Council Tip Catheter: Foley vs Coude, Guidewire Use, Sizes (14Fr, 16Fr, 18Fr), and Bard Council Tip Foley

Council Tip Catheter:

• What is Council Tip Catheter?
• Foley vs Coude
• Guidewire Use
• Sizes (14Fr, 16Fr, 18Fr)
• Bard Council Tip Foley

What is Council Tip Catheter?

A Council Tip Catheter is a specialized Foley catheter designed with a reinforced, round opening at the tip that allows the passage of a guidewire. This feature makes it particularly useful in difficult catheterizations where standard Foley catheters cannot be advanced due to urethral strictures, false passages, or an enlarged prostate. The reinforced opening prevents tearing of the catheter during guidewire insertion, providing a safer and more controlled approach.

Council tip catheters are typically used by urologists, emergency physicians, and trained clinicians in hospital settings. Their design allows for a “wire-guided” technique, improving success rates and reducing trauma when compared to blind attempts. These catheters maintain the same basic balloon mechanism as regular Foley catheters but offer more precision in placement, especially in complex urological cases.

Foley vs Coude

A Foley catheter is a standard indwelling catheter with a straight tip, used widely for routine urinary drainage. In contrast, a Coude catheter has a curved or angled tip that helps navigate the urethra when encountering resistance, such as from prostate enlargement or mild strictures. While the Coude design improves maneuverability, it does not allow guidewire insertion because it lacks a Council tip opening.

A Council Tip Foley differs from both because it combines the function of a Foley catheter with the ability to pass a guidewire. This makes it the preferred choice when previous attempts with a straight-tip or Coude catheter have failed. While Coude catheters rely on angled navigation, Council tip catheters rely on guidewire-guided placement, providing greater control in advanced or difficult catheterizations.

Guidewire Use

The defining feature of a Council tip catheter is its compatibility with a guidewire. During difficult catheterization, a flexible or hydrophilic guidewire is inserted into the urethra first—often under sterile conditions using direct visualization or blind passage by trained specialists. Once the guidewire reaches the bladder, the Council tip catheter is advanced over the wire using the reinforced opening at the tip.

Guidewire-assisted catheter insertion helps avoid urethral trauma, false passages, or further irritation. It is particularly effective in patients with urethral strictures, post-surgical changes, prostate enlargement, or those who have undergone previous traumatic catheter attempts. This technique provides a safer alternative to forced catheterization and often prevents the need for emergent suprapubic catheter placement.

Sizes (14Fr, 16Fr, 18Fr)

Council tip catheters are available in the same French sizes as standard Foley catheters, with **14Fr, 16Fr, and 18Fr** being the most commonly used sizes. The choice of size depends on the patient’s anatomy, indication for catheterization, and clinical scenario.

• 14Fr – Often used for smaller anatomy or when minimal trauma is desired.
• 16Fr – Standard size used in most adults for routine drainage.
• 18Fr – Preferred in cases requiring better drainage (e.g., blood clots, hematuria) or when the anatomy accommodates larger sizes.

The inner lumen of Council tip catheters is reinforced so that guidewire passage does not distort the catheter’s structure. Balloon sizes are typically 5–10 mL for adult drainage.

Bard Council Tip Foley

The Bard Council Tip Foley catheter is one of the most widely used models in hospitals. Manufactured by Bard (now part of BD), this catheter features a round reinforced eyelet specifically designed to accept standard urological guidewires. Bard catheters are known for their smooth silicone or latex-coated surfaces, which reduce friction and improve patient comfort during insertion.

Bard’s Council tip variant is commonly used in urology departments and emergency settings for challenging catheterizations. Many clinicians prefer Bard due to its durability, consistent balloon inflation, and reliable guidewire compatibility. This catheter is available in various French sizes and lengths, making it suitable for a wide range of clinical applications, including difficult male catheterizations, post-operative drainage, and cases with urethral abnormalities.