Everything You Need to Know About Coude Catheters

Urinary catheters have a variety of different features that make catheterization easier for the user, one of them being the type of tip. There are two basic types of catheter tips, straight and coude. While straight tip catheters are the most common, some individuals find them difficult to use and are prescribed coude tip catheters instead.

What is a coude catheter?

 Coude tip catheter                            Straight tip catheter

A coude catheter is a type of catheter with a curved tip. The bent tip allows the catheter to bypass obstructions and navigate spaces that a straight catheter, which has a completely straight tip, may have trouble with. Coude catheters often feature an indicator on the funnel end or a guide stripe that runs along the entire length of the catheter, indicating which direction the tip is pointing. Besides this feature and the design of the tip of the catheter, coude and straight catheters are identical.

Types of coude catheters

There are a variety of catheters available today and most catheters come in both coude and straight tips. Intermittent catheters are available with a coude tip and are inserted and removed from the bladder several times a day by the user or their caretaker. This type of catheter is often preferred by those seeking more freedom and independence, as well as those who struggle with frequent urinary tract infections (UTIs) which are a common side effect of indwelling catheters. If you are unable to catheterize comfortably with a straight tip intermittent catheter, your doctor may prescribe a coude tip intermittent catheter that will better navigate your body.

Foley catheters, a type of indwelling catheter, are also available with a coude tip. These must be attached to a collection bag at all times or are fitted with a valve that can be opened and closed when needed. Foley catheters are typically left in the body for up to a month and are usually inserted by a medical professional. This type of catheter is often used post-surgery when recovering from trauma or an infection, or for individuals who are struggling to deal with the hassle of self-catheterization with an intermittent catheter. If your medical professional is having trouble inserting a straight tip Foley catheter because of obstructions or strictures, they may find that a coude tip Foley catheter works better.

Types of coude catheter tips

There are three different types of coude catheter tips, each made for different situations:

• Tapered Tip: these are the most common type and feature a short, strong curve that allows it to bypass both enlarged prostates and strictures.

• Rusch Tiemann Tip: these feature a tip that is longer, smaller, and more flexible than the other types. This makes it ideal for navigating strictures and can make catheterization more comfortable.

• Olive Tip: features a round, ball-shaped tip that helps facilitate smoother passage by preventing the catheter from getting caught on obstructions like false passages.

Note: A false passage occurs when the catheter is inserted incorrectly, forming another opening that the catheter wrongly passes through. Repeated insertion of the catheter into a false passage can cause discomfort, trauma, and strictures.

Pros

Benefits of using a coude tip catheter, compared to a straight tip catheter:Helps bypass enlarged prostates and other obstructionsBetter at navigating through stricturesCan prevent the catheter from getting caught on obstructions such as false passagesDecreased pain and discomfort

Cons

Drawbacks to using a coude tip catheter, compared to a straight tip catheter:Slower insertionMore difficult to insert because the coude tip needs to be positioned correctly (pointing up!)Increased dexterity needed to twist the catheter around obstructions and stricturesMay require more lubricationCoude catheters can be more costly, depending on your co-pay or remaining deductible with your insurance

Who are coude catheters best for?

Men and boys are the most common users of coude catheters, but they can be used by women as well. This is due to the fact that men are more likely to experience the factors listed below.

Common reasons for using a coude catheter:Benign Prostatic Hyperplasia (BPH): also known as an enlarged prostate, is common in men as they ageUrethral Stricture DiseaseUrethral strictures, blockages, or traumaScarring from prostate surgeryRadiation in the pelvic area from cancer treatmentFalse passages in the urethra or stomaFemales with an atrophic vaginaMale and female with a stoma (passage in your belly leading to your urethra) might also find coude catheter easier than straight

If you are able to catheterize comfortably with a straight tip catheter, there is no need to switch to a coude tip. Coude catheters are recommended as an alternative for those who experience difficulty or pain when using straight catheters.

How to use an intermittent catheter with a coude tip

As with all intermittent catheters, there is a slight learning curve to using coude catheters. But with the right preparation and help you’ll soon be able to self-cath with ease. Below we’ve listed steps for male and female intermittent catheterization, although it’s important to consult with your doctor or nurse beforehand as they will be able to best instruct you on how to self-catheterize.

The most important thing to remember and the biggest difference between inserting a straight catheter vs a coude one is the direction of the tip. When inserting a Coude catheter you need to verify the tip of the catheter is pointing upwards. Most catheters have a raised bump on the funnel end of the catheter or a guiding stripe along the catheter that can help point the right direction while you’re inserting the catheter.

For men:

1. Have all your catheter supplies ready.
2. Wash your hands thoroughly with warm water and soap, then dry completely. If soap and water are unavailable, use an antibacterial hand sanitizer. After doing so, you may also choose to wear gloves for extra precaution.
3. Hold your penis and retract the foreskin if uncircumcised, then clean the insertion area by gently wiping the area with an alcohol-free antiseptic wipe.
4. Remove your catheter from its packaging and apply additional lubricants if you use any.
5. Situate yourself comfortably and hold your penis at a 45-degree angle away from your body.
6. Slowly insert the catheter into your urethra, making sure to keep the tip positioned facing upward. Remember that most coude catheters have an indicator such as a stripe or raised bumps that will help you know which direction the tip is pointed. It’s important that you never force your catheter. If at any time you feel pain or resistance, take a deep breath, relax, and try again. Start over if necessary.
7. Once urine begins to flow, insert the catheter about one inch further. Then you can lower your penis to allow urine to flow naturally.
8. After urine stops flowing, shift your body a few times to make sure all urine has been emptied, then slowly remove your catheter.
9. Dispose of your catheter and any additional used supplies.
10. Wash your hands again with warm water and soap.

For women:

1. Have all your catheter supplies ready.
2. Wash your hands thoroughly with warm water and soap, then dry completely. If soap and water are unavailable, use an antibacterial hand sanitizer. After doing so, you may also choose to wear gloves for extra precaution.
3. Clean the insertion area by separating the labia and gently wiping the area with an alcohol-free antiseptic wipe.
4. Remove your catheter from its packaging and apply additional lubricants if you use any.
5. Situate yourself comfortably with your thighs spread apart.
6. Slowly insert the catheter into your urethra, making sure to keep the tip positioned facing upward. Remember that most coude catheters have an indicator such as a stripe or raised bumps that will help you know which direction the tip is pointed. It’s important that you never force your catheter. If at any time you feel pain or resistance, take a deep breath, relax, and try again. Start over if necessary.
7. Once urine begins to flow, insert the catheter about one inch further.
8. After urine stops flowing, shift your body a few times to make sure all urine has been emptied, then slowly remove your catheter.
9. Dispose of your catheter and any additional used supplies.
10. Wash your hands again with warm water and soap.

Is a coude catheter right for you?

Coude tip catheters can navigate obstructions and help make cathing more comfortable. If your straight tip catheter has been giving you trouble, or you think a catheter with a coude tip would work better for you, talk to your doctor to see what they recommend.

If you’re switching from a straight tip to a coude one you will need a new prescription from your doctor, but this is a fairly easy process, so don’t let it deter you from finding the best catheter for your needs.

Better Health offers a variety of intermittent catheters, both with coude and straight tips. If you’re interested in learning more about your different options, start by receiving our free samples or taking our product quiz.