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:
Leaks. This may be a sign that your catheter is blocked by clotted blood or debris. Tell your doctor if you see blood clots in your urine or you think something is blocking the flow of urine.
Bladder spasms. These can happen if your bladder tries to push out the catheter. Medicine can help.
Other, less common side effects are:
What Is An Indwelling Catheter
An indwelling urinary catheter , generally referred to as a Foley catheter, is a closed sterile system with a catheter and retention balloon that is inserted either through the urethra or suprapubically to allow for bladder drainage. External collecting devices are connected to the catheter for urine collection
Indwelling urinary catheters are recommended only for short-term use, defined as less than 30 days The catheter is inserted for continuous drainage of the bladder for two common bladder dysfunction: urinary incontinence and urinary retention.
Connecting To A Night Bag
Your nurse will show you how to connect your leg bag to a night bag. The night bag holds a large volume so you will not have to empty your bag while you sleep.
Figure 23. Inserting night bag tubing into leg bag
Never connect the night bag to the ureteral connecting tubing. The weight of the leg bag can pull the catheter out of your body if it falls.
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About Your Urinary System
Your urinary system consists of your kidneys, ureters, bladder, and urethra. Your kidneys produce urine that collects in the renal pelvis at the top of your ureters . Your ureters carry urine from the kidneys to the bladder.
Figure 1. Your kidney, renal pelvis, and ureter
Figure 2 and Figure 3 . Female and male urinary systems
Figure 4. Nephrostomy catheter
What Is Known As A Rule Out
Rule out: Term used in medicine, meaning to eliminate or exclude something from consideration. For example, a normal chest x-ray may rule out pneumonia.
Is a set of signs and symptoms that occur together?
Well, Websters Dictionary defines a syndrome as a group of signs and symptoms that occur together and characterize a particular abnormality or condition. Another definition is a set of concurrent things, such as emotions or actions, that form an identifiable pattern.
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Note The Time Of Your Appointment
A staff member from Interventional Radiology will call you 2 business days before your procedure. If your procedure is scheduled on a Monday, theyll call you on the Thursday before. Theyll tell you what time to arrive at the hospital for your procedure and remind you where to go.
If you dont get a call by noon on the business day before your procedure, call . If you need to cancel your procedure for any reason, call the healthcare provider who scheduled it for you.
Slide : Alternative Catheter Types
Straight Catheters
- Inserted directly into the urethra and bladder.
- Removed after insertion and drainage of bladder.
- Used intermittently.
- Placed surgically directly through skin into the bladder.
- Connected by tubing to a bag used to collect and measure urine.
External “Condom” Catheters for Men
- Does not enter the bladder.
- Connected by tubing used to collect and measure urine output.
- Cannot be used to treat acute urinary retention.
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Remove Devices From Your Skin
Talk with the healthcare provider who manages your diabetes care before your appointment if you wear:
- A continuous glucose monitor .
- An insulin pump.
The manufacturer recommends you remove these devices from your skin before your scan or procedure. Your healthcare provider will tell you how to manage your glucose while your device is off. They can also help you schedule your appointment closer to the date you need to change your device.
Make sure you have an extra device with you to put on after your scan or procedure.
When Should I See My Doctor
Always see your doctor if you notice any blood in the urine or have symptoms of a urinary tract infection.
You should see your doctor or continence advisor if your catheter keeps getting blocked or if you have any pain due to your catheter.
Seek medical attention for any of the catheter problems mentioned above that cannot be managed with simple self-care measures.
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Choosing The Right Catheter And Equipment
Your health professional will help you choose the right catheter and equipment for you. This will depend upon the reason you need the catheter, how long it is expected to remain in place, and what will best suit you and your lifestyle.
- external circumference of the catheter
- inside space of the catheter the right size for you is the smallest size possible to drain your bladder adequately
- material for example, silicone, latex or Teflon, or a combination of these. The material selected will depend on how long the catheter will be in place
- length, shape, design and structural features decisions about the length of the tube, the size of the collection bag and the means of attachment will depend on factors such as whether you are able to walk, how and where you intend to store or wear your collection bag, and how frequently you will be able to empty it
- how to secure or anchor your catheter to make you comfortable and reduce possible trauma. Catheter supports prevent unnecessary tugging of the catheter tubing on the bladder and irritation of the urethra and its opening
- lifestyle needs your catheter should be customised to your lifestyle choices for example, it may need to be easily portable, discreet, and have all the necessary features for you to be able to use it confidently, such as a handling aid.
Enhancing Healthcare Team Outcomes
An interprofessional approach to suprapubic catheters
Suprapubic catheterization is sometimes needed when drainage via the urethra is not possible. While the procedure is usually performed by a urologist, the nurse is usually in charge of monitoring the catheter and the urine output. Nurses need to know the potential complications of this procedure such as bowel injury and must regularly examine the abdomen. In addition, the patient needs to be monitored for signs and symptoms of a urinary tract infection. Patients who are confused may pull and try to remove their suprapubic or urethral catheters. Techniques and methods to secure catheters from such attempts are well described elsewhere. Finally, a common problem with suprapubic catheterization is leakage at the skin site and hence the nurse should monitor this area for signs of incontinence.
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Having Your Nephrostomy Catheter Placed
Your nephrostomy catheter will be inserted by an interventional radiologist. An interventional radiologist is a doctor who specializes in image-guided procedures.
The procedure usually takes less than 1 hour. Your interventional radiologist will explain the procedure to you and give you time to ask any questions before you sign a consent form.
After the procedure, your catheter will be attached to a bag to collect the drainage.
Sometimes, nephrostomy catheters are placed urgently when you are sick. In other cases, though, you will be scheduled to come into the hospital for the procedure. If this is the case, follow the guidelines below.
Slide : Male Catheter Insertion Procedure
- Keep nondominant hand in this position, do not remove!
- Lubricate tip of catheter with sterile lubricant jelly.
- Holding the coiled catheter in dominant hand, gently introduce the catheter tip into the urethral meatus.
- If using coude catheter, point catheter tip upward to 12 o’clock position.
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How Is This Device Inserted
Your doctor will insert and change your catheter the first few times after youre given one. Then, your doctor may permit you to take care of your catheter at home.
First, your doctor may take X-rays or perform an ultrasound on the area to check for any abnormalities around your bladder area.
Your doctor will likely use the Stamey procedure to insert your catheter if your bladder is distended. This means that its overfilled with urine. In this procedure, your doctor:
Your doctor may also give you a bag thats attached to your leg for the urine to drain into. In some cases, the catheter itself may simply have a valve on it that allows you to drain the urine into a toilet whenever needed.
SPC insertion is a short, safe procedure that usually has few complications. Before the insertion, your doctor may recommend taking antibiotics if youve had a heart valve replacement or are taking any blood thinners.
Possible minor complications of an SPC insertion include:
To remove an SPC, your doctor:
What Kind Of Problems Should I Watch Out For
Here are some of the problems to watch for:
- Urine stops draining out of the catheter
- You feel unwell with pain, fever and abdominal discomfort
- Urine is leaking around the catheter this can be normal around a new catheter site
- The area around the catheter becomes red and sore
- Bleeding. It is not unusual to see blood in the urine following a change of catheter but this usually settles in 24 hours.
Occasionally the skin around the catheter heals over and small skin tags form. If they become problematic i.e. bleed easily and interfere with catheter changes, they can be treated by your healthcare professional.
Some healthcare professionals recommend turning the catheter when cleaning the area to help prevent the catheter sticking to the bladder wall. If you notice anything unusual or feel unwell, contact your doctor or nurse.
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What Is The Difference Between A Stent And A Catheter
A balloon catheter is a long, thin plastic tube with a tiny balloon at its tip. A stent is a small, metal mesh tube.
Is a suprapubic catheter considered an indwelling catheter?
Indwelling suprapubic catheters are hollow, flexible tubes inserted into the bladder through a small cut in the abdomen . They are used to drain urine from the bladder and, in the management of bladder dysfunction, are often considered an alternative to a urethral catheter.
Conditions That May Require Urinary Catheterisation
Urinary catheterisation can be useful for people with bladder problems, such as:
- urinary retention inability to empty the bladder, for example due to neurological conditions such as stroke and multiple sclerosis, or other factors such as faecal impaction or enlarged prostate
- bladder obstruction for example, caused by bladder stones or narrowing of the urethra .
It can also be useful on a temporary basis, such as:
- to help people to retrain their bladder catheterisation can be discontinued as soon as bladder control is re-established
- after surgery to the genital area such as prostate gland or hip surgery or a hysterectomy
- for the first few days after major surgery or to monitor fluid output in patients receiving intravenous fluids.
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Arrange For Someone To Take You Home
You must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure.
If you dont have a responsible care partner to take you home, call one of the agencies below. Theyll send someone to go home with you. Theres a charge for this service, and youll need to provide transportation. Its OK to use a taxi or car service, but you still need a responsible care partner with you.
| Agencies in New York |
After 5 p.m., during the weekend, and on holidays, call and ask for the Interventional Radiology fellow on call.
Slide 1: Securing Drainage Bag
- Advance tubing another 3-5 cm once you see urine in the tubing
- Inflate balloon with 10 cc sterile water
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Which Is An Abnormal Narrowing Of The Ureter
Ureterectasis is the abnormal narrowing of a ureter. a. True b. False Dysuria is difficult or painful urination. a. True b. False
What does ablation mean in relation to ureterectasis?
Ablation is a treatment that involves the removal of a body part or the destruction of its function. a. True b. False Ureterectasis is the abnormal narrowing of a ureter.
How To Catheterize The Bladder In A Female Child
, MD, Nemours/Alfred I. duPont Hospital for Children
Bladder catheterization can be done for diagnosis and/or treatment.
The main reason to insert a bladder catheter in female children is to
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Collect a sterile urine sample for testing in very young children who cannot void on command
Less common reasons include
-
Monitoring of urine output in certain hospitalized patients
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Types Of Drainage Catheters
Your urinary system can be drained with a catheter in 2 ways. Your doctor will discuss this with you before your procedure.
Nephrostomy catheter
A nephrostomy catheter is placed if your doctor cannot bypass the blockage or if your ureter has been injured. It passes through your skin and into your renal pelvis. One end of the catheter forms a loop in this area. The other end of the catheter will extend from your body . It will be attached to an external drainage bag strapped to your leg.
Nephro-ureterostomy catheter
Figure 5. Nephro-ureterostomy catheter
A nephro-ureterostomy catheter is placed if the blockage in your urinary system can be bypassed. It passes through your skin and into the renal pelvis. It is guided across the area of blockage down to your bladder.
One end of the catheter will be in the bladder. The other end of the catheter will extend from your body . It will be attached to an external drainage bag strapped to your leg. This catheter lets urine flow in 2 directions. It can go out to the drainage bag or into the bladder.
Ask About Your Medications
You may need to stop taking some of your medications before your procedure. Talk with your healthcare provider about which medications are safe for you to stop taking. Weve included some common examples below.
Blood Thinners
Blood thinners are medications that affect the way your blood clots. If you take blood thinners, ask the healthcare provider performing your procedure what to do. They may recommend you stop taking the medication. This will depend on the type of procedure youre having and the reason youre taking blood thinners.
Examples of blood thinners include:
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Do not stop taking your blood thinner medication without talking with a member of your care team.
Read Common Medications Containing Aspirin, Other Nonsteroidal Anti-inflammatory Drugs , or Vitamin E. It has information about medications youll need to avoid before your procedure. It also tells you what medications you can take instead.
Medications for Diabetes
Before your procedure, talk with the healthcare provider who prescribes your insulin or other medications for diabetes. They may need to change the dose of medications you take for diabetes. Ask them what you should do the morning of your procedure.
Your care team will check your blood sugar levels during your procedure.
Diuretics
A diuretic is a medication that makes you urinate more often. Hydrochlorothiazide and furosemide are common diuretics.
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How Do I Look After My Suprapubic Catheter
Always wash your hands before and after emptying your catheter bag, or before and after emptying your bladder using the valve. You should wash the area around the insertion site with cooled boiled water once or twice a day. Some people find cleaning the wound with a sterile saline solution a good method of keeping the area clean.
A dressing will cover the wound after the operation and you should keep it in place until the wound has healed. Although not always necessary, many people prefer to wear a dressing around the wound all the time. The type of dressing may vary, your healthcare professional will be able to advise you of an appropriate dressing. Do not put any creams or talc around the site. To prevent pulling, it may be advisable to secure the catheter to the abdomen with a fixation device or tape. Your health care professional will advise you if this is necessary and help you decide on the best method.
In order to prevent urinary infections and encourage drainage, you should ensure you have an adequate daily fluid intake . A good mix of fluid types is recommended i.e. water, squash and juice. Keep bladder-irritating drinks e.g. tea, coffee and fizzy drinks to a minimum. Cranberry juice can be helpful to prevent bladder infections but should be avoided if you are taking Warfarin. Try to avoid constipation make sure that you include wholemeal bread, fruit and vegetables in your diet.