Patient Education in Intermittent Catheterization: A Consensus Conference

Clinical experience strongly suggests that selecting the right catheter from the beginning reduces the likelihood of complications and promotes adherence to regular catheterization.  Nevertheless, selection of the optimal catheter for a particular patient is often a matter of trial and error.

A consensus panel of clinical experts was formed to create these guidelines and the summary article was published in the “Journal of Wound, Ostomy and Continence Nursing” in September 2023.  Support for this project was provided by Coloplast Corporation, but Coloplast did not influence or participate in the consensus statements presented in the paper.

The consensus panel of experts developed fifteen consensus-based statements to provide guidance for teaching individuals who require intermittent self or assisted catheterization as part of their overall medical management.  The consensus offers clinicians an introductory framework that can guide selection of intermittent catheters for an individual patient.  Adequate training of patients in proper catheterization technique is vital to ensure that the bladder is drained completely, and urethral damage is minimized.

Key Consensus Statements:

Single use catheters are recommended for self or assisted intermittent catheterization:

  • Single-use catheters are recommended to decrease the risk of infection that could occur due to sub-optimal cleaning technique, or because of trauma related to the process of cleaning and reusing catheters.

Catheter coating recommendations should consider friction, patient characteristics, comfort, and catheterization time:

  • Factors associated with a successful and sustained program of intermittent catheterization include comfort when catheterizing; ease of product use including insertion, urine drainage and evacuation of urine from the bladder, catheter disposal or reuse, and absence of catheter-related complications such as hematuria or urinary tract infection.
  • Hydrophilic coating or pre-lubricated gel coatings often alleviate pain/discomfort, reduce time required for intermittent catheterization, and reduce individual risk of negative sequelae like urethral damage resulting in hematuria and/or urinary tract infections.

When instructing self or assisted intermittent catheterization essential elements include a) equipment; b) hygiene; c) insertion; d) drainage; e) disposal:

  • Hygiene is of the utmost importance to reducing the likelihood of medical complications due to bacterial infection.
  • Instructions on catheter insertion techniques and the need to reposition the catheter to facilitate complete bladder emptying should reflect and accommodate patient characteristics such as poor hand dexterity and/or vision, lack of sensation, tremors, body habitus, and positions limiting visibility and/or access to the urethra.

Due to the risk of hypersensitivity, latex containing catheters are not recommended.

  • There is no cure for latex hypersensitivity, and latex allergy is a common cause of anaphylaxis.

Recommended catheter tip design should be based on specific patient characteristics (urethral obstruction, difficulty accessing meatus or passing catheter).

  • The heterogeneity of patients requiring intermittent catheterization requires a nuanced, focused approach to training the patient on the optimally selected catheter during program initiation to ensure best outcomes for patients.

The full published article and all 15 consensus statements can be found here:

Patient Education in Intermittent Catheterization: A Consensus Conference

Reference:

Quallich, S., Lajiness, M., Engberg, S., & Gray, M. (2023). Patient Education in Intermittent Catheterization: A Consensus Conference. Journal of wound, ostomy, and continence nursing: official publication of The Wound, Ostomy and Continence Nurses Society50(5), 393–399. https://doi.org/10.1097/WON.0000000000001013


For follow up questions please reach out to:

Thea Zickermann DC, MBA

Program Manager – US Medical Affairs | Continence Care

Chronic Care Payors & Evidence

Email:  ustzic@coloplast.com

Phone: 612.291.2190

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