Urinary catheter: Uses, types, and what to expect

16/01/2019

This article outlines the different types of urinary catheter and provides advice on how to avoid side effects.

Uses

A doctor may recommend a urinary catheter for a person who has difficulties when urinating. Reasons for needing a catheter can include:

a blockage in the urethra, which is the tube that carries urine out of the bladder
injury to the urethra
an enlarged prostate in males
birth defects affecting the urinary tract
kidney, ureter, or bladder stones
bladder weakness or nerve damage
tumors within the urinary tract or reproductive organs

A healthcare provider may also insert a urinary catheter:

to accurately measure urine output in critically ill people
to drain the bladder before, during, or after a person has surgery
during childbirth, to drain the women’s bladder after an epidural anesthetic
to deliver medication directly into a person’s bladder
for treating a person with urinary incontinence if other treatments have not been successful

An indwelling catheter is similar to an intermittent catheter but remains in place for a period of days or weeks.

One end of the indwelling catheter has a deflated balloon attached. A healthcare provider will insert this end into the bladder and then inflate the balloon with sterile water to hold the catheter in place.

There are two main types of indwelling catheter, which have different insertion techniques:

Urethral catheter. Also called a Foley catheter, the healthcare provider inserts this type through a person’s urethra.
Suprapubic catheter. A doctor will surgically insert the suprapubic catheter through a small hole a few inches below the belly button. This operation will take place in the hospital while the person is under a local or a light general anesthetic.

What to expect

Indwelling catheters typically drain into a collection bag. A person can strap the bag to the inner thigh or attach it to a stand in a position lower than the bladder.

It is important to empty a drainage bag before it becomes full. For most people, this will mean emptying the bag every 2–4 hours. A person should also attach a clean, unused drainage bag twice per day and attach a larger bag at night.

Some indwelling catheters use a valve instead of a bag. Keeping the valve closed allows the bladder to fill up.

A person can then open the valve to empty their bladder and drain the urine out into a receptacle. Some people find this more convenient than using a drainage bag.

Side effects

Many people find suprapubic catheters more comfortable than urethral catheters. They are also less likely to cause an infection than a urethral catheter.

However, both types of indwelling catheter can cause the following side effects:

Bladder spasms

It is quite common for people with indwelling catheters to experience bladder spasms. This occurs when the bladder attempts to pass out the balloon section of the catheter. A doctor may prescribe medications to reduce the frequency and intensity of these spasms.

Blockages

People with an indwelling catheter may notice debris in the catheter tube. Though normal, these mineral deposits can sometimes block the catheter and prevent drainage.

It is essential for a person to notify a healthcare provider immediately if their catheter becomes blocked, or if they are passing blood clots or large pieces of debris.

Pain and discomfort

Long-term use of the indwelling catheter can cause pain and discomfort. It is important to discuss this with a doctor, who will be able to provide or advise on appropriate pain relief.

The main disadvantage of using a catheter is that it can allow certain bacteria to enter the body and cause infection.

According to the Centers for Disease Control and Prevention (CDC), urinary catheters are responsible for around 75 percent of UTIs that people acquire in the hospital. The risk of infection is highest when using an indwelling catheter.

Doctors refer to a UTI that results from catheter use as a catheter-associated UTI (CAUTI). Symptoms of a CAUTI can include:

pain in the lower abdomen or groin area
a high temperature
a burning sensation during urination
more frequent urination

A person can reduce their risk of developing a CAUTI by:

washing their hands thoroughly with soap and warm water before and after touching catheter equipment
keeping the skin around the catheter entrance clean by washing it with mild soap and water twice per day
ensuring that urine collection bags are kept below the level of the bladder, as this will help prevent blockages
not lying on the catheter, as this can prevent the flow of urine through the tube
ensuring that there are no twists or kinks in the tubing, as blockages can raise the risk of infection
keeping hydrated by drinking one or two glasses of liquid every 2 hours

Other activities

It is possible for a person using a urinary catheter to carry out most of their regular activities. A doctor will advise when it is safe for a person to resume working, exercising, or having sex.

Many people who use a catheter are concerned about the effect that it may have on their sex life. Generally, however, people with an intermittent or suprapubic catheter can have sex as normal. Those with a urethral catheter may find sex more difficult, but it is still possible.

Males who use an external catheter can usually remove the sheath during sex or place a standard condom over the top of it. In some cases, it is possible to temporarily remove the tube and drainage bag.

People who use a drainage bag with their catheter may wish to talk to their healthcare provider about the possibility of switching to a valve system. This can make sex easier and more comfortable.

Summary

A urinary catheter is an important aid for people who have difficulty passing urine. There are several different types available, and a person should talk to their doctor about the type that is best suited to their needs.

A common complication of using any type of catheter is an increased risk of UTIs. However, a person can reduce this risk by practicing good personal hygiene and catheter care, as well as learning how to use the equipment correctly.

People should consider talking to a medical professional if they experience any persistent pain or discomfort associated with the catheter. They can offer advice on how to make living with a catheter more comfortable.

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