People who have bladder problems such as urinary incontinence or retention may need the help of a urethral catheter to drain the bladder at scheduled intervals. The urethra is the tubular structure that drains the bladder to the outside. In males, the urethra is longer (8 inches) than in females (2 inches) and there is a more direct path for the female compared to the curves in the male urethra which has 4 distinct sections.
Sometimes catheters are needed to drain the bladder such as during surgery and immobility. However, people may need regular drainage to minimize overflow incontinence, lower the risk of infections from retained urine, and to minimize leakage for those with unstable bladders.
There are two main types of catheters based on the shape of the insertion tip; straight and coudé (curved). Coudé catheters help the tip to navigate around an enlarged prostate that is placing pressure on the urethra and causes the urine to be more difficult to pass to the outside.
The most common catheter conditions are:
- Benign prostatic hypertrophy (enlarged prostate)
- Urethral trauma or stricture
- False passage
- Previous surgery to the prostate
- Radiation to the area
Picture of a bladder and urethra below.
All catheters can be made of a variety of materials such as silicone, rubber latex, PVC, or vinyl. Catheters can be
- Uncoated intermittent catheters
- éPediatric length and caliber catheters
- Hydrophilic catheters-do not need lubrication because they are coated with a substance that turns into a slippery substance when it is inserted
- Pre-lubricated catheters
- Closed system catheter kits
Coudé means ‘elbow’ in French and so coudé catheters have a curved tip so that it can be inserted more easily and with less discomfort for those who may have anatomic variations such as strictures, scarring, narrow urethra, or an enlarged prostate. Coudé catheters are used most commonly in men and children, although any person might be in need of a curved tip. Coudé catheters need to be long enough to gain access to the bladder and in men, the length needed is usually 16 inches.
Coudé options include:
- Tapered tip
- Olive tip- more rounded
- Tiemann tip pretty much the same as the Coude
Picture of a Coudé Catheters
Catheters for urinary drainage can be placed long-term or intermittently. Their length and tip design are the most important factors when selecting the best type for your needs. Lubrication of some sort is needed for each insertion to minimize discomfort.