This is about the tips on catheters!
There is a much written on the describing the tips on catheters with labels or nomenclature used interchangeably, and as there are several types of tips on urinary catheters it may useful to describe "when to use"the different types. We have broken down features and the unique properties each tip has and and describe its specific function or outcome!
First, I describe catheter categories. These categories are relevant to tip labels as we differentiate catheter tips and avoid any confusion…
Intermittent catheterisation
The purpose for intermittent catheterisation is for immediate use or when an "on-demand" channel is required to expel urine from the bladder to disposal. Generally intermittent catheters utilise the natural urethral path into the bladder creating an unobstructed path for the urine to flow out and empty the bladder.
Indwelling Catheterisation
A catheter that is stabilised onto the body or in the bladder to maintain a channel from bladder to disposal. Today, these are typically 2-Way Balloon Foley Catheters. If need be these catheters can be connected to a bag for collection can allow constant drainage. These catheters are placed transurethral, meaning the catheter lies the length of the urethra; or suprapubic, where above the pubic bone a channel is created (by a surgeon) from the bladder specifically for a catheter placement.
Continuous Irrigation Catheters
A 3-Way Catheter will sit in the bladder, held by a balloon, has the capacity to "irrigate" through an input or irrigation channel, as well as offering simultaneous outflow through a drainage channel. These catheters are successfully administered to male patients post-surgery of the bladder or prostate, or as immediate relief to bladder outlet obstruction. Continuous irrigation catheters can also assist to cleanse the bladder of sediment or when cystitis occurs and there is a need to cleanse the bladder.
Sterile irrigation water, antibiotic solutions, acid washes can be introduced to the bladder through the irrigation channel and drawn out via drainage channel.
In addition to removing sediment that can build in the bladder or remove fragments after surgery by continuous irrigation, some 3-Way Catheters can offer compression by tamponade of the balloon of the catheter. Some 3-Way Catheters have a larger balloon designed specifically for tamponade, where the capacity can hold up to 120ml.
External Catheterisation
A external catheter (condom catheter) is a catheter placed outside the body. It’s typically necessary for males who leak frequently. A device that looks like a condom covers the penis head and can be attached to a drainage bag.
So back to those tips!
Why are these tips so varied? The purpose of a catheter is drain the bladder with minimum discomfort, maximal drainage, and at times removal of fragments/sediment as described above. All while trying avoid encrustation or blockage of the catheter, avoid introduction of micro-organisms and infection and reduce any risk of injury to the bladder.
Straight Tip (also known as Conical and Cylindrical). Catheter simply closes at its’ tip.
When to use: most commonly used catheter, and easiest to apply when the urethra is not difficult to access.
Coudé Tip (also Tiemann) is a closed tip catheter angled upward at the tip to assist in negotiating the upward bend in the male urethra. This angled portion is between 10-15mm, this feature facilitates passage through the bladder neck
When to use: for males that have an enlarged prostate gland, stricture or scarring.
Olive Tip (also Carson). A variation on the Coudé tipped catheter in that there is a slightly larger bulb or ball at the very end to assist in negotiating through a contracted urethra
When to use: for males that have an enlarged prostate gland, stricture or scarring, where a
Mercier Tip (also Delinotte). A 3-way catheter angled upward at the tip to assist in negotiating the upward bend in the male urethra, where the angled portion of the catheter is 20-25mm (larger than a Coudé tipped catheter), used for continuous irrigation and/or balloon tamponade post-surgery.
When to use: for males that have an post-prostate surgery for removal of tissue fragment, blood clots and for tamponade
Open Tip. A catheter cut clean at the tip. Designed to provide the widest possible opening from end to end of the catheter. To optimise drainage and minimalist encrustation, build up of debris or crystallisation that can obstruct/black that catheter.
When to use: for those with frequent catheter exchanges due to encrustation or sediment.
Whistle Tip. A catheter bevelled-cut open tip and allows drainage of large amounts of debris (e.g., blood clots). Bevelled opening of the catheter also suggests protection from the bladder tissue from being drawn into the bladder
When to use: for those with frequent catheter exchanges due to encrustation or sediment.
Couvelaire Tip. A 3-Way catheter similar to a whistle tip only the open cut at the tip is curved not bevelled.
When to use: for males post-prostate surgery and where optimal irrigation/drainage to remove debris is required.
Dufour Tip. A 3-Way catheter for post-operative bladder drainage and irrigation for post-operative needs. Dufour tip is a combination a Couvalaire and Mercier tip, where it is angled like the mercier and has the same type of opening at the end of the catheter.
When to use: for males post-prostate surgery and where optimal irrigation/drainage to remove debris is required.
Balloon Tip. A newer catheter tip design with a second balloon on the bladder. One acts as an anchor to hold the catheter in the bladder, the other on the tip! A broad surface area of the balloon suggests less insult (poking) in the bladder wall and prevent further injury.
When to use: for those with who experience pain/discomfort from their indwelling catheter due or have frequent catheter exchanges due to encrustation or sediment.
Over-The-Wire Tip. A catheter with a small opening at the tip to allow a wire to be passed through.
When to use: for males where it is difficult to pass a catheter through the urethra, a wire is pass through first into the bladder and then the catheter is passed over-the-wire. wire is removed once catheter is anchored.
Council Tip catheter is an antiquated term and not commonly used today. Council tip refers to catheters with a drainage eyelet(s) on the shaft, towards the catheter tip. Majority of catheters today have this feature.
Catheters are available in various sizes and lengths to accommodate different patient needs. It is commonly used by people with urinary retention or incontinence, as well as those who need to self-catheterise due to medical conditions such as spinal cord injuries or multiple sclerosis.
It's important to note that catheterisation can be a complex and sensitive medical procedure, and it should only be performed by a trained healthcare professional or under their guidance. If you or a loved one need to use a catheter, it's important to follow the instructions and guidance provided by your healthcare provider to minimise the risk of infection or other complications.
Nia Amaro is a health writer specialising in general wellness, women’s health, men’s health, pelvic floor dysfunction and gender dysphoria. Nia is a current contributor to The Profile Shop.
Disclaimer: The Profile Shop does not offer, nor authorised to provide medical advice, and is not accredited to dispense prescription medications. Should you require any medical attention we can only advise you to seek medical attention from a registered health care professional