Frequently Asked Questions
Most of us have an abrupt introduction into the world of urinary catheters, either as users ourselves, or on behalf of our children, parents or friends. It is a confusing new world, with strange terminologies and little information readily available as to where these products can be obtained, what products there are, or even if we have been prescribed the most suitable product. Also, Is there funding available and where can you get help?
The information below is intended as an over view for users of urinary catheters (it is not a substitute for seeking professional advice).
- Catheter sizes
- Re-using Single Use Catheters
- Purchasing Options
- Why is Paralogic so cheap?
- Where to get help
- Recycling Catheters
Urinary catheters have been in use for thousands of years and they have been made from various materials such as reeds, bronze, gold, silver, wood and lead. The products that we use today were developed in the 1800’s and early 1900’s. This long history has resulted in a number of confusing terms for products and an archaic measurement system.
Intermittent catheters are single use catheters, inserted into the urethra when needed, then removed and disposed of after use. These are also referred to as disposable catheters, Nelaton catheters or "in-out" catheters. The term Nelaton comes from Auguste Nelaton (1807-1873) a Parisian doctor who was the inventor of the modern style of straight tipped intermittent catheter that we use today.
Another form of intermittent catheter is the Tiemann catheter, which has a bent tip for negotiating the male urethra, with a view to making it easier to pass the prostate gland. This catheter is named after George Tiemann, an American who patented the catheter in 1881. Emile Coudé, another French doctor, invented another curved tip catheter, hence today’s curved tipped catheters are referred to as either Tiemann or Coudé catheters, often interchangeably.
Clean intermittent self-catheterisation (CISC) came into standard practice in the community in the 1970’s.
In the 1980’s, catheters with hydrophilic coatings came into popular use. These catheters have coatings which bond with water, forming a pre-lubricated surface for convenient insertion. There are several types of hydrophilic catheters available now, though regrettably these catheters can be very expensive compared to non-lubricated catheters.
Foley catheters are indwelling catheters. Once inserted via the urethra into the bladder, a balloon near the tip of the catheter is inflated with sterile water, holding the catheter in place. Typically, these catheters stay in place for a month at a time. They connect to either a leg bag or a valve to allow drainage as required.
A latex version of these catheters was invented by Frederic Foley, an American Urologist, around 1935. Today Foley catheters are available in both latex and silicone.
These are indwelling catheters, though rather than being inserted via the urethra, they are inserted into the bladder via a surgically created opening in the abdomen. Foley catheters can be used for this purpose, however more recently indwelling catheters with open tips have become popular for suprapubic use. It is thought that the larger and more numerous the drainage holes in a catheter, the more ability to drain mucous and sediment. At the time of writing, there have been no scientific trials that demonstrate the efficacy of this approach, though anecdotal accounts and product popularity suggest the open tips are more effective in this regard.
Male External Catheters
Catheters are available in a condom style for men. These catheters are also known as uridomes, sheaths and condom catheters. At the end of the catheter there is a tube for connection to a bag. These catheters are available in latex and silicone, either self-adhesive or with adhesive strips.
In Paris in the early 1800’s, Joseph-Frédéric-Benoît Charrière created a standard measuring unit for the width of catheters, called the French Gauge system. This system is referred to with several different acronyms, including FG, FR and CH.
The French size is three times the diameter (width) in millimetres, ie D (mm) = FG / 3.
A universal colour coding system has also been created, so each size will always be represented by the same colour no matter which supplier produces them. This colour will be used in the funnel end on an intermittent catheter, or a plastic ring on the connector of a Foley or suprapubic catheter.
Size and colour chart
Paralogic’s intermittent catheters are TGA registered as single use catheters. This means that we cannot advocate for catheter re-use. We are aware that re-use is a common practice and pragmatic nurses have often advised people to re-use catheters when users could not afford to do otherwise. In 2008 the Australian Nurses for Continence published a position statement on the re-use of urinary catheters. A quote from this paper is as follows: "A recent Cochrane systematic review that reviewed 14 randomised controlled trials on this topic concluded that there was no difference in infection rates with single (sterile) or multiple use (clean) catheters for patients who performed intermittent catheterisation (Moore, Fader & Getliffe, 2007). An updated position statement was subsequently released by Continence Nurses Society of Australia in 2017. The paper stated that "healthcare professionals may be professionally liable for any harm visited on the patient if the information they provide to consumers contradicts the information provided in the manufacturer's 'Instructions for Use'.
While the above information might lead catheter users to make their own decisions on the safety of catheter re-use, what has not been researched is the impact of different cleaning techniques and cleaning products on PVC catheters, and what degrading and/or leaching might occur as a result. With this and other factors in mind, Paralogic’s intermittent catheters have been developed with diethylhexyl phthalate (DEHP) free PVC, to prevent any potential leeching of phthalates into the body. (DEHP is a common plastic softener which is potentially carcinogenic). To be clear, this does not mean that re-use of our single use PVC catheters is safe - this is not what they have been designed, tested or TGA approved for.
If we don't sell a product that you're interested in, please contact us, and we will see if it feasible to stock it. We also think you should know what your options are. Chemists do not stock urinary catheters. While they may be willing to order them in for you, they will be obtaining products from us or one of the below suppliers. Options are very limited.
Independence Australia (National)
Independence Australia is an arm of Paraquad Victoria, and they are the largest supplier of continence products in the consumer space in Australia. They are a not for profit and they have warehouses in VIC, NSW, QLD, SA & WA.
Brightsky is an arm of Paraquad NSW, with a showroom in Newington in Sydney’s west. They are also not for profit, and ship nationally. Worth noting is that NSW based members of Paraquad (ie paraplegics and quadriplegics) are entitled to enemas under the PBS if purchased via BrightSky. Paraquad membership is required, and there is a cost for postage.
CH2 (formerly Intouch Direct) (QLD)
Intouch Direct was an arm of the Paraplegic and Quadriplegic Association of Queensland, and formerly CAPS funding could only be spent with Intouch. In 2010, Intouch was bought out by CH2, a $900 million a year revenue company (as of 2015). Shortly after the buy out, CH2 significantly increased prices on many products, and it is for this reason that we recommend trying other retailers first.
Surgical House (WA)
Surgical House are a small privately owned company based in Perth.
PQ Healthcare Supplies (TAS)
PQ Healthcare is an arm of Paraquad Tasmania, a not for profit.
With so many retailers operating as not for profits, how is it that Paralogic can offer products at lower prices?
Unlike the other retailers in Australia, Paralogic deals directly with manufacturers on a range of products, including our intermittent, Tiemann, Foley and male external catheters.
All other products are bought via local distributors. The local distributors sell to both Paralogic and other retailers, and it is the distributors who have the majority of the say on product prices.
Medicare and health funds do not cover the cost of incontinence products. The main sources of funding available are below.
National Disability Insurance Scheme
For those with an eligible disability who are aged under 65, the NDIS will pay for your incontinence products. Read more on What types of continence support do the NDIS fund.
Continence Aids Payments Scheme (CAPS)
People with permanent and severe incontinence can obtain approx. $580 a year through CAPS. This is not means tested, and is paid annually in July. It is also possible to have this payment go directly to a supplier who can hold the funds on your behalf, however this will restrict your choices.
State Funding Schemes
Most of the state funding schemes are being superseded by the NDIS, however they may still be worth considering. These schemes are generally means tested.
The Continence Foundation of Australia runs a helpline which is staffed by nurses. It operates between 8am and 8pm. Call 1800 33 00 66. We recommend this service, the nurses can give you practical advice and really help.
Or, you can talk to us.
Most intermittent catheters are made from PVC, which is technically recyclable. There are specialist programs that recycle PVC waste from hospitals – but only if it hasn’t had contact with bodily fluids. Once an item has made contact with bodily fluids it’s considered contaminated waste and therefore not appropriate for recycling.