Catheter for intermittent catheterization

Abstract

Catheter (10) for intermittent catheterization, in particular for intermittent self-catheterization, wherein the catheter (10) comprises a catheter tube (20) and an insertion element (22), characterized in that the catheter (10) comprises in its distal end region two or more flexible, elongate holding elements (24), the proximal ends (40) of which are arranged around the catheter (10) and which can be applied longitudinally to the penis shaft (14) and optionally to the glans penis (16) by folding over in the direction of the penis, wherein the proximal ends (40) of the holding elements (24) are attached to the insertion element (22) and the holding elements (24) do not have a self-adhesive surface.

Description

BackgroundThe invention relates to a catheter for intermittent catheterization, i.e. discharge of urine, of the type mentioned in the preamble of claim 1, in particular a catheter for intermittent self-catheterization.In patients with bladder dysfunction, it may be necessary to carry out urine drainage regularly by means of a catheter. Neurogenic bladder dysfunction occurs, for example, in patients with cross-sectional paralysis, for example, after spinal cord injury. The contraction of the bladder muscles and the bladder sphincter muscles necessary for emptying the bladder can often no longer be controlled at all or only temporarily be controlled deliberately in such patients. The patients are therefore based on catheters by means of which they can empty their urinary bladder intermittently, for example every 3 hours (intermittent self-catheterism, ISK).In order to be able to be integrated comfortably in the daily day of the patients, the catheters should be sterile and preferably ensure as little as possible of carrying germs from the urethra into the urinary bladder and at the same time can also be easily handled by motor-restricted patients.During the catheterizing process, germs can reach the bladder during the advancement of the catheter, in particular since essential parts of the germs are located in the first 1.5 cm of the urethral entrance during the male. From there, the germs can enter the rest of the urethra and the urinary bladder. For this reason, in the prior art catheters with insertion elements are used in the ISK area, which comprise a lead tip which can be inserted into this initial area of the urethra and thus bridges the germ-loaded area. The catheter tube is then inserted through a flexibly closable opening in the lead tip into the urethra and into the bladder. The risk of the catheter slipping out can also be reduced by the insertion element, which significantly facilitates the intermittent self-discharge of urine for patients with motor restrictions. The insertion elements thus represent a distinct improvement of the ISK catheters. Exemplary insertion elements are described, for example, in US 2014 / 0276661 A1.Despite these improvements, it is often difficult for patients with motor restrictions, such as muscle spasms, to insert the ISK catheters and maintain them on the penis during the diversion process. It would therefore be desirable to further develop catheters in such a way that good safety for insertion and great holding comfort are ensured even for motor-restricted patients.US 4 419 097 A describes a cylindrical housing which can be mounted on the penis tip and the distal shaft end of the penis and is intended to prevent the slipping of a catheter in bedridden patients. However, the housing is rigid, so that the size of the housing must be adapted to the respective patient. In addition, the rigidity results in the housing occupying a large packaging volume and thus being unsuitable for daily transport like ISK patients, e.g. in the jacket pocket.US 2011 / 0230851 A1 proposes using self-adhesive sealing layers to fix a catheter to the penis of a motor-restricted patient. For this purpose, a plurality of self-adhesive sheets should first be adhesively bonded to the oak (glans penis) and these sheets should subsequently be fixed to the oak with larger self-adhesive seals. This is intended to create a liquid-tight seal between penis and catheter. At the same time, the mobility of the foreskin (praepunium) should not be restricted. However, since this catheter is attached to the glans penis only and consists of a relatively complex and adhesive arrangement of retaining elements, the insertion, retaining and removal of the catheter for motor-restricted patients is associated with considerable difficulties.U.S. Pat. No. 5,078,707 A describes a urinary diversion device with semi-cylindrically shaped elements made of elastic material, which can be fixed to the penis of a motor-restricted patient. A liquid-tight fastening of the elastic elements to one another and to the penis is to be made possible by edge-side adhesive strips and further adhesive zones.DE 10 2007 032208 B4 describes an insertion aid for catheters which has the form of a conical sheath, open at the tip, made of sterilizable, elastic material. From the base to the tip, the conical jacket has a gap which, in the relaxed state, is wider than the catheter to be used.It is therefore the object of the present invention to provide a catheter of the generic type which is suitable for the intermittent self-discharge of urine by a man restricted by motor and which enables rapid, reliable and hygienic handling and, moreover, is indelible and transportable with a small transport volume.DESCRIPTION OF THE INVENTIONThe object is achieved by catheters for intermittent catheterization having the features of claim 1.The invention thus relates to a catheter for intermittent catherization, in particular for intermittent self-catherization, wherein the catheter comprises a catheter tube and an insertion element, characterized in that the catheter comprises in its distal end region two or more flexible, elongate retaining elements, the proximal ends of which are arranged around the catheter on the catheter and which can be applied in the longitudinal direction (longitudinal direction) to the penis shaft and optionally to the oak (glans penis) by folding over in the direction of the penis. The catheter is particularly suitable for intermittent self-catherization in a male human subject.As described above, catheters for intermittent (self)catheterization are known for male human subjects. Compared to these known ISK catheters, however, the catheters according to the invention have the advantage that they can be easily fixed to the penis by the flexible, elongate retaining elements and can also be held by motor-restricted patients with only one hand. At the same time, by holding and fixing the holding elements to the penis, the penis shaft and the urethra can be stretched and thus straightened, so that the insertion of the catheter tube into the urethra is simplified and the risk of injury and infection is minimized.The term intermittent (self)catheterization refers to the intermittent (self) evacuation of urine by means of a catheter. A catheter within the meaning of the invention is thus a urinary bladder catheter, i.e. a catheter for draining urine. Intermittent self-catherization refers in particular to the self-catherization carried out by the patient himself, which is repeated regularly. The catheters according to the invention can of course also be used for catheterizing the patient by medical professionals. Use for self-catherization is preferred. The time intervals of the repetition (the frequency) are to be adapted individually and depending on the discomfort, the drinking quantity and the medicaments taken by the patient. Typically, the catheterization is performed four to six times a day.Because of the anatomical differences between male and female urogenital systems, catheters are usually only suitable for individuals of a sex. The catheters according to the invention are specifically adapted to the male urogenital system and thus suitable for use by a male ISK patient or a male human individual.The catheter of the invention comprises a catheter tube. The catheter tube is tubular. Urine can be drained through the catheter tube. Suitable catheter tubes are known to those skilled in the art. The catheter tubes have a length that enables the urinary bladder to be reached and, in particular, the bladder sphincter to be overcome. Preferably, therefore, the catheter tube has a length of 25 cm or more, preferably of 30 cm or more, more preferably of 35 cm or more, e.g. of about 41 cm. In other words, the catheter tube has a length of 25 cm to 60 cm, preferably of 30 cm to 50 cm. For male children or juveniles, these lengths can of course be adapted accordingly. Child's catheter tubes may have a length of, for example, 15 cm or more, preferably 18 cm or more, such as 22 cm. In other words, catheter tubes for children have a length of, for example, 15 cm to 29 cm, preferably 18 cm to 26 cm.The catheter tube also has a stiffness that ensures that the catheter tube is not compressed by the bladder sphincter and is thus closed. Corresponding catheter tubes are known to the person skilled in the art.The outer diameter of the catheter tube can be 6 to 20 Charrieères, preferably 14 to 18 Charrieères. Three Charrees correspond to 1 mm. Catheter tubes for male children preferably have an outer diameter of 6 to 10 Charrieères.Suitable materials and (e.g., hydrophilic) coatings for catheter tubes are known to those skilled in the art. Any material suitable in this context may be used in accordance with the invention.The catheter further comprises an insertion element. Suitable insertion elements are likewise known to the skilled person and have recently already been used for catheters.The insertion element has at its distal end a conical part with a rounded tip (the lead tip). The lead tip has a closable opening (a tube passage) which allows the catheter tube to be pushed through and at the same time minimizes the introduction of germs in the closed state. The lead tip can be inserted into the urethra and has a diameter and length corresponding to this purpose. The tube passage can be composed, for example, of one or more slots crossing one another, i.e. can be designed, for example, in the form of a cross or star.Proximally, the conical part is adjoined by a collar which extends circumferentially in a circular manner. The collar has an outer diameter large enough to stop insertion of the insertion member, i.e., larger (e.g., twice as large) than the diameter of the urethra.Further proximally, the collar is adjoined by an elongate tip holder which is designed at least in sections in the manner of a tube and surrounds the catheter tube. The tip holder serves to stabilize the tube part and the insertion element and to facilitate handling by the user. The tip holder may have a funnel shape, for example, with the wider funnel side proximal to the collar.The insertion element can be formed in one piece or assembled from different elements, e.g. glued, clamped or inserted. Thus, for example, tip holder, collar and / or lead tip can each be individual parts. Accordingly, it is contemplated to form the different parts of an insertion element from different materials. For example, the leader tip may be made of a different material than the tip holder and collar. Such embodiments are known to the skilled person.The insertion element or tip holder, the collar and / or the lead tip are preferably made of a plastic, such as silicone. Preferably, the insertion element consists of tip holder, collar and lead tip.In the unused state, the distal end of the catheter tube is inserted into the lead tip of the insertion element. The lead tip can then be inserted into the urethra. Subsequently, the distal end of the catheter tube is inserted through the insertion element, and in particular the lead tip, as well as through the urethra (urethra) into the urinary bladder. The introduction and placement of the catheter according to the invention is preferably effected after retraction of the foreskin in order to ensure a stable mounting of the catheter.The catheter comprises in its distal end region two or more flexible, elongate retaining elements, the proximal ends of which are arranged around the catheter on the catheter and which can be applied in the longitudinal direction (longitudinal direction) to the penis shaft and optionally to the oak (glans penis). The holding elements are thus designed such that they can be placed on the penis shaft essentially parallel to the longitudinal axis (longitudinal axis) of the penis.The distal end region of the catheter denotes that region of the catheter which is located in the penis after the introduction of the lead tip and in the immediate vicinity of the penis tip, for example after the introduction of the lead tip is 3 cm or less, preferably 2 cm or less, more preferably 1 cm or less, away from the penis tip. If the holding elements are folded in the direction of the penis or are placed on the penis shaft, the holding elements themselves are part of the distal end region of the catheter. In other words, the distal end portion of the catheter is the one which is generally furthest from the medical professional when used by medical professionals. This is the standard term in the catheter art.The retaining elements have an elongate shape with a distal and a proximal end. The distal end of the catheter or of the retaining elements is designated as the end which, during the catheterization with the catheter, will generally be furthest from the body of the medical professional or the least far from the body of the male patient. The distal end of the catheter is referred to as the end which is introduced into the penis during the discharge of urine.The proximal end of a retaining element is the end which during the self-discharge of urine is the least far from the center of the body of the medical professional, i.e. the end which is fastened to the catheter. The distal end of a retaining element is similar to that which is also applied to and held by the penis shaft.The distal end of the penis shaft of the patient is referred to as the end that is furthest from the center of the patient's body.The retaining elements are arranged or attached with their proximal end in the distal end region of the catheter. Preferably, the retaining elements are attached to a part of the catheter that is not movable or only slightly movable relative to the insertion element. Thus, the retaining elements are not fastened to the catheter tube, for example, since the latter is to be inserted into the urethra. Preferably, the proximal ends of the retaining elements are attached to the insertion element, in particular to the collar or tip holder. It is particularly preferred that the holding elements are fastened with their proximal end to the collar of the insertion element or adjacent to the collar of the insertion element, e.g. to the tip holder. Alternatively, however, the holding elements can also be firmly connected, for example, to a sheath which surrounds the catheter tube and contains, for example, a slide gel.Holding elements and insertion element or holding elements and collars of the insertion element can be formed in one piece. Alternatively, the retaining elements can be mechanically fastened to the insertion element, e.g. distally or proximally adjoining the collar of the insertion element. The mechanical fastening can be implemented, for example, by clamping or adhesive bonding. Thus, for example, proximally of the holding elements, a further clamping or adhesive element surrounding the insertion element annularly adjoining the insertion element can be attached to the insertion element. The clamping or adhesive element can be configured, for example, in the form of a ring. The fastening of the clamping element can be ensured in that the clamping element bears very closely against the outer surface of the insertion element. The adhesive element can be bonded to the insertion element and / or the holding elements by a conventional adhesive. Preferably, clamping or adhesive elements directly adjoin the proximal end of the holding elements proximally.The retaining elements are flexible and have an elongate shape. In particular, the holding elements are flexible such that they can be packaged flat against one another (and can be placed against the penis shaft). When placed on the penis shaft, the holding elements conform to the shape of the penis and its movements, as well as to the movements of the holding hand. At the same time, the retaining elements are so stable that they do not tear or are otherwise destroyed during normal use. The flexibility of the retaining elements ensures that the penis can be reliably stabilized by the holding hand and at the same time the catheter does not slip.Suitable materials from which the retaining elements can be produced can be determined by the person skilled in the art on the basis of these requirements. It is particularly preferred that the holding elements are made of a flexible plastic. The flexible plastic will generally be biocompatible. Suitable flexible plastics can be selected, for example, from the group consisting of polyurethanes (PU), thermoplastic elastomers (TPE) and silicones.In a preferred embodiment, the surface of the holding elements comprises a non-slip material. The retaining elements can consist entirely of this non-slip material or can only be coated with it. Alternatively, the surface of the holding elements can also be structured in such a way that slipping is prevented, for example by doubling the surface.In order to ensure easy handling of the catheter even by motor-restricted patients, it is, however, not desirable for the retaining elements to stick to the penis. The retaining elements thus do not have a self-adhesive surface according to the invention.The retaining elements can have a thickness of about 0.05 to 3 mm, preferably 0.1 to 1 mm, such as about 0.5 mm. The thickness can be adjusted depending on the material used."Elongated" means that the holding elements have a greater length in relation to the width. This ensures that the retaining elements can be placed on the penis shaft over a sufficient length. The proximal and distal ends of the holding element are the opposite narrower ends of the elongate holding element. When the holding elements are placed on the penis shaft, the longitudinal axes of the holding elements are aligned approximately parallel to the longitudinal axis of the penis.The holding elements can be rectangular or polygonal, but preferably have rounded corners at least at the distal end. More preferably, the holding elements have a crown-leaf-like shape, for example the shape of crown leaves of Tuplipa kaufmanniana(Seerosen-Tulip).After the insertion element has been inserted into the urethra and the holding elements have been placed on the penis shaft, the holding elements preferably together have an interrupted flower clavicle shape. The proximal ends of the holding elements can be arranged around the catheter, for example, in such a way that an angle of 90° to 180°, preferably of 120° to 180°, is situated between the center of the proximal end of a first holding element and the center of the proximal end of a second holding element.The catheter can have, for example, (exactly) two holding elements. In one embodiment, the catheter has two holding elements which are arranged on the catheter around the catheter in such a way that an angle of 90° to 180°, preferably of 120° to 180°, particularly preferably of approximately 180° C., is situated between the center of the proximal end of the first holding element and the center of the proximal end of the second holding element.The retaining elements have a width which is sufficient to ensure stabilization of the catheter on the penis and at the same time to ensure that, when the lead tip is introduced into the urethra, the view of the insertion point, i.e. the urethral opening, remains free. In order to take account of the latter requirement, the holding elements are preferably designed such that they cover from 90° to 270° of the penis circumference at the oak margin (corona gland), particularly preferably from 90° C. to 180° of the penis circumference, when they are placed around the penis.The holding elements can, but do not have to, overlap in the state in which they are applied to the penis shaft. The retaining elements can have a width of, for example, 1.5 to 4 cm, preferably between 2 and 3 cm, such as 2.5 cm, at their widest point. The holding elements can have a length of, for example, 4 cm or more, preferably 6 cm or more, for example, 6.5 cm, at their longest point. In other words, the holding elements can have a length of 4 to 10 cm, preferably of 6 to 8 cm, at the said location. This length ensures secure fixation by the patient's hand to the penis shaft.The individual holding elements can be separate parts. Alternatively, however, it is also possible for two or more retaining elements, preferably all retaining elements of a catheter according to the invention, to be produced jointly from one piece. In other words, in this embodiment, all (or two or more) retaining elements contained in a catheter according to the invention would be formed together as one part. The two or more retaining elements can be cast, printed or cut out as a part from a material, for example. Subsequently or simultaneously, a hole having the diameter of the tip holder can be inserted between the holding elements, through which hole the tip holder can be pushed and fastened (e.g. clamped or glued).The catheter may further comprise a sheath for the catheter tube, the sheath containing a lubricant. Suitable materials for the coating and suitable lubricants are known to those skilled in the art.The catheter may also be packaged in a sterile outer package. Thus, a contamination of the catheter with germs before being unpackaged by the user is substantially prevented and the risk of infection is significantly reduced. Suitable sterile outer packaging is known to the skilled worker.In a further aspect, the invention relates to a method for intermittent self-catheterisation, characterised in that the method comprises the steps of: a) inserting the leading tip of the insertion element of a catheter according to one of the preceding claims into the urethra; b) applying the holding elements in the longitudinal direction to the penis shaft and optionally to the oak (glans penis) by folding over; c) holding the holding elements and the penis firmly by one hand, preferably between the thumb and one or more fingers in the opposition position to the thumb; d) optionally stretching the penis shaft; and e) inserting the catheter tube into the urethra. "Longitudinal" or longitudinal direction denotes the direction which runs parallel to the longitudinal axis of the penis.Step b) may be performed before, after, or simultaneously with step a). In step b), the holding elements are held between two or more fingers or in the palm. Likewise, step c) may be performed during or after step a).Similarly, step c) preferably occurs at least during step e) (and / or d)) or continues during the execution of step d) and / or e). Moreover, step c) is preferably continued during the discharge of urine through the catheter tube following step e). The way in which the holding elements are held on the penis shaft by the patient can be varied depending on the motor restrictions of the patient.In step d), the penis shaft can be stretched. This is done by simply holding and stretching in the palm of the user. Step d) may be performed before or during step e), i.e. the stretching of the penis may be performed before or during the insertion of the catheter tube.Brief Description of the FiguresExemplary embodiments of the invention are schematically illustrated in the drawings. The following are shown: FIG. 1 shows a catheter and a penis according to the invention, wherein the lead tip and the urethral opening are aligned with each other; and FIG. 2 shows the catheter according to the invention from FIG. 1 in a plan view of the tube passage of the lead tip.Exemplary EmbodimentsFurther advantages, characteristics and features of the present invention will become apparent from the following detailed description of exemplary embodiments with reference to the attached drawings. However, the invention is not limited to these embodiments.Referring now to FIG. 1, a method of using a catheter 10 in accordance with the present invention is shown wherein the lead tip 32 of the catheter 10 is aligned with the urethral opening of the penis 12 so that the lead tip 32 can be inserted into the urethra. Because of the better displayability and in particular the visibility of the individual elements, no human hand is shown which holds the penis 12 and the holding elements 24 for the introduction of the lead tip 32.The catheter 10 includes a catheter tube 20 which passes through an insertion element 22. Within the insertion element 22, the catheter tube 20 extends to just before the tube passage 30 and can be easily pushed through the tube passage 30 after the introduction of the lead tip 32 into the urethra.The catheter tube 20 is welded into a sheath 28 containing a slip gel. The sheath 28 may be closed at its distal end by one or more weld seams. The sheath can likewise also be closed at its proximal end (not shown) by a weld seam. At its proximal end (not shown), the catheter typically includes a funnel or other element which may assist in draining urine to another container or disposal facility.The insertion element 22 has a tip holder 42 and further distally a collar 26 which is formed peripherally in the distal end region of the insertion element 22. Further distally, the insertion element 22 has a lead tip 32 which is suitable for insertion into the urethra. The lead tip 32 has a rounded shape at its distal end to reduce the risk of injury. In addition, the distal end of the lead tip 32 is provided with a tube passage 30 through which the catheter tube 20 can be passed and advanced into the urethra and the urinary bladder.Proximally of the collar 26, two retaining elements 24 are attached to the insertion element 22 and the tip holder 42, respectively. In the exemplary embodiment shown, the holding elements 24 are fastened to the insertion element 22 by a ring which runs around the insertion element and can be made of the same material as the holding elements 24, for example. Alternatively, the holding elements can be formed integrally with the insertion element 22. The two holding elements 24 are shown in FIG. 1 in the folded-down state (solid, thick line), in which the holding elements 24 run substantially orthogonally to the penis and catheter tube 20. Since the holding elements 24 are very flexible, they can be moved flexibly into a position in which the longitudinal axis of the holding elements 24 is aligned substantially parallel to the longitudinal direction of the penis and the holding elements are placed against the penis shaft 14. A dashed, thick line shows the two holding elements 24 which are being moved into such a position in which they are applied to the penis shaft. The holding elements 24 (dashed, thick line) are already aligned substantially parallel to the longitudinal axis of the penis shaft 14, but are not yet placed on the penis shaft 14.It can be seen that the holding elements 24 have a length which allows the holding elements 24 to be placed against the oak 16 and in particular along the penis shaft 14 in the longitudinal direction and to be held firmly with one hand. It will be appreciated that the view of the lead tip 32 to be inserted will be clear in this configuration.FIG. 2 shows the catheter 10 according to the invention from FIG. 1 in a plan view of the tube passage 30 of the lead tip 32. The catheter 10 shown has an insertion element 22 which comprises a collar 26 and a lead tip 32 which is formed in the distal direction (i.e. in the direction of the body of the individual) of the collar 26. The lead tip 32 has a cross-shaped tube passage 30. In order to allow a simple and reversible pushing through of the tube passage 30, the lead tip 32 is made of a flexible plastic. The tip of the lead tip 32 will flexibly open when pressure is applied to the tip from the interior of the insertion member 22 through the distal end of the catheter tube 20. The distal tip of the lead tip 32 will close again as soon as the catheter tube 20 is pushed out of the tube passage 30 or pulled back in the proximal direction.The catheter 10 in FIG. 2 has two holding elements 24. The holding elements 24 are situated approximately in the position which is illustrated in FIG. 1 with the thick, solid lines, i.e. substantially orthogonally to the longitudinal direction of penis 12 and catheter tube 20. The proximal ends of the support members 24 are the ends attached to the insertion member. The retaining elements have an elongate and simple crown-blade-like shape, i.e. the shape of a simple crown blade, for example that of a Gänseblümchenkronblatts.Although the present invention has been described in detail on the basis of the exemplary embodiments, it is obvious to a person skilled in the art that the invention is not limited to these exemplary embodiments, but rather that modifications are possible in such a way that individual features can be omitted or other combinations of the presented individual features can be realized, provided that the scope of protection of the appended claims is not left. The present disclosure includes all combinations of the individual features presented.List of reference characters10 Catheter 12 penis 14 penis shaft 16 oak (glans penis) 18 oak margin (corona gland) 20 catheter tube 22 insertion element 24 holding element 26 collar 28 sheath 30 tube passage 32 lead tip 34 fastening ring 36 distal end catheter 38 distal end holding element 40 proximal end holding element 42 tip holder

Claims

A catheter (10) for intermittent catherization, in particular for intermittent self-catherization, wherein the catheter (10) comprises a catheter tube (20) and an insertion element (22), characterized in that the catheter (10) comprises in its distal end region two or more flexible, elongate retaining elements (24), the proximal ends (40) of which are arranged around the catheter (10) on the catheter (10) and which can be applied in the longitudinal direction to the penis shaft (14) and optionally to the oak (glans penis) (16) by folding over in the direction of the penis, wherein the proximal ends (40) of the retaining elements (24) are attached to the insertion element (22) and the retaining elements (24) do not have a self-adhesive surface.Catheter (10) according to claim 1, the insertion element (22) of which has a collar (26), characterized in that the proximal ends (40) of the retaining elements (24) are attached to the collar (26) of the insertion element (22) or adjacent to the collar (26) of the insertion element (22).Catheter (10) according to one of claims 1 or 2, characterised in that the proximal ends (40) of the holding elements (24) are arranged around the catheter (10) in such a way that an angle of 90° to 180°, preferably of 120° to 180°, is situated between the centre of the proximal end (40) of a first holding element (24) and the centre of the proximal end (40) of a second holding element (24).Catheter (10) according to one of the preceding claims, characterized in that the retaining elements (24) consist of a flexible plastic.Catheter (10) according to one of the preceding claims, characterized in that the catheter (10) has two retaining elements (24).Catheter (10) according to one of the preceding claims, characterized in that the holding elements (24) are designed such that they cover 90° to 270° of the penis circumference on the oak margin (18) (corona gland) when placed around the penis (12).Catheter (10) according to one of the preceding claims, characterized in that the retaining elements (24) have a length of 6 cm or more.Catheter (10) according to one of the preceding claims, characterized in that the holding elements (24) have a crown-blade-like shape, preferably the shape of crown blades of Tulipa kaufmanniana.The catheter (10) of any preceding claim, characterized in that the catheter (10) comprises a sheath (28) for the catheter tube (20), wherein the sheath (28) contains a lubricant, and wherein the catheter (10) is preferably packaged in a sterile outer package.A method for intermittent catheterization, in particular for intermittent self-catheterization, characterized in that the method comprises steps in which: a) the lead tip (32) of the insertion element (22) of a catheter (10) according to any one of the preceding claims is inserted into the urethra; b) the holding elements (24), which do not have a self-adhesive surface, are placed longitudinally on the penis shaft (14) and optionally on the oak (16) (glans penis) by folding over; c) the holding elements (24) and the penis (12) are held firmly with one hand, preferably between the thumb and one or more fingers in an opposition to the thumb; d) optionally stretches the penis shaft (14); and e) the catheter tube (20) is inserted into the urethra.

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