When To Call For Help
or seek immediate medical care if:
- You have symptoms of a urinary infection. These may include:
- Pain or burning when you urinate.
- A frequent need to urinate without being able to pass much urine.
- Pain in the flank, which is just below the rib cage and above the waist on either side of the back.
- Blood in your urine.
Watch closely for changes in your health, and be sure to contact your doctor if:
- The area around the catheter becomes irritated, swollen, red, or tender, or there is pus draining from it.
- Urine is leaking from the place where the catheter enters your body.
Types Of Urinary Catheter
There are 2 main types of urinary catheter:
- intermittent catheters these are temporarily inserted into the bladder and removed once the bladder is empty
- indwelling catheters these remain in place for many days or weeks, and are held in position by an inflated balloon in the bladder
Many people prefer to use an indwelling catheter because it’s more convenient and avoids the repeated insertions needed with intermittent catheters. However, indwelling catheters are more likely to cause problems such as infections.
Inserting either type of catheter can be uncomfortable, so anaesthetic gel may be used on the area to reduce any pain. You may also experience some discomfort while the catheter is in place, but most people with a long-term catheter get used to this over time.
Read more about the types of urinary catheter.
Risks And Potential Problems
The main problems caused by urinary catheters are infections in the urethra, bladder or, less commonly, the kidneys. These types of infection are known as urinary tract infections and usually need to be treated with antibiotics.
You can get a UTI from using either a short-term or a long-term catheter. However, the longer a catheter is used, the greater the risk of infection. This is why it’s important that catheters are inserted correctly, maintained properly, and only used for as long as necessary.
Catheters can also sometimes lead to other problems, such as bladder spasms , leakages, blockages, and damage to the urethra.
Read more about the risks of urinary catheterisation.
Page last reviewed: 26 February 2020 Next review due: 26 February 2023
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Removing A Urinary Catheter
Patients require an order to have an indwelling catheter removed. Although an order is required, it remains the responsibility of the health care provider to evaluate if the indwelling catheter is necessary for the patients recovery.
A urinary catheter should be removed as soon as possible when it is no longer needed. For post-operative patients who require an indwelling catheter, the catheter should be removed preferably within 24 hours. The following are appropriate uses of an indwelling catheter :
- Improved comfort for end-of-life care
- Assisting in the healing process of an open sacral or perineal pressure ulcer
- Patients requiring prolonged immobilization
- Select surgical procedures
- Intra-operative monitoring of urinary output
- Patients receiving large-volume infusions or diuretic intra-operatively
When a urinary catheter is removed, the health care provider must assess if normal bladder function has returned. The health care provider should report any hematuria, inability or difficulty voiding, or any new incontinence after catheter removal. Prior to removing a urinary catheter, the patient requires education on the process of removal, and on expected and unexpected outcomes . The health care provider should instruct patients to
Review the steps in Checklist 81 on how to remove an indwelling catheter.
Slide : Indwelling Urinary Catheters1
Images: Figure l. Routes of entry of uropathogens to catheterized urinary tract.An image depicts the male and female lower urinary tract system, and the difference in placement of a catheter in the bladder.
1. Maki DG, Tambyah PA. Engineering out the risk for infection with urinary catheters. Emerg Infect Dis. 2001 7:342-7. PMID: 11294737.
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How Does A Catheter Work
Originally published on: June 25th, 2020. Last modified on December 15th, 2021
A catheter drains urine from the bladder into a drainage bag which may be supported at thigh or calf level. The leg drainage bag requires changing every 5 to 7 days depending on manufacturers instructions.
A Belly Bag or a catheter valve may be recommended. Your District Nurse or Continence Advisor will advise you on which type may be appropriate for your needs.
If you do use a leg drainage bag then it requires emptying when it is half to three-quarters full. Always ensure it does not pull on the catheter.
The bags are usually of 350ml, 500ml, 750ml or 1litre capacity for daytime use . At night an extra 2-litre bag can be fitted easily to the day leg bag to increase the available capacity. These larger night bags mean you dont have to get up in the night to empty the bag. They should be supported on a catheter drainage bag stand.
Understanding Different Types Of Catheter
Two main types of urinary catheter are manufactured either for single-use or for continuous indwelling drainage. The single-use catheter is selected for intermittent catheterisation, passing the catheter through the urethra into the bladder to drain the urine and then it is removed. For those able to undertake the procedure, this has become the recommended way of draining the bladder.
Many people now perform Intermittent Self Catheterisation or Clean Intermittent Self Catheterisation as it is sometimes termed routinely every day on themselves. For others, this is not an appropriate procedure and an indwelling catheter is used for continuous drainage. The indwelling catheter, designed by Dr Foley in 1937 is retained in the bladder by a balloon which can be inflated and deflated. Short-term or long-term drainage can be maintained but the end of the catheter should either be connected to a catheter valve, which can be opened and closed, or to a urine collection bag to create what is termed closed drainage to reduce the risk of bacterial infection.
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Emptying The Catheter Bag
The urine collection bag needs to be emptied regularly. It’s best to empty the bag when it’s about half full or at bedtime. If the doctor has asked you to measure the amount of urine, do that before you empty the urine into the toilet.
When you are ready to empty the bag, follow these steps:
Gathering The Necessary Supplies
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Medical Procedures And Devices
Your health care professional may recommend a medical procedure or device to treat your urinary retention, depending on the cause of the retention. Examples of these procedures and devices include
- cystoscopyusing a cystoscope to look inside the urethra and bladder to find and remove blockages such as urinary tract stones
- laser therapytherapy that uses a strong beam of light to treat an area of enlarged prostate tissue by breaking up the blockage and reducing the obstruction
- prostatic urethral lift, or UroLiftusing tiny implants to lift and hold the prostate away from the urethra so urine can flow more freely
- transurethral electrovaporizationa procedure that uses heat to vaporize an area of enlarged prostate tissue
- transurethral water vapor therapy, or Rezumtherapy that uses water vapor, or steam, to shrink an enlarged prostate
- urethral dilationgradually increasing the size of the urethral opening by stretching the scar tissue, to help treat urethral stricture
- vaginal pessarya stiff ring that is inserted into the to help stop urine leakage, such as with cases of a cystocele or rectocele
Urinary Catheter Side Effects
There are a few things to watch for when you use urinary catheters other than external and condom catheters.
Infection. This is the most common problem. The catheter may let germs into your body, where they can cause an infection of your bladder, urethra, urinary tract, or kidneys. Call your doctor if you:
Bladder spasms. These can happen if your bladder tries to push out the catheter. Medicine can help.
Other, less common side effects are:
- Kidney damage
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Looking After Your Catheter
If you need a long-term urinary catheter, you’ll be given detailed advice about looking after it before you leave hospital.
This will include advice about getting new catheter supplies, reducing the risk of complications such as infections, spotting signs of potential problems, and when you should get medical advice.
You should be able to live a relatively normal life with a urinary catheter. The catheter and bag can be concealed under clothes, and you should be able to do most everyday activities, including working, exercising, swimming and having sex.
Read more about living with a urinary catheter.
Three Way Foley Catheter And Bladder Washout
This article describes a 3-Way Foley catheter, its uses and abuses. 3-Way catheters are often used after prostate gland surgery to help remove blood clots from the urinary bladder. They may also be used for the treatment and management of simple hematuria following disease or trauma.
A Catheter is a highly specialized medical device to facilitate the removal of urine or blood from the urinary bladder. Their use is often abused by athletes for the purpose of inserting someone elses urine into their own bladder to fool the authorities into believing that the urine is their own. Three way Foley Catheters are made of latex or silastic, an engineered plastic.
A picture of a 3-way Foley Catheter is shown below. The three openings are clearly visible. The opening on the top is for the urine and blood to drain out. It is apparent that this is the lumen which is most straight to facilitate the urine and clotted blood to flow out. The lumen just below the number is for the entry of fluid which is to be used for draining the bladder. The third lumen is the smallest of the three lumens. It is for injecting a liquid or air into the balloon at the distal end of the Foley catheter. It is the balloon which prevents the Foley Catheter from slipping out because the inflated balloon is too large to pass through the urethra.
Urinary tract infection, trauma, stricture formation and urethral irritation are the most common complications of this procedure.
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Enhancing Healthcare Team Outcomes
A myriad of clinical conditions may require bladder catheterization. While a physician or a nurse can place the catheter in most cases, consultation with urology is necessary for specific patients. The nurses are essential members of the interprofessional group, as they will predominantly perform the procedure. They also monitor the catheter and assist with the education of the patient and family as needed. The pharmacist will ensure that the patient is not on any medication that can precipitate urinary retention. The physical therapist also plays a role in early mobilization, voiding exercises, and rehabilitation. Interprofessional communication and care coordination among health professionals are vital to enhancing patient-centered care and improve outcomes.
Male & Female Lower Urinary Tract
The lower urinary tract is the term used to describe the bladder and urethra, whereas the upper urinary tract refers to the kidneys and ureters.
Catheterisation of the bladder has been performed since time immemorial to drain urine from the bladder when it fails to empty. The bladder acts as a temporary reservoir for urine on its passage out of the body through the urethra. About 1500 ml of urine a day are produced, containing soluble waste products filtered by the kidneys from the bloodstream.
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Types Of Catheters Available
There are three main types of catheters used for ISC and the majority of these are single use disposable catheters. Some catheters have been designed to be reusable although these are now less common.
These catheters have a hydrophilic coating that create a slippery surface around the catheter when run under water before use. The coating allows for easier insertion into the urethra. These are single use, disposable catheters and are usually made of either PVC or silicone
These are the traditional intermittent catheter and most are designed to be washed and reused. They come in a variety of sizes and made in several materials including silicone, PVC, silver or stainless steel. Silver or stainless steel rigid catheters are only suitable for women due to the length of the urethra. These are less commonly used now due to being a little more time consuming and needing to be clean and lubricate the tubes prior to use.
These can be used straight from the packet without any additional preparation. They come packed in a water soluble gel, which makes them easier to insert. These types of catheter are ideal if you are out and about a lot and not able to access adequate clean water and facilities when emptying your bladder.
What Are The Possible Complications Of Using A Urinary Catheter
The most common complication of catheter use is a urinary tract infection. See your doctor if you have any of the following symptoms:
- pain or burning during or immediately after passing urine
- fever, tiredness or shakiness
- an urge to urinate more often
- passing small amounts of urine more frequently
- pressure in your lower belly
- urine that smells bad or looks cloudy or reddish.
Kidney infections, called pyelonephritis, are less common but are still a risk, and can be caused by an untreated or undiagnosed urinary tract infection.
Other complications include:
Your doctor or nurse can give you advice and problem-solving tips.
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A Look A What’s A Catheter How They Work And What They Are Used For
A urinary catheter is a soft hollow tube, which is passed into the bladder to drain urine. Catheters are sometimes necessary for people, who for a variety of reasons, cannot empty their bladder in the usual way, i.e. passing urine into a toilet or urinal.
Indwelling catheters are usually required short term for a number of weeks or months when continuous bladder drainage is needed, but occasionally they are required for long-term use.
Catheters are manufactured in a variety of materials, which mean they can be left in place for many weeks.
Once inserted a small balloon device is inflated, which prevents the catheter from falling out. On no account must you try to remove the catheter without the balloon being fully deflated. If you have a problem with your catheter seek help immediately.
Short Term Vs Long Term Catheters
Short-term catheter drainage of the bladder is frequently performed for patients undergoing surgical procedures or for those unable to pass urine because of obstruction to the urethra such as men with an enlarged prostate which compresses and closes the urethra. A catheter may be required to introduce therapeutic drugs or to record bladder pressures.
Long-term catheter drainage of the bladder is considered only as a last resort because of the risk of complications from catheter-associated urinary tract infections. Patients treated in this way form a heterogeneous group which includes those with neurological conditions that prevent the bladder from emptying.
This group includes people with spinal cord injuries, multiple sclerosis or stroke, those with intractable urinary incontinence or chronic debilitating illnesses which restrict their mobility and ability to use a commode or toilet and finally, those who are unfit to undergo surgery.
Passage of a urinary catheter to drain and collect urine from the bladder can resolve a wide range of medical problems and hence its judicious application plays a pivotal role in patient management.
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Living With A Catheter
Some people may find living with a catheter challenging and uncomfortable at first. However, as people become more accustomed to the catheter, they generally find that it has less impact on their daily lives.
This section provides tips on how to prevent and overcome some of the possible complications of catheter use.