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Coudé (Tiemann) Catheter

The coudé catheter — from the French coudé, meaning "bent" or "elbowed" — has an angulated tip (30–45°) that allows the catheter to navigate around an enlarged prostate, a high bladder neck, or a false passage. Also called the Tiemann tip catheter.

Design​

  • Standard Foley construction with an angled tip curving anteriorly
  • A small raised guide (often a raised ridge or bump) on the balloon port indicates tip orientation — always points up (toward the patient's anterior) during insertion
  • Otherwise standard lumens and balloon inflation

Variants​

  • Coudé (Tiemann) tip — smooth angled tip; most common
  • Mercier tip — similar angulation but with a more bulbous tip
  • Council-coudé — combines coudé tip with central guidewire hole

Key Uses​

  • Benign prostatic hyperplasia / enlarged prostate — navigates around the median lobe into the bladder
  • High bladder neck — after radical prostatectomy or post-hysterectomy scarring in women
  • Prior false passage — the angled tip selects the true lumen when a prior Foley has created a false tract
  • Difficult male urethral catheterization — first-line after a failed straight-tip attempt

Technique Pearls​

  • Tip always points up (anterior) during insertion — the balloon-port landmark shows orientation
  • Rotate slowly, not forcefully, if resistance is encountered
  • Stop and call urology if multiple attempts fail — further forcing risks urethral injury

See also: Foley Catheter, Council Tip Catheter.