Which is the recommended size range of a urinary catheter that can be used in a 3 year old child?

When you begin using an intermittent catheter or a foley catheter, your healthcare professional will help you determine which size of catheter is best for your body type and other medical needs. Most healthcare providers will offer samples of intermittent catheters to evaluate when determining the size that is most comfortable and effective for your individual use.

We invite you to contact one of our manufacturer-trained Urology Specialists to request additional samples of intermittent catheters for self-evaluation.

Do intermittent catheters come in different sizes?

Yes. Anatomical differences and a variety of other factors in body function and medical needs require intermittent catheters to be manufactured and sold in sizes. Intermittent catheters are available in different lengths and sizes suitable for men and women.

Understanding the French scale for intermittent catheters and Foley catheters

Catheter size relates to the thickness or diameter of the catheter and is measured in Charriere (Ch) or French Gauge (FG). French sizes only apply to intermittent and indwelling (Foley) catheters.

A French size is comparable to the circumference of the catheter in millimeters. “French” or “FR” is equivalent to 0.33 millimeters, which converts to .013 inch or 1/77 inch in diameter. French size does not apply to the length of the catheter.

• The average catheter size used by adult men is between 14FR to 16FR. Most men use 14FR catheters.
• The average catheter size used by adult women ranges from 10FR to 12FR. Most women use 12FR catheters.
• The average catheter size used by children (pediatric) ranges between 6FR and 10FR.

Selecting Catheter Size

When selecting a catheter for urinary drainage, the smallest possible diameter should be used that still allows adequate drainage.  Using too large of a diameter (or French size) can be associated with increased bladder irritability and trauma.

Healthcare providers will typically recommend the following French sizes to adults:

• 12FR –14FR for drainage of clear urine
• 14FR–16FR for urine containing debris or particles
• 18FR or above if blood clots are present in the urine

How do I know the size of my current intermittent or Foley catheter?

Most catheter manufacturers follow a universal system of color-coding to label the catheter size, and they also clearly indicate the catheter size on the external packaging or wrapper.

Regardless of brand, most intermittent catheters have color-coded funnels that indicate their French size:

Why do I need to use the right size of catheter for my individual body type?

In their 2009 Guideline for Prevention of Catheter-Associated Urinary Tract Infections (CAUTI), the Centers for Disease Control (CDC) recommends that unless otherwise clinically indicated, individuals should consider using the smallest diameter catheter possible, that still allows for good urinary drainage, to minimize bladder and urethral trauma.

What is the difference between the French size of a catheter and its length?

While intermittent catheters and Foley catheters have French sizes according to diameter, it is also important to choose a catheter length that is appropriate for your body type and medical needs.  To properly determine the right product for your personal use, you and your healthcare provider should evaluate both the width and length of the intermittent catheter that you are selecting.

Intermittent catheters are manufactured in three lengths that are designed to meet the needs of different people:

• Standard female length catheters average 7-10 inches. Anatomically, women have a much shorter urethra and can use a shorter, female length catheter. Some larger women or those with reduced mobility or a stoma may prefer to use a male-length catheter.
• Standard male length catheters average 15-18 inches. Men have a longer urethra and require a male length catheter because of this anatomical difference.
• Pediatric length catheters average 11-13 inches. Shorter length intermittent catheters may be easier for women and children to grasp and use, allowing for better flow and urine drainage through the catheter.

May I request samples of intermittent catheters to evaluate another size or style?

Yes, we are happy to assist you with catheter samples and invite you to request them here.

For further information on intermittent and indwelling catheter sizing, talk to one of our manufacturer-trained Urology Specialists and learn how trying different product samples may improve your comfort and quality of life.

Contact a specialist at 855-948-3319

Indwelling Urinary Catheters: Types

Indwelling urinary catheters (IUCs) are semi-rigid, flexible tubes. They drain the bladder but block the urethra. IUCshave double lumens, or separate channels, running down it lengthwise. One of the lumen is open at both ends and allows for urine drainage by connection to a drainage bag.

The other lumen has a valve on the outside end and connects to a balloon at the tip; the balloon is inflated with sterile water when it lies inside the bladder, and allows for retention in the bladder.  These are known as two-way catheters.

The name of the Foley catheter comes from the designer, Frederic Foley, a surgeon working in Boston, Massachusetts, in the 1930s. His original design was adopted by C. R. Bard, Inc. who manufactured the first prototypes and named them in honor of the surgeon.

Foley Catheter Sizes

Catheter sizes are colored-coded at the balloon inflation site for easy identification

The relative size of a Foley catheter is described using French units (Fr).  In general, urinary catheters range in size from 8Fr to 36Fr in diameter. 1 Fr is equivalent to 0.33 mm = .013" = 1/77" in diameter.  

The crosssectional diameter of a urinary catheter is equal to three times the diameter.

Since urethral mucosa contains elastic tissue which will close around the catheter once inserted, the catheter chosen should be the smallest catheter that will adequately drain urine.  

Size Considerations

• The routine use of large-size catheters diameters can cause more erosion of the bladder neck and urethral mucosa, can cause stricture formation, and do not allow adequate drainage of peri-urethral gland secretions, causing a buildup of secretions that may lead to irritation and infection. 
• Larger Fr sizes (e.g., 20-24 Fr) are most commonly used for drainage of blood clots.  
• The most commonly utilized indwelling transurethral and suprapubic catheters range from 14 to 16Fr in both adult females and males. 
• A 14 or 16 Fr is also the standard catheter in most commercially available IUC insertion kits or trays.
• In adolescents, catheter size 14 Fr is often used but for younger children, pediatric catheter sizes of 6-12 Fr are preferred.  

Shape and Design Variations

The distal end of most urinary catheters contains two ports (lumen or channel or dual lumen).  One is a funnel shaped drainage channel to allow efflux of urine once the catheter is placed and the other is the inflation/deflation channel for infusion of water into the retention balloon.  The infusion port for the balloon is usually labeled with the size of the balloon (5cc or 30 cc) and the size of the catheter.

 
Three-way catheters are available with a third channel to facilitate continuous bladder irrigation or for instillation of medication.  This catheter is primarily used following urological surgery or in case of bleeding from a bladder or prostate tumor and the bladder may need continuous or intermittent irrigation to clear blood clots or debris.

The catheter should have a smooth surface with two drainage eyes at the tip that allow for urine drainage.

Drainage eyes are placed either laterally or opposed. Opposing drainage eyes generally facilitate better drainage.

Catheter products have changed significantly in their composition, texture, and durability since the 1990s.

The challenge is to produce a catheter that matches as closely as possible to the normal physiological and mechanical characteristics of the voiding system, specifically the urethra and bladder. Foley catheters come in several subtypes, which are described in the area designs.

References

1. Jahn P, Beutner K, Langer G. Types of indwelling urinary catheters for long-term bladder drainage in adults. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD004997. DOI: 10.1002/14651858.CD004997.pub3.Newman DK, Cumbee RP, Rovner ES. Indwelling (transurethral and suprapubic) catheters. In: Newman DK, Rovner ES, Wein AJ, editors. Clinical Application of Urologic Catheters and Products.  Switzerland: Springer International Publishing;2018,  47-77.
2. Newman DK. Devices, products, catheters, and catheter-associated urinary tract infections. In: Newman DK, Wyman JF, Welch VW, editors. Core Curriculum for Urologic Nursing. 1st ed. Pitman (NJ): Society of Urologic Nurses and Associates, Inc; 2017, 439-66.
3. Newman DK. The indwelling urinary catheter: Principles for best practice. JWOCN. 2007;34:655-61 DOI: 10.1097/01.WON.0000299816.82983.4a
4. Newman DK, & Wein AJ. Managing and Treating Urinary Incontinence, Second Edition.  Baltimore: Health Professions Press;2009a;445-458.