When
we first needed to cath my daughter, I was handed a box of stiff
plastic catheters, a bottle of betadine, and a squeeze bottle of KY
jelly. First off, I was appalled that we were supposed to reuse the
same 20 caths for a month. But more importantly, I had no idea that
there were any other available options.
Fortunately,
I soon was introduced to a new urological supply company that was happy
to suggest products, get them approved through insurance, and allow us
to experiment a bit. After about ten free sample trials, we found the
perfect solution that minimized mess, was easy to use, eliminated
discomfort, and was completely sterile from start to finish.
This
article is designed to introduce you to the various types of catheters
out there, in hopes that no one else will have to go through the horror
that was our first few weeks of cathing.
Catheter Sizes, Lengths, and Tips
Catheters
are measured using the French scale, which is a unit that measures very
small diameters. 1 French is equal to 1/3 mm. Children typically use
catheters that are 8 French, 10 French, or 12 French, with babies using
5-6 French, and teens and adults using 12-20 French catheters. While in
general smaller children use smaller diameter catheters, anatomy can
vary, and you may need to try several sizes before settling on the right
size. Start small, and only upsize if you cannot get urine to flow
easily, or if urine leaks passively around the catheter.
Catheters
also come in several different lengths. In general, there are short
“female” catheters and longer “male” catheters. Because the female
anatomy has a much shorter urethra, some women--especially those who
self-cath into a toilet--prefer a shorter catheter. The longer “male”
catheters tend to be more useful for men, boys, and anyone attempting to
cath into a receptacle or diaper. Some pediatric catheters are also
shorter in length. Many catheters these days are labeled as unisex,
with a moderately long length. As a parent, I always found a longer
male or unisex catheter to be ideal, especially if I was trying to cath
into a receptacle or diaper.
While
most catheters are straight, there are some that have different tip
styles. Coude catheters have an angled tip that may be useful for men
and some individuals with anatomic abnormalities. Most have funnels on
the end to easily empty urine, but a few have luer ends that are
straight.
Various sizes and lengths of straight catheters
Simple Straight Catheters
The
most basic catheters are straight caths usually made out of plastic
(vinyl or PVC), silicone, or red rubber. They range from rigid PVC
catheters, which are easier to insert but can be uncomfortable, to soft
red rubber ones that contain latex. In between are “soft” catheters,
made of slightly softer material that some users find more comfortable.
Red rubber catheter
These
types of catheters may be packaged alone, with no gloves or other items
for cathing. If you choose to use this type of catheter, you may also
want to obtain catheter insertion kits, which typically contain
lubricant, gloves, and povidone-iodine cleansing cloths. Some are
available with a prepackaged accessory kit or a full closed system kit.
Hydrophilic Catheters
Hydrophilic
catheters are coated with a special lubricating solution, that when
mixed with water creates a catheter that slides with remarkable ease and
comfort. They become extremely slippery, but still remain rigid enough
to insert with ease. Most come packaged with a water packet inside.
The package is squeezed until the water packet bursts and lubricates
the catheter. After about 30 seconds, the catheter is ready to be
opened and used. A few require you to soak the catheter in water. In
general, these are not recommended because they are likely to be
contaminated during the soaking process.
Hydrophilic cath in packaging with water packet
Hydrophilic
catheters may be packaged alone, meaning you would also need an
insertion kit if you need gloves or cleaning cloths. Many are packaged
as part of a closed-system set.
Closed System or Touchless Catheters
Both
regular straight caths (of all types and materials) and hydrophilic
caths are also available as a closed system kit. In this case, the
catheter is contained within a collecting bag. Most also include an
introducer that can be placed into the tip of the urethra first,
allowing the catheter to enter the urethra completely “touchless,” and
minimizing the risk of infection. Most closed system caths come either
prelubricated (in the case of regular straight caths), or with a
prelubricated introducer and water pack for hydrophilic caths.
Closed System Kit
These
systems are extremely convenient, as most are all-in-one systems that
include the catheter with attached collection bag, gloves, cleaning
wipes, and other necessary items. They work very well for cathing at
school, when you are out and about, and during travel.
Other Types of Specialty Catheters
There
are a few other types of catheters out there that may be of assistance
to certain users. These include catheters with an antibacterial
coating, easy grip catheters for those with limited dexterity, compact
catheters that can fit into a pocket, and even catheters packaged in the
style of cosmetics for those who need more style.
Expectations
You
should expect that you have a choice of different types of catheters,
and the ability to trial different types of catheters until you find one
that works. If your company will not assist you, find a new urological
company. You should also expect to receive enough catheters (and
insertion kits if necessary) so that you never have to reuse catheters.
Good luck cathing, and we hope you find a product you love!
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