There are three main types of catheters;
Two are internal- intermittent and indwelling- and a third, external. So, is one better than the other? Here, we will discuss the differences between the three and the side effects that one should know before using.
External catheter systems, also commonly referred to as condom cath, or Texas Catheter, are available for men. And while MEC’s have been historically geared toward men, there are versions available for females as well. These are designed with form-fitting cups.
These MEC’s are dubbed safer to use than internal catheters because a tube does not need to be placed in the bladder to remove urine. It allows the person to self cath. The catheter fits over the penis and connects to a drainage bag that is strapped to your leg. There are several different sizes and versions of MEC available. Many of this type are disposable and generally are reliable for about a day or two, which serves the purpose if the need is temporary. However, there are reusable external catheters for active men with incontinence, and are often used as an alternative to diapers and pads.
Although much safer than inserting a tube into the urethra, there are some problems associated with MEC’s:
- Chance of infection, although far less than with internal
- Skin irritation and rashes could possibly occur from the friction caused by putting an external catheter in place. We offer Shield Skins, and Adhesive Removers to help manage these problems.
- Catheter coming undone. For instance, in older men the penis may have retracted it may be difficult to keep it from staying on. This is were a Retracted Penis Pouch is an option.
Indwelling catheters are a closed system inserted into the urethra to allow the bladder to drain, or in cases with a two-way catheter (Foley), fill up. Having two purposes is one reason that makes them different than external catheters, which only help empty. But because these devices are inserted into the urethra and bladder and left there over several weeks before being changed, problems can arise.
- First of all, when the device is initially inserted into the urethra, it can for some be painful and uncomfortable. Along with that can come a burning sensation and sometimes even spasms.
- Second, although a water-filled balloon inside the bladder usually tightly secures the catheter, sometimes the catheter can fall out. This could be a result of using the wrong size catheter.
- With this a third problem can arise- leakage or bypass, which means that urine comes out, but not through the tube.
- Blockage can also occur by using an internal cath as well. Bacteria, mucus or crystallization of protein can cause this.
- Finally, a urinary tract infection can occur from bacteria, leakage or blockage. In fact, UTI is the most common contracted hospital infection.
- Other infections could occur as well as a result of internals over several months.
- More serious results that could come about are bladder stones, blood in the urine, tearing of the urethra.
However, despite the problems that can occur with indwelling caths, sometimes they are the only option. For example, pregnant women having an ultrasound done need full bladders to achieve a proper picture. If the bladder is not as full as it needs to be they will need to be catherized with a Foley to fill the bladder with saline. Another, probably more prevalent, reason is that people who cannot manage using an intermittent cath themselves, which will be discussed in the next section, may find it easier to manage their everyday lives with an indwelling catheter. This is usually found in nursing homes, hospitals or with people with medical conditions who live alone in their own homes.
Intermittent catheters are another type of internal cath, although they are inserted and removed only when needed. This very sterile method of removing urine are used by people every three to four hours to void the body of residual urine that may still be in the bladder. Once the process is complete, the catheter is removed until the next time for use rolls around. Because the catheter is removed after each use, there is less chance of infection. Since it is easy to learn how to do so, this type of catheter is usually inserted by the user himself or by a family member, as opposed to the more permanent indwelling version in which a medical professional usually inserts it- and it stays.
There are not many side effects to using an intermittent catheter but there can be some swelling and tenderness around the urethra due to the reinsertion throughout the course of the days. Infection can also occur if sterilization techniques are not in place.
Medicare’s policy change regarding single use intermittent catheterization started April 1st, 2008. Up until the spring of 2008, Medicare and insurance companies would only cover 4 intermittent catheters per month, and works out to one a week. The average person urinates about 4 to 6 times per day. So patients would re-use the same catheter about 40 times a week. Consequently, many people repeatedly got UTI’s (urinary tract infections). Which can be very painful, and takes a week-long course of anti-biotics to resolve. So, in April 2008, Medicare finally changed their policy. They now recommend single-use only for intermittent catheters, and will reimburse for every catheter up to 200 intermittent catheters per month or 35 MEC’s per month. Insurance companies usually copy Medicare guidelines, so now most insurance companies reimburse for single-use catheters. Doctors now need to write on the prescription how many times a person caths per month, so a certain amount of catheters can be provided.