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
Various sizes and lengths of straight catheters
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.
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 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
Closed System Kit
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.
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.
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!