Coude catheter is not the most common catheter. Commonly, the Coude catheter is known for its curved tip ending. The mystery behind this unique name of coude catheter is the French term ‘coude’ which means “bent”. It is a particular type of single-use urinary catheter usually used for the same purpose as other catheters. The indication of a coude catheter is the evacuation of urine from the bladder in different conditions like a failure in the insertion of other catheters, management of urinary retention, anatomical abnormalities like Benign Prostate Hyperplasia(BPH), and Prostatomegaly. They are pronounced as (Coo — Day).
Coude catheter’s unique bent tip allows it to pass the catheter easily from the narrow region bypassing the narrow region easily and minimizing the risk of injury to the patient. These catheters are made up of materials like silicone and latex. Catheters are available in both the foley form and also intermittent form offering variety for medical use.
Types of Coude Catheter
Coude catheters are available with variations in their structure making them more functional, distinctive, and effective for Various conditions. Here are mentioned some of the types of coude cathter with their unique features and some indications.
- Tapered Curved coude catheters
- Straight coude catheters
- Foley coude catheter
- Intermittent coude cathters
1. Straight Coude Catheters
The catheter has a straight body/shaft with a curved tip making it easy to navigate or bypass the obstruction easily during catheterization. They are suitable for patients with Prostate enlargements and anatomical irregularities. These catheters are available in both intermittent and Foley forms.
- Intermittent Coude Catheters: The catheter that is designed for intermittent use i.e. for short duration called intermittent catheters. They are used in post-operative periods. Intermittent coude catheters are available in various lengths and sizes to accommodate different patient needs.
- Foley Coude Catheters: Foley Coude catheters are intended for long-term use. They feature a balloon at the tip. They are inserted with the same procedures as other urinary catheters which are inflated with 10 ml of sterile water to a fixed catheter inside the bladder for continuous drainage of urine. Foley coude catheter is usually prescribed for patients with long-term use like post-operative patients.
2. Curved Coude Catheters
Curved Coude Catheters possess a curved shaft/body along with a curved tip. This unique design offers increased flexibility for catheterization, reducing the risk of injury and bypassing narrow obstacles easily which makes it an excellent choice for patients with complex or winding urethral pathways, and for patients with anatomical anomalies.
These catheters are mainly made up of silicone and latex.
- Silicone Coude Catheters: Silicone is best in flexibility and comfort during insertion. They are less likely to cause irritation or allergic reactions. Silicone catheters are suitable for long-term use, as they are less prone to hardening over time.
- Latex Coude Catheters: Latex is comparatively cost-effective and widely available. However, they may cause allergic reactions in some patients and can harden over time, making them less suitable for extended use.
Coude Catheter Insertion
Coude Catheter insertion is a medical procedure that is performed by a trained health professional such as a nurse or a physician, Here is a step-by-step guide to the insertion procedure of a coude catheter:
Materials Required:
- Coude catheter of specific size
- Sterile gloves
- Sterile xylocaine jelly
- Adhesive tape for catheter fixation
- Syringe 10 ml
- 10 ml Sterile water
- Urobag (Urine collection bag)
- Antiseptic solution
Procedure:
- Take consent from the patient and explain the procedure to the patient keeping the patient in a comfortable position lying on their back with legs apart.
- Wash hands and put on sterile gloves.
- Ensure that you have the correct type and size of catheter Open the catheter package and place it.
- Prepare the lubricating xylocaine jelly, syringe, sterile water, and urobag.
- Gently clean the genital area with an antiseptic solution to reduce the risk of infection as hygiene is mandatory.
Male Catheterization
- Gently clean the penis with the surrounding area with an antiseptic solution to maintain hygiene.
- Hold the penis at around 45- 60 degrees with a non-dominant hand.
- Insert xylocaine jelly in the urethra and apply jelly to the catheter’s tip. for patient comfort.
- Holding the coute catheter near the tip with the bent tip upwards, gently and slowly insert the catheter into the urethra.
- Continue to advance the catheter slowly, as resistance may be encountered in some cases.
- Monitor for Urine Flow, Once the catheter has passed through the obstruction or curved pathway, urine begins to flow into the collection bag.
- Inject 10 ml of sterile water using a syringe in case of an indwelling coude catheter. This secures the catheter in place.
- Secure the Catheter in a place with the adhesive tapes.
- Dispose of the waste products properly as they are infectious waste.
- Remove the gloves and wash your hands properly.
Female Catheterization
- Patients must be in a lithotomy position with the knee flexed.
- Gently clean the surrounding area with an antiseptic solution to maintain hygiene.
- Apply xylocaine jelly to the tip of the coude catheter.
- Separate the labia majora and minora with the thumb and index finger to get access to the urethra.
- Gently and slowly insert the catheter inside the urethra until urine begins to flow.
- Insert the catheter up to the tip fully inside and inject 10 ml of sterile water with the syringe to fix it inside the urethra.
- Secure the Catheter in a place with the adhesive tapes.
- Dispose of the waste products properly as they are infectious waste.
- Remove the gloves and wash your hands properly.
It’s crucial to follow best practices and adhere to infection control guidelines during the coude catheter insertion procedure. Patients should be monitored and supported throughout the process to minimize any discomfort and ensure their well-being.
Foley catheter size
Urinary catheters are available in various sizes as needed for the specific needs of patients. The size of a catheter is typically denoted by a French (Fr) size, which is a unit of measurement. According to the French scale,1 French is equal to 0.33 millimeters. Here are some common sizes of urinary catheters and their typical uses:
- 8 Fr — 10 Fr: They are for pediatric use, designed for use in children, particularly infants and young children.
- 12 Fr — 14 Fr: These catheters are used for pediatric as well as adolescent patients.
- 16 Fr — 18 Fr: These sizes are commonly used for adult male patients and adult female patients. They are also used for intermittent catheterization.
- 20 Fr — 24 Fr: Larger catheters with bent curve tips i.e. coude catheters are typically used for adult male patients, especially those with BPH.
- 26 Fr and above: These catheters are larger and are sometimes required for individuals with significant urethral strictures or obstructions.
Selection of appropriate catheter size is essential as inappropriate sizes may cause urethral injury and severe discomfort in the patients leading to severe complications in the patients. Proper training and knowledge of aseptic techniques are crucial when selecting and inserting catheters to ensure patient safety and comfort.