises when the normal function of the bladder is disrupted and the ability to store or empty urine is affected. Intermittent catheterization mimics the body’s natural function to accumulate and release urine stored in the bladder thus providing health benefits and reinforcing natural body function.
When the bladder is functioning properly, it naturally fills with urine and is stored there until released. In the case of intermittent catheterization, a catheter is used to empty the bladder at regular intervals throughout the day. While urine is sterile, leftover liquid in the bladder creates a breeding ground for bacteria to congregate and multiply. Proper bladder filling and emptying also allows the muscles and lining of the bladder to properly expand and relax over the course of a day thus decreasing potential leakage, thus more confidence and control of one’s day.
Preventing infection and maintaining good bladder health is one of the most important parts of intermittent catheterization. Your medical professional will suggest if catheterization is right for you and what type of catheters to use. This could include intermittent catheterization like a straight or coudé catheter or something more long term like an indwelling Foley catheter setup. If the plan includes using intermittent catheters, the best practice is to discard a catheter after each single use to ensure that only sterile product is coming into contact with your body, thus significantly decreasing the risk of infection. Also, Medicare now covers up to 200 catheters per month, increased from the old standard of 4 per month. Therefore, it is advised to use a new, sterile catheter each day.
This diagram below, provided by the National Health Service, instructs the proper techniques for washing one’s hands. Be sure to complete each of these steps before and after inserting or removing a catheter to ensure reduce the risk of contracting a urinary tract infection.
Mayo Clinic advises that, on average, individuals should consume between two and three liters each day. This number will change for each individual; however, it’s good to aim for eight 8oz glasses of water unless otherwise instructed by your physician or catheterization care plan. Take special note of caffeinated beverages and spicy food as they can act as irritants to the bladder and can cause frequent or irregular need for bladder emptying.
Regularly emptying one’s bladder allows for the natural expansion and relaxing of the bladder walls. Your personalized catheterization plan provided by your doctor will instruct you on the number of times per day to catheterize. On average, half a liter of urine collection each time you catheterize is optimal.
Medicare, Medicaid and most private insurances following suit, provide new, sterile supplies for each need to catheter. This reduces an individual’s likelihood for UTIs and bacterial contamination because catheters should be discarded after each use.
A clean environment is paramount before each catheter insertion and removal. Following proper hand washing and preparation before inserting or removing catheters will reduce one’s likelihood for UTIs or transferring other germs and bacteria into the bladder through the urethra.
How to perform self-catheterization
There are three main steps to intermittent catheterization for both men and women. First preparation, then insertion, followed by removal.
To prepare, start by ensuring you have freshly washed hands, following the hand washing instructions above. Next, ensure all the necessary supplies are accounted for and in an easy to reach area. You will want a new sterile catheter, supplies to clean the opening of the urethra and water solvent lubricant, if necessary. Inspect the supplies, especially the catheter to insure it is not damaged or exposed to the open environment. Position yourself either on the toilet or across from it in a chair, whichever is more comfortable for you. Spread your legs comfortably so you have ample area to address the genitals.
Once prepared, begin by cleaning the area of the genitals close to the urethra with your cleaning supplies, usually a moist towelette or soap and water. Once cleaned, lubricate the catheter, if necessary, using your water-based lubricant. The two ways to accomplish this effectively is to either tear both ends of the lubricant packet off and slide the catheter through it or tear one end and squeeze the lubricant down the shaft of the catheter. Slowly and carefully insert the catheter into the urethra and insert another inch to insure both eyelets are within the bladder. Once inserted, consciously relax. Pressing on your belly or coughing can help begin the flow of urine into the collection bag or into the toilet, depending on your catheter type. Remain calm and still until the flow of urine stops.
Begin to slowly remove the catheter to see if more urine empties as the eyelets leave the bladder. Once removed, clean and dry the opening of the urethra with a dry towel or cloth. If using a collection bag, measure the contents to note the average amount of liquid collected for the given time period since last catheterization and discard the urine into the toilet. Discard the materials in the proper waste receptacle and wash hands to prevent the spread of germs.
Conditions that cause catheterization
- Spinal Cord Injuries
- Spina Bifida
- Multiple Sclerosis
- Traverse Myelitis
- Prostate Cancer / BPH
- Urinary Incontinence
- Urinary Retention