The Ultimate Guide to Urinary Catheters 2020

Welcome to our comprehensive guide to all things urinary catheters! 

Urinary catheters are used for a variety of reasons. Two of the most common reasons a healthcare provider will recommend one is if the individual is experiencing urinary incontinence or urinary retention. Some individuals are prescribed urinary catheters for long term use while some are prescribed catheters for a temporary period, such as after a surgery.

Whether you’re completely new to urinary catheters or you’ve been using them for a while, this guide will help you choose the best urinary catheter for your lifestyle.

Once you’ve finished reading, you can browse our site to find more information and find the right products for you. 

Let’s get started!

What is urinary catheterization? How does a urinary catheter work?

Before we dive into the different types of urinary catheters, let’s start with the basics.

Catheterization is a process used to drain urine from the bladder using an external device — called a urinary catheter — when the bladder is unable to empty urine by itself. 

The urinary catheter is a small, hollow, flexible tube that is inserted into the urethra and up into the bladder. One of the most common types of urinary catheterization is intermittent catheterization, which means the user inserts and removes the catheter several times per day. However, we’ll discuss other types of catheterization in this guide as well.

Why is urinary catheterization important?

The human body needs to keep the bladder empty of fluids in order to avoid infection, keep your organs healthy, and prevent urine leakage. When the bladder isn’t able to empty itself, unnecessary stress is put on the kidneys, which can ultimately lead to kidney failure and sometimes irreversible damage.

While urinary catheters are sometimes used as a short-term medical solution, and only necessary until an individual regains the ability to urinate on their own, there are many cases in which a urinary catheter must be used for a prolonged, or even permanent, amount of time.

Why would someone need to use a catheter?

There are many reasons a person may need to use a urinary catheter, but the main issue is urinary retention—when someone can’t empty their bladder on their own. The reasons for this issue may include but are not limited to:

  • a past surgery on the prostate gland, surgery in the genital area or surgery on the hips
  • a spinal cord injury
  • dementia or other conditions that impair mental function
  • kidney stones, blood clots or severe enlargement of the prostate gland
  • spina bifida or other birth abnormalities like bladder exstrophy
  • medications that affect the ability of the bladder muscles to squeeze and empty urine on their own 

What are the different types of urinary catheters?

There are several different types of urinary catheters available. The four most common types are intermittent urinary catheters, indwelling urinary catheters, suprapubic catheters, and external catheters.

Intermittent urinary catheters

How are Intermittent urinary catheters used?

Intermittent urinary catheters are most commonly used to manage retention or partial retention of urine. They are inserted and removed by the user (without the assistance of a medical professional) several times per day, allowing the bladder to drain. Once the bladder is drained of urine, the user is able to remove the catheter on their own as well. This process is called self-catheterization. 

To be more specific, one end of the catheter is left open, either allowing the urine to drain into a toilet or attaching to a drainage bag that collects the urine. The other end leads to the urethra and, ultimately, the bladder. 

If you’re considering an intermittent urinary catheter, you’ll also need to think about what type of intermittent catheter you want. Options include:

Closed system kits vs. just the catheter

Closed system kit catheters are single-use, self-contained catheters that come with their own urine collection bags. Due to their single-use, individually packaged nature, closed system kits minimize the chance of contamination during catheter insertion because you never have to directly touch the catheter tube. This keeps the urethra extra safe from bacteria. On the other hand, you may find that you don’t need the entire system and simply need the catheter itself. If you’re prone to UTIs, it is recommended to start using closed system catheters and track improvement over time.

Coudé catheters vs. straight catheters

Coudé tip catheters have a curved tip, while the rest of the catheter aside from the tip is straight. These catheters are a good choice for people with scar tissue, enlarged prostates or any other obstructions that may be blocking the urethra since the curved tip of the catheter is able to bypass these obstructions. It is important to keep the tip of the catheter pointing up during insertion. Some of the Coudé catheters have a blue guideline throughout the catheter to help you better aim and keep the tip pointing up.

If you do not have any obstructions, you will likely be fine with simply a straight catheter. Just as the name suggests, straight tip catheters are completely straight throughout. However, it’s important to note that these catheters are still flexible and able to move and bend as needed. If you try a straight tip catheter and experience difficulty during insertion, try a Coudé tip catheter as it might solve the problem.

Lubricated vs. non-lubricated catheters

Pre-lubricated catheters are lubricated right out of the packet to allow for smoother insertion and improved comfort. There are a few different types of lubrication: hydrophilic, gel, and silicon.

  • Hydrophilic catheters are coated with a water-activated coating, which is highly slippery and smooth. The hydrophilic coating makes insertion more smooth but is messier and should be handled with more caution as the packaging usually contains residual water solution. In addition, some users find them too slippery for handling.
  • Gel lubricated catheters are pre-lubricated with water-soluble lubrication. This lubrication makes insertion smoother—it doesn’t drip or makes a mess, but it can leave a sticky residue on the body.
  • Silicone oil makes the catheter more oily and makes insertion smoother, and it doesn’t drip or leak. However, some people might not find it sufficient and would need to add more lubrication.
  • Many catheters come with no lubrication and you can use them as is or add lubrication separately. When lubricating the catheter yourself, you should make sure to use a sterile, water-soluble gel. There are many different brands of lubricating gel or jelly—talk to your medical supply provider to choose the one that’s right for you since every person’s skin has different needs.

Can I use intermittent catheters more than once?

The FDA recommends using a new intermittent catheter each time. Each catheter is sterilized and often pre-lubricated to make insertion more smooth. 

What are the pros and cons of intermittent catheters?

Advantages of intermittent catheters:

  • They are the most common type of urinary catheters on the market.
  • They pose less risk for a distended bladder infection than prolonged or permanent urinary catheters.
  • They better allow you to maintain an active lifestyle.

Disadvantages of intermittent catheters:

  • The user must get comfortable with self-catheterization.

How do you choose the best intermittent urinary catheter for you?

While it’s important to discuss your catheter options with your urology care providers, we’ve rounded up a few key characteristics of urinary catheters that may help you choose the right one for you.

Comfort

You’ll likely be using your intermittent urinary catheter quite frequently, so ensuring that your catheter is comfortable is key. Make sure you’re using the tip most suited to you and that you’ve tried different lubrication options as they can make the insertion and removal more smooth and less painful. Another factor is the softness of the catheter—you want to make sure it’s firm enough so you can easily guide it in but soft enough that it doesn’t injure your urethra or cause any discomfort.

Length and width

Intermittent urinary catheters come in different tube lengths and widths. Catheter width is measured in french units or FR for short. Since every individual’s body is different, it’s important to determine the right fit for you. The correct length and width can also help prevent infections as well as make it easier to handle the catheter during insertion and removal. If you’re experiencing pain or discomfort right before your catheter hits the bladder, you might be using a catheter that is wider than your bladder neck and should try one FR size down. If, on the other hand, you feel like the drainage is too slow, you can try a catheter that is one FR up.

The most common length for females is 6 inches (20-26cm), while the most common length for males is between 13-16 inches (40-45cm).

Dexterity

If hand dexterity and/or handling is a concern for you, aim to find a stiffer catheter or one that features a handling aid—a large attachment that makes it easier to hold. This will give you a more secure and steady grip on the catheter as well as make it safer to handle due to less risk of bacterial contamination.

Individual needs

One of the most important aspects of choosing the urinary catheter that’s right for you is your lifestyle. Depending on your daily life and level of activity, you may be more or less concerned about your urinary catheter being discreet. Some catheters are more compact than others and can be carried in your pocket or purse. Some catheters feature a sticky dot that allows you to hang the package on the bathroom wall while cathing, and others have an insertion sheath that allows non-touch insertion. 

If you travel a lot, you may want to check out some of the compact and pre-lubricated alternatives so you can travel lighter with your catheter suppliers.

Your medical supplier should help you determine what factors are most important to you and how your urinary catheter will fit into your lifestyle. 

Indwelling urinary catheters

How are indwelling urinary catheters used?

Unlike the intermittent urinary catheter which is inserted and removed regularly, the indwelling urinary catheter is left in place for a few days.

As far as insertion goes, an indwelling urinary catheter is inserted the same way the intermittent urinary catheter is. However, the indwelling urinary catheter is able to stay in place in the bladder with the help of a water-filled balloon. This prevents the catheter from falling out. Once the catheter is inserted, use a syringe with a sterile water solution to inflate the catheter’s balloon so it’d keep in place. Another name for this type of catheter that you may recognize is the Foley catheter.

In the case of indwelling urinary catheters, a urine collection bag is used. The collection bag can be attached to a stand on the floor or strapped to the user’s leg. 

Can I use indwelling catheters more than once?

While every user is different, the indwelling urinary catheter should typically be replaced at least every 30 days.

What are the pros and cons?

Advantages of indwelling catheters:

  • They are often able to be fitted with a valve, allowing urine to be drained into a toilet instead of a collection bag.

Disadvantages of indwelling catheters:

  • They may pose a higher risk for CAUTI, Catheter-Associated Urinary Tract Infection, than intermittent catheters.

Suprapubic urinary catheters

How are suprapubic urinary catheters used?

A suprapubic catheter is another type of urinary catheter that is left in place.

However, a big difference between the suprapubic urinary catheter and the indwelling urinary catheter is that the suprapubic catheter is not inserted through the urethra. Instead, the suprapubic catheter is inserted through a hole in the abdomen where it then goes directly into the bladder. The process is done under anesthesia—either general, epidural, or local.

So, why would a suprapubic urinary catheter be used instead of an indwelling or intermittent urinary catheter? A suprapubic catheter is used when the individual’s urethra is blocked or damaged. This may be caused by scar tissue, enlarged prostate, or other issues.

Can I use suprapubic catheters more than once?

The suprapubic urinary catheter is typically replaced every 4 to 12 weeks.

What are the pros and cons?

Advantages of suprapubic catheters:

  • Similar to the indwelling catheter, a suprapubic catheter can either be attached to a urine collection bag strapped to the leg or a valve can be attached that allows urine to be drained directly into the toilet—giving the user options.

Disadvantages of suprapubic catheters:

  • The main con of the suprapubic catheter is the surgery process, as mentioned above.

External urinary catheters

How are external urinary catheters used?

External urinary catheters are placed outside of the body and are used to handle incontinence, not retention. Men’s external catheters are often called Condom catheters and they are named as such because they are placed over the head of the penis, just like a condom. 

Meanwhile, female external catheters include urethral inserts that are inserted into the urethra and create a seal near the end of the bladder. These are custom fit by a medical professional for each individual woman’s body.

Can I use external catheters more than once?

Male external catheters are single-use and it is recommended to replace them at least every 24 hours to prevent skin irritation. Female external catheters have reusable and disposable components.

What are the pros and cons?

Advantages of external catheters:

  • External catheters are a great alternative to diapers, pads, and other incontinence absorbent products. The urine is collected outside of your body into a bag, so there’s no odor or wetness. 
  • They are more suited to an active lifestyle. The catheter connects to a leg bag, and there are even sport leg bags that aren’t visible under your clothes.

Disadvantages of external catheters:

  • If worn for too long, external catheters can cause skin irritation—however, there are several types with different adhesive options, so if one is causing irritation, ask your medical supplier about alternatives. 

How to choose the right external catheter for you?

When choosing the right external catheter for you, comfort is the key factor. You can determine that based on:

Material

External catheters come in several different materials. You should choose the one that works best with your skin to ensure your comfort. Options include latex, silicone, polyvinyl chloride (PVC) and polyurethane (PU) catheters.

Adhesive

There are also two types of adhesives on the market in terms of external catheters: non-adhesive external catheters and self-adhesive external catheters. With non-adhesive, you are able to choose the type of skin glue, adhesive strips, or foam strips you would like to use to affix the catheter to your body. Meanwhile, self-adhesive external catheters come with a sticky film. This makes application easier but provides more limited options in terms of what works with your skin. 

Are there any complications to worry about when using urinary catheters?

Just like any other medical device, urinary catheters do come with the risk of some complications. 

The most common complications of urinary catheters include but are not limited to:

  • Urinary tract infections (also known as UTIs)
    • Symptoms of urinary tract infections may include:
      • A feeling of burning or pain in the lower abdomen or back area
      • Blood in your urine
      • Fever
      • Increased urinary frequency or feeling or urgency
      • Painful urination
  • Allergic reactions (these are often due to the material of the catheter—talk to your doctor and consider switching from latex to silicone or vice versa)
  • Urethra injury
  • Septicemia (a serious bloodstream infection)

You should talk to your doctor about your individual risk for these compilations and how you can best avoid them. 

However, there are some simple ways to avoid complications:

  • Make sure you frequently clean your urinary catheter and entry site.
  • One-time-use catheters should always be thrown away after each use—do not try to get another use out of them
  • Always stay hydrated so that your body produces urine and that urine is regularly drained from the body. This will help avoid bacteria buildup. 

We hope this thorough guide to all things urinary catheters and urinary catheterization has helped you or a loved one you care for. As always, please consult your doctor or other medical professionals for advice tailored to your specific needs. 

You can find all of Better Health’s urinary catheter products here. If you need help finding the best urinary catheter for you, you can reach out and talk to one of our care specialists at 415-475-8444, chat with us in real-time, or send us a message here! We’re always here to help.

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