New guidance for intermittent catheters

The National Institute for Health and Care Excellence (NICE) have announced new guidance for prescribing intermittent catheters for people who struggle to empty their bladder completely. 

Every year, over 95 million intermittent catheters are prescribed in the NHS. These have a range of features and costs, and so NICE investigated whether the catheter models with extra features were worth the additional costs through improved benefit to patients. These features include special coatings, specially designed cases or handles, or integrated drainage bags or tip protectors. 

Some people who need to use an intermittent catheter may find that some catheter designs are hard for them to use. This makes them more risky in terms of drawing blood when in use or making urinary tract infection (UTI) more likely. These are important side-effects to avoid, and some of the special features of modern catheters are thought to help to make these problems less likely.

The resulting analysis showed that there was not enough evidence to determine whether the price variation between different catheter models is justified. As such, it is important to ensure that everyone has access to a range of catheter models with different features, so that people can be prescribed a catheter that is comfortable and easy to use correctly.

As part of the NICE consultation process, the MS Trust expressed how important it is that people can have catheter models that suit them and their lifestyles. Along with other charities and patient experts, we explained how someone's hand dexterity, balance or spasticity could affect their choice of the best catheter model. We also explained that people might need different models to use at home and out of the house, and the need for privacy, dignity and discretion. 

People with MS and other conditions requiring self-catheterisation also expressed their views. They described how using an intermittent catheter helped them to feel more confident about working, shopping and leisure activities outside their homes.

• Your medical team should have a range of intermittent catheters available, so that there will be a catheter that meets your needs and preferences and is clinically appropriate for you.
• You and a healthcare professional should decide together which intermittent catheters to use. These decisions should take into account how easy and comfortable the catheter is for you to use, and how much the catheter will help to reduce the risk of urinary infection.
• Your needs may change over time, and so you should be able to review whether you should switch to a different model.
• If more than one catheter meets your needs and preferences and is clinically appropriate, your team will choose the least expensive. This recommendation should not affect you if you already have a catheter that is clinically appropriate and meets your need, but should be considered when you review your catheter use.
• You should be given training on how to do intermittent catheterisation.
• If you develop complications such as pain, discomfort, infection or bleeding, you should have support to see if changing to a different type of intermittent catheter helps.

• Bladder problems : Our webpage introduces bladder issues in MS and what you can do about them.
• Managing your bladder: a guide for people with MS : Our book on bladder self-management, available free from our shop.
• How can I manage my MS bladder?: Listen to our podcast, where bladder experts discuss modern techniques you can use yourself.
• Finding a toilet when out and about : Tips to help you feel confident you can find a loo when you need one.
• Catheters : All about these discrete and useful devices to help you empty your bladder.
• Catheters: You're going to put that where? : One person's experience with catheterisation.
• Top tips for MS bladder health : A short video to help you maintain bladder function.
• What can you do about bladder problems in MS? : A short film featuring expert advice from a consultant expert nurse.