The dictionary definition of choice is “a situation in which you can choose between two or more things” (Cambridge Dictionary) such as choosing which colour jumper to wear. But often within the field of healthcare making a choice between two treatment options can be particularly difficult as you may not know enough about either option to enable you to make this decision. So, this is where the term informed choice comes in as “an act of choosing when you have enough knowledge or information to help you do this” (Cambridge Dictionary).

Where do you get the additional information needed to make an informed choice?

It is the role of the healthcare professional to provide enough information to enable you to make this choice. Though it is often considered a good idea to get your information from a variety of sources rather than just one source to avoid bias in the information. However, it is important to make sure that the information is of high quality and comes from a reliable source. This has become even more important in recent years with the increase in the use of social media, where everyone has an opinion, advice or knowledge to give. This additional information can be written information or practical information gained by experience. The experience of the patient (past or present), the experience of a fellow patient in a similar situation or the experience of a healthcare professional with previous patients.

When discussing a new topic such as intermittent self-catheterisation (ISC), it is very easy to become overwhelmed with information, making the choice of a catheter to start with even more difficult, rather than easier. Another term that is frequently used in healthcare is the ‘expert patient’. There is no-one who knows your body better than you do. But in the situation of learning a new skill, you are the novice and need to develop knowledge and experience to become the expert.

Your healthcare professional may try to help you, by choosing a catheter for you to start learning the skill of ISC, based on their knowledge of catheters and what they have learnt about you. As you become more proficient at the skill of ISC you will gradually gain a better understanding of what you want from your catheter, what your routine is, and where you use your catheter.

Where do you get the additional information needed to make an informed choice?

The length and diameter of the catheter.

Catheters are manufactured in 3 lengths. Standard (Male), Paediatric and Female lengths.

• Standard (Male) 40-45cms
• Female 15-30cms
• Paediatric 15-25cms

The lengths chosen are usually self-explanatory but sometimes a female may choose a longer catheter if they use a wheelchair or have a higher BMI.

The diameter of the catheter (or size) is measured in Charrière (Ch), which is a third of a millimetre and range from 6Ch – 26Ch (2mm – 8.6mm). Most people use a 10 – 14ch catheter. Here there is a balance between comfort (a smaller size) and urine flow (larger size is quicker to drain the bladder). The smaller sizes are used for children and the larger sizes are used when there are blood clots or mucous in the urine.

Handle of the catheter

Some catheters have a more obvious chunky handle or place to hold the catheters which can be useful if you have reduced dexterity. Some also have a “gripper” on the length of the catheter to make it easier to insert, particularly for men as they have longer catheters.

Integrated drainage bag

It is possible to have a catheter that has a drainage bag already attached to the catheter. This can be very useful if you are a wheelchair user or are unable to drain your bladder directly into the toilet.

Coating

Most catheters on the market today have a hydrophilic (water-loving) coating that makes the catheter easier to insert. It is activated by water (either that you need to add or thar is already in the package – useful if you don’t have access to running water). Some coatings are a gel coating that is applied to the catheter as you remove it from the packaging. Gel is an option if the water-based coating stings on insertion or feels like the catheter is drying out or sticking as you try to withdraw it, or you just prefer the sensation of a gel coating.

Discreet packaging

It may be important to you that the catheter packaging is discreet, particularly if you will be catheterising at work. Does it fit in your jacket or trouser pocket? Would it blend in if you dropped your handbag?

Easy to open packaging

This can be particularly important if you have reduced hand dexterity. As you can see there are many features for you to consider that can make catheterising easier particularly in a public place. Don’t think that you are limited to one style of catheter. It might be a good idea to “mix and match” your catheters, so that you have a variety to suit the different days that you might experience. When talking to your specialist nurse about ISC, give some thought to what is working well and parts of the process that aren’t working so well. Make sure to consider where you might be catheterising, and what equipment might you need.

Further information

Find more information about bladder and bowel health in our information library at www.bbuk.org.uk.

You can also contact the Bladder & Bowel UK confidential helpline (0161 214 4591).

For further advice on bladder and bowel problems speak to your GP or other healthcare professional.

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