What is a Urinary Catheter Used For?
A urinary catheter is a hollow, partially flexible tube inserted into the bladder through the genital opening. Its purpose is to collect or drain urine into a bag attached at the other end of the tube.
Individuals may need urinary catheters for short-term or long-term use. Most individuals will only need the catheter temporarily until the condition affecting your bladder resolves. However, there are also instances that require long-term catheter use.
Here are some of the common reasons why you may need a urinary catheter insertion.
The doctor may recommend urinary catheter insertion if you need to undergo surgery on your prostate or genital area, especially if the operation requires general anesthesia, as general anesthesia often renders you incapable of controlling your bladder functions.
People with critical conditions that require accurate urine output monitoring will also benefit from having a urinary catheter.
Urinary retention happens when a person cannot empty their bladder completely because something blocks the urine flow or the bladder cannot contract or relax correctly to initiate urination. Until the cause of retention resolves, the doctor may order catheter insertion to empty the bladder.
People with urinary incontinence, a condition where they experience urine leakage because they cannot control their bladder, may also need a catheter.
Bladder Outlet Obstruction
If there’s a blockage in the urine flow that cannot be corrected by medications or surgery, long-term catheter use may be required.
People with irreversible health conditions (end-stage cancers) who can no longer regain their bladder control or those with health issues that make position changes difficult may need urinary catheterisation.
How does a urinary catheter work?
Generally, all urine catheters work the same way: one end of a thin, hollow, and partially flexible tube will be inserted through the genital opening until it reaches the bladder. Afterwards, urine will flow from the bladder to the bag attached at the other end of the tube. But, of course, a catheter’s “mechanism” still depends on the type and gender of the person who needs the catheters.
Before we proceed to the different types of urinary catheters, it’s important to understand the difference between male and female catheterisation.
Difference Between Male and Female Catheterisation
The male urethra is longer than the female urethra. Understanding the length of the urethra, the tube where urine passes through to leave the body, is essential because it’ll also dictate the catheter tube’s length.
Since the male urethra is longer, the catheter tube for men should also be longer. Generally, male catheters measure 30 to 40 centimetres, while female catheters measure only about 7 to 20 centimetres. However, it’s important to note that there are also “unisex” catheters, which both men and women can use.
Besides length, the diameter of the tube indicated by the French scale (written as “f” or “fr”) is also vital. Most male catheters are 14fr to 16fr, while females are 10fr to 12fr.
Types of Urinary Catheters
There are three types of urine catheters: indwelling or Foley catheters, external or condom catheters, and short-term or intermittent catheters.
Indwelling or Foley Catheters
Indwelling catheters are catheters that stay in your bladder. Since the catheter remains in your bladder, ensuring that it doesn’t slide out is crucial. To prevent the tube from sliding out, it has a balloon on one end; the healthcare practitioner inflates the balloon with water so that the tube stays in place. Once the patient no longer needs the urine catheter, the healthcare practitioner only has to remove the water from the balloon to deflate it. Afterwards, they can easily pull the tube out.
There are also different types of Foley catheter drainage bags. Some are meant for in-home or hospital use, while others can be secured to the leg so that you can walk or go about your daily life as per usual. Likewise, some bags have a valve at the bottom to enable frequent drainage to the toilet.
Lastly, keep in mind that indwelling catheters can be inserted in two ways: via the urethra (urethral) or a small hole in the abdomen (suprapubic).
Indwelling Urethral Catheters
An indwelling urethral catheter is a type of indwelling catheter where the tube passes through the urethra and into the bladder. Urethral catheters are the most common type of indwelling catheters.
Indwelling Suprapubic Catheters
Suprapubic catheters are usually for long-term use; generally, it needs changing every 4 to 8 weeks. The doctor makes a small hole in the abdomen to insert the tube directly into the bladder. Because the doctor needs to make an incision, the procedure is done under general, epidural, or local anesthesia.
Intermittent or Short-term Urinary Catheters
Unlike indwelling catheters, intermittent catheters don’t have to stay in the bladder, so it doesn’t have a balloon on one end. You need to insert the catheter and drain urine several times a day.
If you need an intermittent catheter, the doctor will teach you how to insert the tube properly. Most prepacked intermittent catheters already have lubricated tubes for more comfortable insertion. The other end of the tube may be open-ended, so you can directly drain urine to the toilet. You may also choose to attach the other end to a drainage bag.
External or Condom Catheters
Finally, we have the external or condom catheters for men who experience urinary incontinence.
Unlike the two previous types we’ve discussed, an external catheter doesn’t have a tube that goes into the bladder. Instead, the man wears a condom-like device with a tube attached to the tip. The tube is then connected to a drainage bag that can be secured to the leg. Whenever the man experiences urine leakage due to incontinence, the urine will flow through the tube and into the bag.
Who Needs Urinary Catheters?
Now that we’ve discussed the clinical indications, general mechanism, and types of catheters, let’s talk about who needs to use them.
In addition to the clinical indications we’ve explained above, the doctor may also recommend indwelling urinary catheter insertion if you:
- Have a neurologic condition that compromises the function of your bladder (multiple sclerosis, dementia, spinal cord injury)
- Need bladder irrigation, a procedure that washes out the inside of the bladder
- Need to receive chemotherapy
- Are giving birth and need to empty your bladder
Likewise, people with the following conditions may need intermittent catheterisation:
- Kidney failure
- Lower urinary tract symptoms such as urinary urgency and frequency
- Bladder calculi or the presence of calcium stones in the bladder
And, finally, condom or external catheters are meant for men who experience urinary incontinence.
However, do take note that having any of the above mentioned conditions doesn’t automatically mean that you’ll need urine catheters. Your doctor will tell you if you need urine catheterisation or if your condition can be managed through therapy or medications.
Should you feel that you need a urinary catheter, talk to your doctors. Those who dislike visits to the clinics or hospitals can doctors via a teleconsultation or in-person, all in the comfort and privacy of your home.
How Long Does a Person Need a Urinary Catheter?
How long a person needs urine catheters mainly depends on their condition and the type of catheter used.
For instance, people who have a temporary loss of bladder control (surgery, acute bladder retention, giving birth, etc.) may not need urine catheters for long. On the other hand, people with chronic and irreversible conditions may be subjected to long-term catheterisation.
The type of catheter also matters. Most catheters are sterile and disposable, which means you need to replace them after use. This won’t be an issue for those using a Foley catheter since it can last for weeks. However, people with intermittent or condom catheters may ask their doctor about the possibility of using reusable catheters and will need to thoroughly clean the reusable catheter and parts of the tube that enters the body.
Possible Complications of Having a Urinary Catheter
Because a catheter is essentially a foreign object in our body, there may be some side effects. Some potential side effects and complications include:
If the catheter “bothers” your bladder, it may spasm and cause pain in the area above your pubic hair or the rectum. Bladder spasms may also result in urine leakage around the catheter. If this happens, call your doctor as soon as possible. To stop the cramp, the doctor may give you medication or temporarily remove your catheter.
Blood in the Urine (Hematuria)
Your urine may also contain blood clots while you have a catheter, especially if you underwent prostate cancer surgery. If it’s not a blood clot, you may notice that your urine is pinkish. Be sure to call your doctor right away if you see that your urine has too much blood or large blood clots; some clots may block the catheter tube and prevent the urine from flowing.
Any catheter may bring bacteria into any part of your urinary system, causing urinary tract infections. Common signs of UTIs are fever, cloudy urine, and pain or burning sensation in the urethra or genital area. Left untreated, UTIs can lead to a severe kidney infection.
Sensitivity to Latex
It’s not the case for everyone, but some people are allergic to latex. This could cause irritation and swelling of the urethra (urethritis) and to the other parts that come in contact with the latex catheter and balloon (for indwelling catheters).
When the catheter is unable to drain all the urine, the remnants can crystalise and form stones. However, experts highlight that this condition is common among people whose catheters stayed longer in their body than the recommended period.
People who use long-term indwelling catheters have a higher risk of developing bladder cancer. According to reports, irritation and infection can trigger the development of cancer cells in the bladder. Over time, these tumour cells can become cancerous.
Finally, incorrect or repeated catheter insertion can cause injury or scarring in the urethra. The trauma may occur after “forcing” the catheter inside, or when the tube has inadequate lubrication.
Caring for a Urinary Catheter
You can prevent the occurrence of complications by properly caring for your catheter. Here are some tips to keep in mind:
Learn Everything About The Catheter You’re Using
After learning that you need a urinary catheter, listen carefully to your doctor as he or she explains how your catheter works.
It’ll be less stressful if you only need the catheter for the duration of your hospital stay, but if your doctor decides that you need a catheter after returning home, you will have to learn how to clean the area and drain the urine. Additionally, take note of all the warning signs that you need medical help:
- Bladder spasms that don’t go away
- Fever and chills
- Finding blood in the urine or around the catheter
- Strong-smelling and cloudy-looking urine
- Very little or no urine flow
- Swelling and pain in the urethra
- Finding stones in the catheter or urine bag
Be Thorough About Cleanliness
The best way to reduce the possibility of infection is to ensure cleanliness before, during, and after having a catheter. If the catheter is designed for one-time use, do not reuse it. If it is reusable, follow the cleaning instructions closely.
Make sure to clean the area where your catheter is inserted every day and after each bathroom use. For suprapubic catheters, cover the insertion site on your abdomen with clean or sterile gauze.
Be mindful of the drainage bag; clean it according to the manufacturer’s instructions. If your bag has a valve where you drain the urine to the toilet, ensure that the valve does not touch anything; if it comes in contact with any surface, especially the floor, clean it with soap and water.
Finally, wash your hands before and after handling your catheter and draining the bag.
Drink Plenty of Water
You can reduce the risk of infection by keeping your urine diluted (clear or pale yellow in colour), so ensure that you’re well-hydrated by drinking 8 to 12 glasses daily.
The bowel lies close to the bladder, so anything that happens in the bowel can affect the bladder. Constipation can put pressure on the bladder and may interrupt urine flow.
Take Care of the Tube and Bag
Ensure that urine flow is not interrupted by ensuring there’s no kinks or bends in the tube. More importantly, keep the tube intact; a catheter with a hole, no matter how little, can be an entryway for infection-causing organisms. As for the bag, make sure that it’s lower than your bladder. This prevents the urine from flowing backwards.
Continue with Your Physical Activities
Having a catheter should not stop you from performing your regular activities. Your doctor will talk to you about when you can resume travelling, swimming, exercising, or having sex.
Normally, sexual activities will not be a problem for intermittent and suprapubic catheters. People with an indwelling catheter may need more time to adjust. In case it’s hard for you to have sex while wearing a catheter, the doctor will teach you how to remove and replace the tube.
Our Homage Nurses can help with catheter insertion and care, as well as the changing, emptying and cleaning of urine collection bags, all in the comfort of your home.
- David D. Cravens|Steven Zweig. (2000, January 15). Urinary catheter management. AAFP American Academy of Family Physicians. Retrieved December 6, 2020, from https://www.aafp.org/afp/2000/0115/p369.html
- Indication of catheterization for intermittent catheters (IC). (n.d.). UroToday – The Global Online Community of Urologists. Retrieved December 6, 2020, from https://www.urotoday.com/urinary-catheters-home/intermittent-catheters/description/indications-intermittent-catheters.html
- Lachance, C. C., & Grobelna, A. (14, May). Management of patients with long-term indwelling urinary catheters: A review of guidelines – NCBI bookshelf. National Center for Biotechnology Information. Retrieved December 6, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK545495/
- Types of urinary catheters – NHS. (2017, October 23). nhs.uk. Retrieved December 6, 2020, from https://www.nhs.uk/conditions/urinary-catheters/types/
- Urinary catheters: History, current status, adverse events and research agenda. (17, November). PubMed Central (PMC). Retrieved December 6, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4673556/