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Coudé tip catheter

The coudé catheter has a curved tip and is derived from the French term “coudé” for “elbow.”

The slight bend just proximal to the tip, allows the coudé catheter to be manoeuvred beyond obstructions in the bulbar and prostatic urethra. The curvature of the coudé catheter mimics the natural curvature of the male bulbar and prostatic urethra, posing less risk of creating urethral trauma or a false passage than a straight tip catheter. This curve can also help advance the catheter into an anteriorly retracted female urethral meatus.

Louis Auguste Mercier (1811-1882) first described the coudé catheter in 1836 and the bi-coudé catheter in 1841.

Early coude and bicoude catheters. Eynard catalogue
Early coudé and bicoudé catheters. Eynard catalogue

coudé or Coudé…that is the question

They fool me to the top of my bent.

William Shakespeare. Hamlet, Act III, Scene 2.
Hamlet laments that Rosencrantz and Guildenstern have treated him like a fool and he is now at breaking point….

In 1957, the medical students society of the Welsh National School of Medicine at Cardiff, published the biography of one Dr. Emile Coudé in their ‘journal‘ – The Leech. The biography of the alleged inventor of the “Coudé catheter” was equipped with footnotes and even a photograph – all spurious, of course. This was the first biography in a series called “Lesser Known Names in Medicine and Surgery.

EMILE COUDÉ (1800-1870)

Although the catheter he designed is in common use today. Little is known of Coudé in this country.

He was born the son of a country doctor in the small town of Villeneuve-la­-Comtesse, near the west coast port of La Rochelle. As a boy he loved to play around the ancient castle with its fourteenth century keep, which is still a well-known tourist attraction of the region.

As he grew up he attended lessons in the local school, but in his spare time he loved to accompany his father on his rounds in the small coach-and-pair. Occa­sionally he would be allowed inside a house to look at a patient with his father (a special treat, this). but usually he had to wait outside, looking after the horses.

On one of these occasions. Pierre, the larger of the two horses, was stung by a wasp. Frightened, he bolted, causing the other horse, Phillippe, to run off as well. Emile was in the carriage at the time. He tried in vain to halt the horses by pulling on the reins, until, as a wheel went into a small pot-hole in the rough country road, he was thrown off. He was not badly hurt, but a long gash on his right leg left him a scar there for the rest of his days.

EMILE COUDE (1800-1870)
Emile Coudé **

As time went by, Emile spent more and more time with his father, visiting patients. In his twenties, he went to Paris to study under the great Dupuytren at Hotel Dieu. Like most people he found Dupuytren’s nature unattractive, though he was certainly a great surgeon and teacher. Coudé himself was one of the “brigand’s” assistants at the first removal of a mandible ever performed. It is not known exactly how long Coudé spent in Paris. He said later that although he had undoubtedly learned much from Dupuytren, he had learned much more from his father.

On his return to his native town, Emile Coudé played an ever-increasing part in his father’s practice. But he had always been interested in surgery, and so in 1832 he accepted the post of assistant surgeon at Niort, seventeen miles north of his home town. It was here that he designed the catheter which bears his name.

In cases of retention of urine he found the catheters then available were difficult to use, being either perfectly straight and rigid, or else, as he put it in his memoirs, “bent to many weird shapes. as if a catheter should copy exactly the bends of the male urethra.”

After trying many different designs, he hit upon the well-known “bi-Coudé” catheter. Other doctors referred to it as the “Coudé catheter“, but its inventor’s natural modesty caused him to add the prefix “bi” (because it had two bends) in order to hide his name. The first published description of the instrument appeared in 1835

Coudé had married in 1830, and his son Robert began to learn medicine from his father, as Emile had done before him. When Emile Coudé retired in 1865, his son was already an assistant surgeon at Bordeaux. Before he died, in 1870, Emile expressed a wish to be buried in the place of his birth. He was buried on June the fourteenth and his tombstone can still be seen in the small cemetery attached to the beautiful thirteenth century church at Villeneuve-la-Comtesse

**The only known portrait of Emile Coudé

Surely nobody of note could possibly have taken this seriously. This simple, beautiful satire…published in a medical student journal with no intention to deceive…

Except the enigmatic, world renown surgeon and clinical educator Hamilton Bailey. In 1958, Sir Hamilton Bailey was preparing a new edition of his Short Practice of Surgery. As he later reported in letters to the Lancet and the British Medical Journal, he did not detect the falsity of the Coudé biography until his text was in page proof. Consequently several pages of the new edition had to be reset and biographical references to Coudé deleted.

Coude Hamilton Bailey 1958 1

The incident caused a flurry of letters in the British medical press including the Lancet (August 30, 1958), where one Hercule Coudé proclaimed that the honour of his illustrious granduncle Emile had been impeached…

Coude Hercule coude 1958 3

And, in the BMJ (August 30, 1958) Peter Birkett, a former editor of The Leech, pointed out that any familiarity with the source would have made the satirical intent of the article on Coudé obvious.

Coude Birkett 1958 2

At the cost of some public embarrassment to Hamilton Bailey (and the cost of reprint expenditures of his publisher), the matter of the coudé catheter finally appears to have been straightened out.


References

eponymictionary

the names behind the name

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

Dr John Mackenzie 002

Dr John Mackenzie MBChB FACEM Dip MSM. Staff Specialist Emergency Prince of Wales Hospital; Consultant Hyperbaric Therapy POW HBU. Lead author of Emergency Procedures App | Twitter | | YouTube |

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