In And Out Urinary Catheter

Risks And Potential Problems

How to manage painful urination with urinary catheter? – Dr. Sanjay Phutane

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

How To Insert A Catheter

This article was medically reviewed by Sarah Gehrke, RN, MS. Sarah Gehrke is a Registered Nurse and Licensed Massage Therapist in Texas. Sarah has over 10 years of experience teaching and practicing phlebotomy and intravenous therapy using physical, psychological, and emotional support. She received her Massage Therapist License from the Amarillo Massage Therapy Institute in 2008 and a M.S. in Nursing from the University of Phoenix in 2013.There are 9 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. This article received 28 testimonials and 87% of readers who voted found it helpful, earning it our reader-approved status. This article has been viewed 927,862 times.

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.

Instructions For Removing The Catheter

Follow the directions closely. Note: If the catheter doesnt come out with gentle pulling, stop and call your healthcare provider right away.

Empty the bag of urine if needed.
Wash your hands with soap and warm water. Dry them well.
Gather your supplies. This includes a syringe, wastebasket, a towel, and a syringe that was given to you by your healthcare provider.
Put the syringe into the balloon port on the catheter. The syringe fits tightly into the port with a firm push and twist motion.
Wait as the water from the balloon empties into the syringe. Depending on how large the balloon is, you may need to repeat this process several times until all of the water is out of the balloon.
Once the balloon is emptied, gently pull out the catheter.
Put the used catheter in the wastebasket. Also throw away the syringe.
Use the towel to wipe up any spilled water or urine if needed.
Wash your hands again.

Caring For Your Leg Bag

The tubing from your leg bag should fit down to your calf with your leg slightly bent. If you have extra tubing, you may need to cut it. Your nurse will show you how to do this.
Always wear the leg bag below your knee. This will help it drain.
Place the leg bag on your calf using the Velcro® straps your nurse gave you. Use a leg strap to secure the tubing to your thigh.
If the straps leave a mark on your leg, they are too tight. Loosen them. Leaving the straps too tight can decrease your blood flow and cause blood clots.
Empty the leg bag into the toilet every 2 to 4 hours, as needed. You can do this through the spout at the bottom. Dont let the bag become completely full.
Dont lie down for longer than 2 hours while youre wearing the leg bag.

When Urinary Catheters Are Used

A urinary catheter is usually used when people have difficulty peeing naturally. It can also be used to empty the bladder before or after surgery and to help perform certain tests.

Specific reasons a urinary catheter may be used include:

to allow urine to drain if you have an obstruction in the tube that carries urine out of your bladder . For example, because of scarring or prostate enlargement
to allow you to urinate if you have bladder weakness or nerve damage that affects your ability to pee
to drain your bladder during childbirth if you have an epidural anaesthetic
to drain your bladder before, during or after some types of surgery
to deliver medicine directly into the bladder, such as during chemotherapy for bladder cancer
as a last resort treatment for urinary incontinence when other types of treatment have been unsuccessful

Depending on the type of catheter you have and why it’s being used, the catheter may be removed after a few minutes, hours or days, or it may be needed for the long term.

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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How To Place A Urinary Catheter

It sounds silly, but I have found that people often struggle to place urinary catheters in female patients, especially patients with higher BMIs. Once you understand what landmarks to look for, though, youll be able to get the catheter in the right spot every time!

The first step in placing a catheter is to identify the urethral meatus.

Place the first two fingers of your non-dominant hand at the introitus and .
Now keep that hand there it doesnt move from now until the catheter is in!
Identify the anterior commissure .
Look directly posterior from the anterior commissure. Note that the mucosa of the vestibule is smooth, while the mucosa of the anterior vaginal wall is rugated .
The urethral meatus can be found
Clean the urethral meatus
Apply lube to the tip of the catheter
Introduce the catheter with your dominant hand, holding it like a pencil
Advance the catheter until you see urine
With an indwelling catheter that has a balloon, advance another centimeter or two to ensure the balloon tip of the catheter is all the way in the bladder, then inflate the balloon.

FAQs

Q: How do I know which port to inflate on the indwelling catheter?

Q: Does it matter what fluid I inflate the balloon with?

Q: What sizes of catheters are normally used?

A: Urinary catheters are described in French . The smaller the number, the smaller the diameter. For adults, most Foley kits contain a 16 Fr catheter. 14 Fr catheters are also commonly used for comfort.

Q: What materials are available?

Catheters : The Basics Of Urinary Catheter Types

How a Bladder Catheter Works

There are three main types of Catheters: intermittent catheters, indwelling catheters, and external catheters. Both intermittent catheters and indwelling catheters are considered internal urinary catheters, and as the name suggests, external catheters are considered external urinary catheters. Read on to learn more about these 3 types and the different types of each.

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What Is A Catheter

A catheter is a thin, flexible tube that can put fluids into your body or take them out.

If you have trouble peeing or canât control when you pee, a urinary catheter that goes into your bladder can get rid of urine for you. If you need blood or medicine, your doctor might use an intravenous catheter thatâs connected to one of your veins with a needle. For example, if you had cancer and needed chemotherapy, thatâs how youâd get it.

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.

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How Should I Prepare For Self

Your healthcare provider will show you how to perform self-catheterization. The process gets easier with practice. Before performing self-catheterization, you should:

Try to urinate the regular way.
Wash your hands with soap and water.
Wash your genitals with soap and water or an antiseptic towelette. This step lowers infection risk.
Remove the catheter from its package being careful to keep it very clean.
Apply a water-based lubricant on the tip and top two inches of the insertion end of the catheter if needed. Some catheters come pre-lubricated.

Latex Vs Silastic Catheters

Silastic catheters have been recommended for short-term catheterization after surgery. Compared with latex catheters, silastic catheters have a decreased incidence of urethritis and, possibly, urethral stricture.18 However, use in animal models for longer than six weeks showed no difference in inflammatory response between latex and silastic catheters.18 Because of its lower cost and similar long-term outcomes, latex is the catheter of choice for long-term catheterization. The cost differential becomes less significant in patients who do not require frequent catheter changes.6 Silastic catheters should be used in latex-allergic patients.

Catheters impregnated with various substances have not proved to be beneficial in patients with long-term catheterization. Silver-impregnated catheters, antibiotic-coated catheters and electrified catheters may diminish bacteriuria for a few days but are costly and have no role in long-term catheterization.4,19â21 In one study, silver-impregnated catheters were associated with more frequent bacteriuria and an increased risk of staphylococcal bacteriuria.21

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What Are The Different Types Of Urinary Catheters Available

Urinary catheters fall under three main categories:

Intermittent Catheters, or in-and-out catheters are single-use catheters that are used to drain the bladder each time the bladder is full, or at regular intervalsfor most, this occurs three to six times a day. Intermittent catheters are inserted into the urethra when the bladder is full, and are removed and discarded after each use. There are a few different types of intermittent catheters: straight catheters and coude catheters.
Indwelling Catheters are catheters that stay within the bladder for continuous drainage. When inserted through the urethra, they are often referred to as Foley catheters or balloon catheters, as the catheter is held in place in the bladder by a small inflatable balloon. Indwelling catheters can also be inserted through an surgical opening above the pubic bone in the abdomenthese are called suprapubic catheters. A healthcare professional is needed to insert and replace the catheter periodically. Indwelling catheters are attached to a leg or drainage bag to collect urine from the bladder continuously.
External Catheters,

How Do I Perform Self

Regardless of gender, the steps for performing self-catheterization are generally the same. Females may find it helpful at first to use a mirror to find the urethral opening where urine comes out. To perform self-catheterization:

Sit on the toilet .
Use firm, gentle pressure to insert the lubricated end of the catheter into the urethra.
Hold the other end of the catheter over the toilet bowl or container.
Slowly slide the catheter until it reaches the bladder and urine starts to flow out of the tube.
Continue inserting the catheter another inch or two.
Hold the catheter in place until the bladder empties.
Slowly and gently slide out the catheter.

How Do You Care For A Urinary Catheter

One-time use catheters and reusable catheters are available. For reusable catheters, be sure to clean both the catheter and the area where it enters the body with soap and water to reduce the risk of a UTI. One-time use catheters come in sterile packaging, so only your body needs cleaning before inserting the catheter.

You should also drink plenty of water to keep your urine clear or only slightly yellow. This will help prevent infection.

Empty the drainage bag used to collect the urine at least every 8 hours and whenever the bag is full. Use a plastic squirt bottle containing a mixture of vinegar and water or bleach and water to clean the drainage bag. Read more on clean intermittent self-catheterization.

While UTIs are the most common side effects associated with urinary catheters, there are other potential side effects that you may discuss with your doctor. These include:

bladder spasms and pain, which may feel like stomach cramps
blood or other debris getting trapped inside the catheter tube, which may stem from blockage in the catheters drainage system
catheter leakage, which may happen from a blockage in the system, or from pushing during toileting if youre constipated
urethra or bladder injuries

While not all side effects from urinary catheter use are completely avoidable, you may help reduce your risk with certain dietary and hygiene steps, as well as preventing blockages in the catheters drainage system.

Discuss the following risk factors with your doctor:

What Are The Potential Risks Or Complications Of Self

Urinary Catheter Care | UCLA Urology

Inserting a catheter can raise the risk of introducing infection-causing bacteria into the body, but having an indwelling Foley catheter presents even a higher risk. So if possible, CIC is a better option than an indwelling Foley. With any type of catheter, you have a higher chance of having a:

Bladder infection, perforation or spasms.

Signs of urinary tract infection .
Skin rash or sores at the site of insertion.

A note from Cleveland Clinic

Some people need self-catheterization for a short time. Depending on the cause of the bladder problem, medications or surgery may correct the problem. If you have a chronic problem or a condition that is expected to get worse over time, you may always need to use a catheter to urinate. Everyoneâs situation is different. Talk to your healthcare provider about what you can expect.

Last reviewed by a Cleveland Clinic medical professional on 10/23/2020.

References

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Looking After Your Indwelling Catheter

If you have an indwelling catheter its important to make sure your drainage bag is kept lower than your bladder, and make sure there are no kinks in the tubing this makes sure urine flows from your bladder into the drainage bag and not back up your urethra into your bladder. Its a good idea to empty your drainage bag regularly during the day so the weight of a full bag doesnt pull on the tube.
Most people will be supplied with a bag to use during the day and a different one at night. Catheter bags can be cleaned each day and reused. Your health professional will let you know how often you need to use a new bag and will show you how to properly clean and dry the bags. Its important to follow the advice of your doctor or nurse to minimise your risk of infection.
Indwelling catheters are usually changed every 612 weeks by your doctor or nurse.

Its possible to maintain your sex life with an indwelling catheter talk with your doctor or nurse about ways to manage this.

Urethral Vs Suprapubic Catheters

Suprapubic catheters are recommended by some physicians for short-term use when a catheter is needed for gynecologic, urologic and other surgeries.1 Theoretically, there are fewer microbes on the abdominal wall than on the perineum, creating less risk for infection. Another advantage is easier catheter changes. Suprapubic catheters can also be clamped to test for adequate voiding. Some patients might also prefer a suprapubic catheter to enhance self-image and sexual functioning. Other patients prefer its comfort and convenience.1 Disadvantages of suprapubic catheters include the risk of cellulitis, leakage, hematoma at the puncture site, prolapse through the urethra1 and the psychologic barrier of insertion through the abdominal wall.

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Preventing Infections And Other Complications

Having a long-term urinary catheter increases your risk of developing urinary tract infections , and can also lead to other problems, such as blockages.

You will be advised about measures to take to minimise these risks, such as:

regularly washing your hands, body and catheter with warm water and soap its particularly important to clean your hands before and after touching your equipment
ensuring you stay well hydrated you should aim to drink enough fluids so that your urine stays pale
preventing constipation staying hydrated can help with this, as can eating high-fibre foods such as fruits, vegetables and wholegrain foods
avoiding kinks in the catheter and making sure any urine collection bags are kept below the level of your bladder at all times