Skip to main content

Intermittent Catheters — Straight and Hydrophilic

Intermittent catheters are used for clean intermittent self-catheterization (CIC) — the gold-standard bladder-management strategy for many neurogenic bladder patients, patients with incomplete emptying, and those with continent catheterizable channels (Mitrofanoff, Monti).

Device Classes​

Straight / Robinson Catheter​

  • Simple polymer (PVC, silicone, or latex) catheter without balloon
  • Single-use — discarded after each catheterization (avoids biofilm, reduces CAUTI)
  • Lubricated separately (K-Y, sterile lubricant)
  • Lowest-cost option

Hydrophilic-Coated Catheter​

  • Polymer catheter with a hydrophilic coating that becomes slippery when hydrated
  • Pre-packaged with saline or water activation; ready-to-use
  • Reduced urethral trauma and UTI rates in randomized data
  • Examples: Speedicath (Coloplast), LoFric (Wellspect), Cure Catheter

Closed-System Catheter​

  • Catheter packaged within a sterile collection bag
  • Used without the catheter tip being touched
  • Often hydrophilic-coated
  • Preferred by many patients for hygiene and convenience
  • Higher cost

Coudé-Tip Intermittent​

  • Angled-tip variant for male patients with prostatic urethral difficulty
  • See Coudé Catheter

Indications​

  • Neurogenic bladder — the dominant application (SCI, MS, spina bifida, detrusor-sphincter dyssynergia)
  • Detrusor underactivity / incomplete emptying
  • Continent catheterizable channels — Mitrofanoff, Monti, Indiana pouch
  • After bladder augmentation — lifelong CIC is the expected post-operative course
  • Post-operative urinary retention where trial-without-catheter has failed

Clinical Considerations​

  • Frequency: typically q4–6 hours awake, with a final void before sleep and first upon waking
  • Hand hygiene is the principal determinant of CAUTI risk — not sterility of the catheter itself
  • Insurance coverage varies widely; straight catheters are lowest cost but hydrophilic/closed-system options reduce UTI and improve patient experience (favored by AUA, EAU, and NICE guidelines for neurogenic bladder)
  • Latex-free options are standard; many patients have latex sensitivity

Complications​

  • CAUTI — lower rates than indwelling catheter but not zero
  • Urethral trauma — strictures can develop with decades of CIC
  • Channel stenosis — Mitrofanoff / Monti channels can stenose requiring periodic dilation or revision
  • Self-image / adjustment — particularly at initiation in pediatric and newly spinal-cord-injured patients

See also: Foley Catheter, Bowel Segments, Coudé Catheter.