Product Information

Why Instill A Lubricant Into The Urethra Before Inserting a Catheter?

  • The entire urethra is more evenly coated with lubricant to expand and open the urethra.
  • The instillation of lubricant opens the urethra for the catheter, making it less likely to catch in the folds of the lining or in narrowed openings such as near the prostate in males.
  • A more even coating of lubricant on the urethral lining can reduce the risk of damage to the urethra caused by catheter friction or contact of the catheter with the urethral folds in the lining. This cannot be done by coating the tip of a catheter before insertion in the urethra. This is because much of the lubricant is often pushed off the outside of the catheter as the catheter is pushed into the closed urethra.
Benefits of Viscosity
  • More viscous lubricating gel provides fuller and more uniform distension of urethra, reducing risk of tears and easing travel of catheter or scope through urethra 
  • More time and volume in contact with urethra lining offers better lubrication, more comfortable for patient and more time for analgesic to work
cathejell

Data on File – Comparative Syringe pressures of 2% Lidocaine gels – BioSyent Pharma

Cathejell high viscosity gel dilates the urethra and adheres to the urethral lining to ease catheter travel within the urethra. This means there is lubrication and anesthetic where you need it, all along the length of the urethra.

Cathejell’s high viscosity gel will remain on the surface of instruments you apply lubrication to such as a cystoscope before a cystoscopy and not run off.

Syringe Pressure

Syringe pressure and the rate at which gel is instilled has a direct effect on patient comfort when instilling gel lubricant.1,2

  • A comparative study demonstrated that distension of the urethra causes pain, and rapid distension causing more pain.1
    • Study compared 2 sec instillation of gel versus 10 sec instillation time of gel and found significantly less pain with slower instillation which allows more time for the urethra to accommodate distension

This demonstrates the importance of Instilling a lubricating gel like Cathejell into the urethra and doing so slowly, since it gradually distends the urethral folds, reducing pain, while opening and filling the urethra with gel eases insertion of the catheter, and reduces the risk of injury.

Cathejell’s unique accordion style syringe was designed specifically to allow a controlled slow, low pressure instillation rate of gel into the urethra resulting in a more gradual distension of the urethra and lowering the risk of pain.

Slower gel instillation = significantly less pain

Cathejell‘s accordion syringe is designed for slow gel instillation

  1. Tzortzis et al, Intraurethral Lubricants-a Critical Literature Review and Recommendations, J of Endourology, vol 23, Number 5, May 2009 p821-826
Figure 1: Cathejell anesthetic lubricating gel
Benefits of Instillation With an Anesthetic Lubricating Gel

Individuals often experience pain or discomfort during catheterization. This is common during the early phases of learning to perform intermittent self-catheterization. It is important to have catheter lubrication along the entire length of the catheter to minimize the risk of pain and injury. In men, the correct positioning of the urethra can decrease pain and discomfort. Pain and discomfort usually decrease over time with increased experience.

The addition of an anesthetic to a urethral lubricating gel helps minimize pain caused by the stretching of the urethra and friction of the catheter on the lining of the urethra.1,2

 Cathejell contains an anesthetic, 2% lidocaine hydrochloride, that allows for effective numbing of the lining of the urethra for prevention and control of pain when catheterizing the male and female urethra. Cathejell starts to work in three to five minutes with full numbing effect within five to 10 minutes after instillation into the urethra.  It is possible to insert the catheter immediately after putting the lubricating gel in the urethra; however, if you do not wait the 5 minutes you may not get the full benefit of the anesthetic to numb the area and further reduce the risk of pain while inserting the catheter.

Studies Show Less Pain With Lidocaine Gel

 Cystoscopy studies:1,2

  • Show a significant decrease in moderate and severe pain when a lidocaine gel is used versus just a lubricating gel
  • Use of a lidocaine gel found patients were 1.7 times less likely to have pain

 Catheterization Studies2

  • Patients rank urethral catherization among the top 3 most painful invasive procedures in hospitals
  • The use of lidocaine lubricating gel reduced pain for most patients relative to lubricating gel alone
  1. Borch M et al, A Randomized Trial of 2% Lidocaine Gel Versus Plain Lubricating Gel for Minimizing Pain in Men Undergoing Flexible Cystoscopy, UROLOGIC NURSING / July-August / Volume 33 Number 4 page 1-7
  2. Aygin D, Usta E., The effect of lubricants used in indwelling bladder catheterization through urethra on procedure-related pain: a literature review, Int J Clin Exp Med 2017;10(2):1995-2005, www.ijcem.com

Cathejell®

Trusted by Doctors and Patients for 50 Years

Cathejell® Features & Benefits

Cathejell was designed to meet the needs of doctors and patients who wanted a product that was designed to be safe, easy to prepare and use, and more comfortable for the patient. For over 50 years Cathejell has delivered on that promise to doctors, nurses, and patients in hospitals and at home.

The unique accordion style syringe made it easier to control the rate of injecting gel into the urethra, making it more comfortable for the patient. That same design also allowed the convenience of opening the syringe and preparing it for use with the same hand, keeping it sterile.

Cathejell is a highly viscous, or thick, lubricant gel with an anesthetic, lidocaine, to reduce pain. By injecting a highly viscous lubricant gel directly into the urethra, it is possible to achieve a more even coating of lubricant on the lining of the urethra. The urethra is normally closed and is gently opened by the lubricating gel, which keeps the urethra open in front of the catheter. This provides an easy lubricated path for the catheter to follow to the bladder. This reduces the risk of pain and injury.

Cathejell Indications and Dosing

Cathejell Is Indicated For: Surface Anesthesia And Lubrication

      • For adult male and female urethra during catheterization, cystoscopy, exploration by sound, and other endourethral operations
      • Nasal and pharyngeal cavities in endoscopic procedures such as gastroscopy and bronchoscopy
      • Proctoscopy, rectoscopy
      • Tracheal intubation
      • Symptomatic treatment of pain in connection with cystitis and urethritis

Recommended Dose And Dosage Adjustment

Dosage: Dose varies with area of application‡
Usual Dosage Maximum Dosage
Adults 5-20 g
(½ – 2 syringes)
40 g (4 syringes)
Children** Varies as a function of age and weight Up to 3 g/10 kg
(⅓ syringe /10 kg)
No more than 40 g (4 syringes) in a 24-hour period for any age

Please refer to the Patient Information Leaflet

When fully compressed, each syringe expresses approximately 10 g of Cathejell® (9.4 mL, 200 mg lidocaine hydrochloride)

The amount expressed may vary with the technique used.

**Lidocaine should be used with caution in children younger than two years of age as there are insufficient data to support the safety and efficacy of this product in this patient population at this time.

References

      1. Tzortzis et al, Intraurethral Lubricants: A Critical Literature Review and Recommendations, Journal of Endurology, Vol 23, Number 5, May 2009 p 821-826
      2. Aygin D, Usta E, The effect of lubricants used in indwelling bladder catheterization through urethra on procedure-related pain: a literature review, Int J Clin Exp Med 2017;10(2):1995-2005, www.ijcem.com