Intermittent self-catheterisation

Intermittent self-catheterisation is of value for patients with neurogenic bladders, may also be considered for any patient with residual urine ( NICE CG171 September 2013), and is also used for stricture therapy. This form of management is only undertaken after medical or specialist consultation.

Residual urines not only cause a reservoir for infection but could also reduce the vascular supply to the bladder tissue making it more susceptible to bacterial invasion.

Some advantages of intermittent self-catheterisation:

  • increasing independence for the patient
  • risks associated with long-term indwelling catheters are reduced
  • risk of urethral trauma is reduced
  • risk of encrustation is removed
  • reduces risk of reflux to the upper urinary tract
  • greater freedom for expression of sexuality

The patient must be willing and able to carry out this procedure on a regular basis. It is very important that a full discussion takes place with the patient, plus the giving of written information before the patient learns the technique. A nurse with the knowledge and skills should teach this procedure and the patient should remain under regular review. The number of times a patient self-catheterises in 24 hours varies according to the residual urine.

Patients performing intermittent self-catheterisation who suffer with recurrent UTIs should have their technique observed, however may benefit from a more specialist catheter, which should be discussed with a specialist nurse.

All catheters used for intermittent self-catheterisation have the generic name, Nelaton.

Sizes of intermittent self-catheters

  • Paediatric: 6-10ch
  • Male: 12-16ch
  • Female: 10-14ch

The smallest size that is suitable for the patient should be used except when used in stricture therapy.

Please refer to the bladder and bowel nurse specialist for further advice on appropriate products if required.

Types of Intermittent Self-Catheterisation

These are single use catheters with integrated lubrication systems

Male options:

HydroSil® (Rochester)
  • Gripper Male 10-18 (73610 - 73618) (£45.31 = 30, £1.51 each)
Actreen® Hi-Lite (Braun)
  • Male 8-16 (227208E - 227216E) (£44.97 = 30, £1.50 each)

Female options:

Actreen® Hi-Lite (Braun)
  • Female 6-16 (238306E - 238316E) (£44.97 = 30, £1.50 each)
Actreen® Mini Cath (Braun)
  • Female 10-14 (228010E - 228014E) (£43.96 = 30, £1.47 each)
HydroSil® (Rochester)
  • Rose Female 10-18 (71410 - 71418) (£46.91 = 30, £1.56 each)

Paediatric use only

Speedicath® (Coloplast)
  • Paediatric 30cm 6-10 (£44.70 = 30, £1.49 each)

For specialist initiation only in the following patients:

  • Patients who have undergone major pelvic surgery and have a bladder neck anastomosis, e.g Cystectomy and formation of neo bladder/robotically assisted laparoscopic prostatectomy
  • Patients with multiple stricture surgeries
  • Patients with large volume residuals which may take a long time to drain
  • Patients who have undergone radiotherapy to the cervix, prostate or bladder; whose urethras will therefore be more friable
  • Patients who have an artificial urinary sphincter in situ (AUS)
  • Patients with recurrent UTI when the other products have failed

Male options:

Lofric® Origo with water (Wellspect Healthcare)
  • Nelaton 40cm 10-18 (4431025 - 4431825) (£51.64 = 30, £1.72 each)
  • Tiemann 40cm 10-18 (4441025 - 4441825) (£54.64 = 30, £1.72 each)

Female options:

Lofric® Sense (Wellspect Healthcare)
  • Female 15cm 8-14 (4160825 - 4161425) (£47.37 = 30, £1.57 each)

 

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