Types of catheters

The choice of catheter depends on the precise purpose, since there is so much variability in catheter size, type of material, tip shape, and number of lumens see table 6.4.

• Short-term catheters can remain indwelling for up to 4 weeks

• Long-term catheters should be replaced every 12 weeks Size

Measured according to the Charriere French (F) gauge, where 1F = 0.33 outer diameter.

• A size 12F catheter will have an outer diameter of 4 mm

• For most standard purposes a size 14-18F is adequate

• Size of 20-24F is used for bladder irrigation or washout (for debris, mucus, or clots)

• Male length catheters are longer (40-45 cm) compared to those used in females (20-26 cm)

Tip shape

• A straight, floppy-tip standard catheter is suitable for most cases

• The upward-deflected stiff Coude tip is better for negotiating the high bladder neck or the occlusive prostatic urethra

• The whistle-tip catheter, with an end opening, is often better suited for the washout of larger bladder clots

Lumen

Catheters may be—

• Single lumen (e.g., intermittent self-catheterization, urodynamics)

• Double lumen (e.g., most standard catheters)

• Triple lumen (e.g., irrigating catheters)

Triple-lumen catheters have smaller outflow lumens than the corresponding-size double-lumen catheters.

Complications of bladder catheterization include—

• Infections

• Urethra—discharge, trauma, stricture, catheter hypospadias

• Discomfort

Table 6.4. Catheters

Type Nature Uses Comments

Table 6.4. Catheters

Type Nature Uses Comments

Inflexible

After urological surgery For bladder irrigation

Short-term use only

Latex

Made from purified rubber Soft

General use

Short-term use Causes urethral irritation Risk of latex allergy Prone to crust formation

Teflon-coated latex

PTFE coated Soft

General use

Short/medium-term use Reduced urethral trauma

Silicone elastomer

Silicone elastomer coated Reasonably soft

General use

Short/medium-term use Reduced encrustations

Pure silicone

Inert material Very soft

Thin walled, larger lumen

Long-term catheterization

Long-term use

Gradual deflation of balloon

Absorbs urethral mucosal secretions

Long-term catheterization

Long-term use Reduced encrustation Reduced bacterial colonisation

Narrow-lumen

Small calibre plastic catheters Stiff

For urodynamic testing

For immediate use

Hydrophilic

Semi-stiff

Intermittent self-catheterization

Huge range of choice Usually single use

• Urine bypassing

• Catheter encrustation

• Social—embarrassment, impaired sexual function

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