How are catheters used to manage urinary incontinence?
To manage urinary incontinence, or bladder control loss, your doctor may recommend that you use a catheter. There are several different kinds of urinary catheters available, but in general they can be broken down into internal and external options.
Internal urinary catheters
The two most common types of internal urinary catheters are intermittent and indwelling (also called Foley catheters). Both are designed with a small tube that is passed through the urethra (the duct which carries urine out of the body) and into the bladder (a sac which holds the urine until it is passed from the body through the urethra). Once in place, catheters allow for passage of urine from the bladder into a drainage bag or directly into the toilet.
In general, intermittent catheters are available in a three different styles: straight, coudé (curved) and closed (connected to a bag), and are made of three different materials: red rubber (latex), silicone and PVC (polyvinyl chloride). There is a lower incidence of urinary tract infections (UTI) with intermittent catheters when compared to other options, such as indwelling catheters. Within the intermittent line of catheters, there is an even lower incidence of UTIs with closed-system catheters, which reduce the chance of introducing bacteria into the bladder, limit hand contact with the catheter itself, and drain directly into a bag.
Note: Although both men and women can use intermittent catheters, the coudé tip is usually used for men to get around blockage such as urethral stricture, enlarged prostate or benign prostate hypertrophy (BPH). Health care providers explain to patients how to insert and remove intermittent catheters so patients can catheterize as needed at home.
Indwelling (Foley) catheters
An indwelling catheter remains in the bladder for an extended period of time and is inserted by your doctor or health care professional. The catheter is held in place with a small balloon that is filled with water after insertion. The open end is connected to a bag that can be worn on the body, or hung from the bed or wheelchair. A drain valve on the bag allows for emptying as needed.
For patients who have some sort of obstruction that does not allow the flow of urine through the urethra, a suprapubic catheter may be recommended. A suprapubic catheter is surgically inserted into the bladder through a small incision in the abdomen to allow for draining the bladder. The thin, flexible tube connects the bladder inside the body to a drainage collection bag outside the body.
External urinary devices
Men who experience urinary incontinence may benefit from a male external catheter called a condom catheter. This type of catheter is worn like a condom and connects to a leg bag or bedside drainage collector. Condom catheters are easy to put on and remove.
Specialty medical devices
Along with catheters, there are specialty medical devices available to help manage urinary incontinence. For men, Edgepark offers incontinence pumps, which utilize non-invasive, sensor-driven technology that pulls urine away from the body. For women, female urethral inserts are used to prevent stress incontinence, so they may provide women with an alternative method to manage urinary leakage.
Health insurance coverage for catheters
Medicare has certain guidelines for the amount of catheters an individual can receive each month. Most private health insurance companies follow guidelines similar to those of Medicare. Please call Edgepark at 1-866-528-2142 for questions about health care coverage guidelines and catheters.
In general, the guidelines are as follows:
Intermittent catheters - Medicare allows for one catheter for each episode of catheterization, up to 200 intermittent catheters per month based on times catheterizing.
Indwelling (Foley) catheters - No more than one catheter per month is covered for routine catheter use. Non-routine catheter changes are covered when documentation substantiates medical necessity.
External (condom) catheters - Generally, male external catheters should not exceed 35 per month.
Note: A caregiver or health care professional may need to help with catheter use, depending on an individual’s mobility and hand dexterity.