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.

Download as a PDF

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At Convatec, ‘forever caring’ is our promise to give patients and healthcare providers the support they need as we bring to life our vision of pioneering trusted medical solutions to improve the lives we touch.

Existing complications of traditional coated hydrophilic Intermittent Catheters

Clean intermittent self-catheterisation (CISC), while straightforward for some, can be both difficult and painful for others.

• 40% of participants affirmed “I have pain (the catheterisation is painful)”.¹
• CISC can also cause trauma to the urethra and result in bleeding.²
• 31% of people using hydrophilic coated catheters had blood in their urine, potentially higher than in uncoated catheters.²

In a recent ‘Guide to intermittent catheterisation technology’ supplement published by the British Journal of Nursing, pharmaceutical science lecturers from Queen’s University Belfast stated:

“A significant problem, noted anecdotally and in the literature, is catheter-coating dry-out³.

Hydrophilic-coated catheters are normally provided in packaging containing a hydrating fluid or supplied with a hydrating pouch for use prior to insertion. Once fully hydrated, they remain wet and lubricious for a relatively short amount of time only (5–20 minutes). As hydration falls below 75%, the coating loses its lubricious properties and becomes adhesive, tending to stick to the urethral mucosa⁴. Correspondingly, the increased force and friction on catheter withdrawal has been reported to cause trauma⁵, microtrauma and urethrorrhagia⁶.

It has been reported that almost one third of patients using hydrophilic-coated catheters were found to have haematuria, while 40% reported pain associated with catheter use. Persistent urethral bleeding is common with ICs, occurring in 11–28% of users^6,7,8. Furthermore, the delicate epithelial lining of the urethra forms the first line of innate immune defence against pathogens, so any injury could increase the likelihood of urinary tract infection (UTI).

ICs have been associated with development of trauma-induced urinary strictures, known to increase a patient’s risk of developing a UTI^9,10.”

Innovative Catheter Technology

We have not seen any significant changes in catheter technology since the 1980s, when the first hydrophilic catheter was launched. Until now.

We would like to introduce you to FeelClean Technology, Convatec’s unique, patented catheter technology delivering a smooth, easy cathing experience with products that do not stick^10,11.

Our GentleCath Glide and new, compact GentleCath Air range of catheters incorporate this pioneering FeelClean Technology designed to make the task of CISC an easier and more comfortable experience.

90% of users rated GentleCath with FeelClean Technology better than their usual catheter for comfort during use.¹²

So what makes FeelClean Technology different? Unlike traditional coated hydrophilic catheters, we have integrated the water-loving, hydrophilic properties within the catheter material itself – so your patients can enjoy no sticking, reduced residue^10,11 and relief whenever they cath.

What do our customers think of GentleCath with FeelClean Technology catheters?

“The catheter is significantly better on removal. Pain is significantly reduced for patients who catheterise regularly.” Rachel Skews,Urology Nurse Practitioner, North Bristol NHS Trust

“I have tried several different catheters. With other catheters, the hydrophilic coating is sticky, and I found that when withdrawing those catheters, it left a residue in my urethra and I was getting UTIs.  When I discovered GentleCath catheters, I was so happy, I cried. I have been using GentleCath for 18 months now and my infections have significantly decreased.” Alison Hodgson, Ex Nurse & MS Patient, Wolverhampton

A seamless service for your patients with Amcare Group DAC

For over 30 years, the Amcare Group has provided support to people living with a variety of medical conditions. We pride ourselves on offering a first-class personalised delivery service.

As your prescription partner, we offer a reliable, convenient, and discreet service direct to your patient’s door.

Once you have prescribed GentleCath for your patients, register them with Amcare for an easy, seamless service. We will take care of everything and support your patients through the next steps of their journey with intermittent catheters.

Why choose us?

• We have a team of professionals available 8am-8pm Monday to Friday, and 9am-1pm on Saturday to answer your patients’ questions.
• We handle your patients’ prescription requests for them, so they don’t have to worry. We offer a no-fuss, personalised care plan and make sure we are delivering supplies on time, every time.
• If a user is unhappy with their catheter, our team of Product Specialist experts will offer advice or help you select alternative options from a huge variety of product choices.
• With the ‘Follow my Parcel’ app, our delivery partner DPD enables users to arrange the best possible discreet delivery experience.
• Amcare is currently rated 4.1 (Great) on Trustpilot by our customers.

Convatec. Healthcare is changing. So are we.

Find out more about GentleCath intermittent catheters, visit: www.gentlecath.com/uk

Find out more about Amcare Group, visit: www.amcaregroup.co.uk

© 2022 ConvaTec. /® are trademarks of the ConvaTec group of companies. AP-61414-GBR

References:

1. Roberson D, Newman DK, Ziemba JB, Wein A, Stambakio H, Hamilton RG, Callender L, Holderbaum L, King T, Jackson A, Tran T, Lin G, Smith AL. Results of the patient report of intermittent catheterisation experience (price) study. Neurourol Urodyn. 2021 Sep 13.Irwin NJ, McCoy CP, McCullough AR, Corbett DJ. Use of in vitro and haptic assessments in the characterisation of surface lubricity. J Engin Med. 2019;233(1):84–90.
2. Rognoni C, Tarricone R. Intermittent catheterisation with hydrophilic and non hydrophilic urinary catheters: systematic literature review and meta-analyses. BMC Urol. 2017 Jan 10;17(1):4.
3. Guldager PM, Fredskilde KW, Nalbandian MT. Intermittent urinary catheter. Google Patents; 2019.
4. Vaidyanathan S, Krishnan KR, Soni BM, Fraser MH. Unusual complications of intermittent self-catheterisation in spinal cord injury patients. Spinal Cord. 1996;34(12):745–7.
5. Humphreys O, Pickering M, O’Cearbhaill ED, Flanagan TC. A biomimetic urethral model to evaluate urinary catheter lubricity and epithelial micro-trauma. J Mech Behav Biomed Mater. 2020;108:103792.
6. Webb R, Lawson AL, Neal D. Clean intermittent self-catheterisation in 172 adults. Br J Urol. 1990;65(1):20–3.
7. Bakke A, Vollset SE, Høisæter PÅ, Irgens LM. Physical complications in patients treated with clean intermittent catheterization. Scand J Urol Nephrol. 1993;27(1):55–61
8. Santucci RA, Joyce GF Wise M. Male Urethral Stricture Disease. The Journal of Urology, Vol. 177, No. 5, 2007, pp. 1667-1674.
9. Krebs J, Wöllner J, Pannek J. Urethral strictures in men with neurogenic lower urinary tract dysfunction using intermittent catheterization for bladder evacuation. Spinal Cord. 2015;53(4):310–313.
10. WHRI6933 TA 1369 FeelClean Phase 1 Report.
11. WHRI7131 TA 1486 v2.
12. A Multi-Centre Clinical Investigation to Assess the Performance of GentleCath Glide Intermittent Catheters. Study U378 GentleCath Glide Final Report. July 2018. Data on File. ConvaTec Inc.

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Cutting out your baseplate can seem like a task. Making sure you haven’t left any gaps that expose your skin to output and creating a seal strong enough to protect from leakage can be stressful.

When you use a Convatec Mouldable Technology baseplate, you don’t have to worry about gaps and a secure seal. Let the patented technology in the baseplate take care of that.

But don’t just take our word for it. Keep reading to learn more about Glen Neilson’s stoma story and how Mouldable has helped him to live life on his own terms and carry on doing the things he loves most, like climbing mountains. Glen has had his ileostomy for 22 years due to Ulcerative Colitis, but has never let his stoma dictate what he can and can’t do.

“My stoma was my life-saver. I completely understand why not everyone shares this feeling. But that’s how I have come to think of my stoma. It saved my life – and completely transformed the way I live my life.

But it hasn’t always been that way. I woke up during surgery in intensive care staring down at it. That wasn’t the best introduction! And neither was catching MRSA in hospital and spending 8 long months recovering at home with a hole in my stomach.

My first stoma bag didn’t bring any joy either. It didn’t help that I had problems around my stoma because of my baseplate and creases – and the fact my bag felt more like a carrier bag! It actually fell off the first time I ever went swimming. It took me two years before I would ever visit a pool again.

It wasn’t until I took to Google and ended up stumbling across the Convatec Natura two-piece bag that things started clicking into place (and I’m not just talking about the baseplate!).

The new bag gave me confidence and the old me started coming back. I got into going to the gym again, walking, golf and wild swimming.

After using the 2-piece Convatec Natura for years, and although I was more than happy with it, I just thought I would see if any new products were available or if there was anything available I didn’t know about as I was training for Kilimanjaro at the time. I wanted something that may not need cutting or worrying about the size compared to the stoma so was even more comfortable while I hiked.

This is when I was introduced to Convatec Mouldable Technology, which honestly was life changing for me. It is just amazing and gives me the confidence to climb mountains do my daily job here in the UK as a firefighter without any worries whatsoever. I truly believe no other product available on the market can match the superiority of the mouldable system.

The best thing about Mouldable is that it’s so easy to apply and there’s no cutting required. You literally just roll the baseplate back with your thumbs, apply it and it then gently returns to its original shape to hug my stoma, giving me a nice snug fit.

Another great thing about Mouldable is that a layer of the baseplate can absorb liquid output, causing it to gently swell around my stoma for an even better fit. Perfect for when I’m climbing mountains or when out on a job as a firefighter!

I would recommend Mouldable to anyone, as it literally has been life changing for me.

Want to learn more? Find out what others had to say about Mouldable in the video below.

The post Love your stoma skin with Convatec Mouldable Technology™ appeared first on Bladder & Bowel UK.