Intermittent catheters: Best practice management


If you’ve ever wondered what the difference between straight tip and coude tip catheters are, this is the article for you! Here we go into all the details you need to know to help your patients navigate living with an intermittent catheter.

Intermittent catheterisation is often used for both short and long term continence management, because it avoids the complications more frequently seen with indwelling catheters – such as infections, bladder stones and catheter blockage.

Who needs them and why?

Due to their availability and low cost, intermittent catheters are often considered the best choice for patients with urinary incontinence, whether as a result of spinal cord injury, multiple sclerosis or spina bifida, or those who suffer from urinary retention.

Intermittent catheterisation allows for normal bladder dynamics so patients feel more in control of their bladder function. This boosts confidence and self-esteem and minimises the risk of urinary tract infections (UTIs), the most common complication of all types of catheterisations.

For short-term users, intermittent catheterisation delivers a faster recovery and return to normal voiding after surgery.

How are they used?

An intermittent catheter is a single-use, disposable catheter that the patient inserts, removes and discards once retained urine has drained. This may be need to be repeated between four and six times per day, to match normative urination schedules.

What kinds of intermittent catheters are available?

Intermittent catheters come in many shapes, sizes and types. There are male and female versions, no-touch catheters, compact units and lubricated hydrophilic models.

    • Of the different types of intermittent catheters, evidence shows that hydrophilic single-use catheters are best at reducing the risk of complications. They have a polymer coating that produces a thick, slippery substance when water is applied to the catheter’s surface. They’re easier to insert and decrease the risk of damage to the urethra by reducing friction.
    • Straight tip catheters are the industry standard. They are designed with a straight tip for easy insertion and eyelets for draining urine.
    • Coude tip catheters have a slight bend in the insertion tip to make urination easier for those with narrowing or blocking of the urethra (i.e. for prostate problems). This is easier to remember if you know that ‘coude’ is the French word for ‘elbow.’ For some men, coude tip catheters are easier to thread through the two curves of the male urethra as it travels into the bladder.
    • Female intermittent catheters are generally up to 25cm long and come in French sizes ranging from 8 Fr to 24 Fr.
    • Male intermittent catheters are up to 42cm long (to accommodate the longer male urethra) and also come in French sizes from 10 Fr to 24 Fr.

What are the complications?

The most common complication of all types of catheterisations is urinary tract infection (UTI). Because the bladder environment is sterile, inserting a catheter can increase the risk of bacterial contamination (but keeping urine inside the body is far more dangerous).

To counteract any potential UTI, you should ensure your patients know they must clean their hands and the entry site with mild soap and water before and after catheter insertion.

To help prevent infection, it’s also important patients remain well hydrated to keep their urine clear or only slightly yellow. Eating high-fibre foods – fruit, vegetables and wholegrains – can reduce constipation while keeping fit and healthy maintains better continence. Low impact exercise is best.

Independence Australia carries a wide range of intermittent catheters. Click here to view our full catheter range.