Clean Intermittent Catheterization: Where do we go from here?

A Question for Trudy:

Hello!

My name is Dristi. I am a biomedical engineering student from Illinois Institute of Technology. I am working on a project with a team to create a new hydrogel coating for intermittent urinary catheters. I recently found your blog, Trudy Triumph, during my research. After reading through it, I was wondering if we could talk more in depth on what you, as experts, feel are the main concerns or problems with using catheters.

The purpose of our interests in your feedback would be to determine what current catheters products failed to give users a positive experience. We would like to get your input or anonymous input from your blog, whichever you are comfortable with.

Thank you for your time and efforts.

Respectfully,

Dristi 

Illinois Institute of Technology

BS Biomedical Engineering; MS Electrical Engineering (Bio-Imaging and Signals) 2021

Trudy’s Answer:

 Hi, Drisi. Thank you for your question.  I will put my answer in the blog format in the hope that others will give their thoughts as to what intermittent catheters they use, major concerns, likes and dislikes, etc.

I started off using “red rubber” intermittent catheters.  I was told to wash them in “Dial antibacterial soap” and reuse them.  The process was cumbersome and I admit I found it a bit depressing, seeing my used catheters drying out in my bathroom, as a constant reminder of my new life, as I was not diagnosed until my children had moved out of my home.

As soon as I switched urologists, I was told that I had other choices.  Many Choices, in fact!  I was given samples and eventually settled on the “SpeediCath” style model, manufactured by Coloplast. I have tried others over the years, but keep coming back to this brand because:

1. They are discreet and compact (about the size of a small tube of lipstick).
2. The tip is firm, so when I insert it, I do not need to touch the tip.
3. They are pre-lubricated, so I do not need to lubricate it.
4. I like that they have a good seal so even when kept in my purse or pocket, the part that goes into my bladder is maintained clean and sterile.

From the book;

Beyond Embarrassment, page 75, Advantages of Clean Intermittent Catheterization

Sterile intermittent catheterization was developed in 1947, and, by 1966, a long- term study concluded that this method is state of the art in the management of Neurogenic Bladder. The advantages of clean intermittent catheterization (CIC), which is regarded as the most effective way to aid in bladder-emptying disorders, include a lower risk of urinary tract infections (UTI), urosepsis, and renal damage, besides providing autonomy and mobility.8,9,10 Prior to the availability of sterile intermittent catheterization, renal failure was one of the most frequent causes of death in spinal-cord injury patients, besides the abnormal backflow of urine back up into the ureters from the bladder (vesico-ureteral reflux). (Pressure within the kidney itself can severely damage it and prevent normal function.) Because urethral catheters are the most frequent cause of UTIs in hospitalized patients,11 it is important to adopt a system that reduces that risk. Sterile intermittent catheterization, when used long term, reduces renal scarring and bladder calculi (stones),12 which are common in bladders containing stagnant urine.

Dearest Readers,

How about the rest of you?  What do you like or dislike about your intermittent catheters? Please tell us what you like about yours.

– Trudy

8. Spinu, A., et al. “Intermittent catheterization in the management of post spinal cord injury (SCI) neurogenic bladder using new hydrophilic, with lubrication in close circuit devices—our own preliminary results,” J. Medicine and Life 5, no. 1 (2012): 21-28.

The use of Clean Intermittent Catheterization is so well accepted in some parts of the world that they are provided for free by the health agencies of many countries. They are viewed as an application of the concept of the inseparability of biomedical and social aspects in human functioning, based on the system established by the World Health Organization in 2001, the International Classification of Functioning, Disabilities and Health (ICFCH). For example, since 2008, the Romanian National Assurance House (the Health Plan of Romania) has fully supported the unlimited use of four closed-circuit hydrophilic catheters per day for patients diagnosed with Neurogenic Bladder.

9. De Ridder DJMK, Everaert K, Garcia Fernandez L, et al. Intermittent catheterization with hydophilic-coated catheters reduces the risk of clinical urinary tract infections in spinal-cord injured patients: a prospective, randomized, parallel comparative trial. Europ. Urology 2005 48: 991-995.