Pamela White
Registered Nurse and Head of Clinical Governance & Regulatory Affairs, CliniMed Ltd & SecuriCare (Medical) Ltd
Lifestyle choices, human ability and a support network are all considerations to think about when choosing an ISC catheter, as there is no ‘one size fits all’.
When a person’s bladder does not fully empty, the next step might be to recommend intermittent self catheterisation (ISC). This can be worrying for the patient, who will have to be educated to insert a catheter into their bladder by a health professional. They will naturally have concerns, however using an ISC can be very discreet and be managed often with little impact.
For any patient, this initial discussion and the amount of choice on offer can be overwhelming. Often patients have many questions about the differences between an indwelling catheter and ISC – the discreet nature of ISC can prove to be transformational for patients as there is no permanent tube along with a valve or drainage bag.
Discretion is key
There are plenty of options currently available, such as the length and diameter of the ISC catheter. These options need to be considered when assessing patient’s lifestyle and physical capabilities. There have been many recent improvements in packaging and coatings which allow patients to adapt in using ISC to suit their lifestyle.
Pamela White, Registered Nurse and Head of Clinical Governance & Regulatory Affairs at CliniMed Ltd & SecuriCare (Medical) Ltd explains, “A lot of the time patient choice is caught up with the need for discretion. I’ve known patients walk a mile to find a public bin to dispose of their ISC when no one is around. This type of problem needs to be acknowledged by healthcare professionals when the range of ISC catheters are made apparent.”
“What’s more, there is no reason why a range of ISC products could not be suggested, one for in the home and another for outdoors perhaps. Adding to that, the final decision should always be down to patient’s choice, so they should feel able to come back and say, ‘actually this isn’t working for me’ and try something else.”
There is still a taboo surrounding incontinence and for men especially, the practicalities of disposing with a catheter can limit their enjoyment of activities.
Patient empowerment
White advocates that patients should empower themselves by doing their own research. Her first choice would be the NHS website, but there are other quick and easy ways to speak to a clinician.
“What some people don’t know is that manufacturers themselves often staff a care line so that patients using the products can chat through their worries without needing an appointment. This is great to answer practical questions. The medical device sector is heavily regulated, so that advice from a manufacturer, either by phone or on a website, can be recommended to answer those frequently asked questions about comfort and ease of use. Although when it comes to medical issues – always see a professional first” she says.
For anyone with an ISC who lacks confidence or dexterity, help in the community is often not far away. Whether you speak to a urology nurse specialist, GP, or a continence advisor, all should be able to advise on something that is suitable for new or changing needs. What’s more, recent improvements over the last decade have dramatically improved patient choice when it comes to the ISCs on offer, including the coating.
Choice should be at the heart
As recommended by NICE guidelines, patients should have a choice when it comes to gel or hydrophilic (activated by water) coatings and length and diameter should also be taken into account. These are often dependent on the patient’s dexterity and need for discretion.
For instance, some longer catheters (up to 40cm) can be packaged to appear less bulky and for people with disabilities or dexterity issues, packaging has been adapted to cater for most needs, such as easy opening lids.
White adds, “There is still a taboo surrounding incontinence and for men especially, the practicalities of disposing with a catheter can limit their enjoyment of activities. For instance, men’s toilets aren’t always equipped with discreet bins, but there are catheters available that can be resealed in the packaging mess-free after use if immediate disposal is not possible. These are discussions that can be had with your medical team, who can provide a variety of different ISCs for suitable occasions. This mix and match approach has patient choice at its heart.”
