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Urinary catheters
Definition
A urinary catheter is a tube placed in the body to drain and collect urine from the bladder.
Alternative Names
Catheter - urine; Foley catheter; Indwelling catheter; Suprapubic catheters
Information
Urinary catheters are used to drain the bladder. Your health care provider may recommend that you use a catheter if you have:
- Urinary incontinence (leaking urine or being unable to control when you urinate)
- Urinary retention (being unable to empty your bladder when you need to)
- Surgery on the prostate or genitals
- Other medical conditions such as multiple sclerosis, spinal cord injury, or dementia
Catheters come in many sizes, materials (latex, silicone, Teflon), and types (Foley, straight, coude tip). A Foley catheter, for example, is a soft, plastic or rubber tube that is inserted into the bladder to drain the urine.
Usually your health care provider will use the smallest possible catheter.
There are three main types of catheters:
- Indwelling catheter
- Condom catheter
- Intermittent (short-term) catheter
INDWELLING URETHRAL CATHETERS
An indwelling urinary catheter is one that is left in the bladder. You may use an indwelling catheter for a short time, or a long time.
An indwelling catheter collects urine by attaching to a drainage bag. A newer type of catheter has a valve that can be opened to allow urine to flow out.
An indwelling catheter may be inserted into the bladder in two ways:
- Most often, the catheter is inserted through the urethra. This is the tube that carries urine from the bladder to the outside of the body.
- Sometimes, the health care provider will insert a catheter into your bladder through a small hole in your belly. This is done at a hospital or health care provider's office.
An indwelling catheter has a small balloon inflated on the end of it. This prevents the catheter from sliding out of your body. When the catheter needs to be removed, the balloon is deflated.
CONDOM CATHETERS
Condom catheters are most often used in elderly men with dementia. There is no tube placed inside the penis. Instead, a condom-like device is placed over the penis. A tube leads from this device to a drainage bag. The condom catheter must be changed every day.
INTERMITTENT (SHORT-TERM) CATHETERS
You would use an intermittent catheter when you only need to use a catheter sometimes. You remove these catheters after the flow of urine has stopped.
DRAINAGE BAGS
A catheter is usually attached to a drainage bag. There are two types of bags:
A leg bag is a small device that attaches by elastic bands to the leg. It holds about 300 to 500 milliliters (ml) of urine. You wear it during the day, because you can hide it under pants or a skirt. You can easily empty it into the toilet.
You can use a larger drainage device during the night. It holds 1 to 2 liters of urine. You hang the device on your bed or place it on the floor.
Keep the drainage bag lower than your bladder so that urine does not flow back up into your bladder. Empty the drainage device at least every 8 hours, or when it is full.
To clean the drainage bag, remove it from the catheter. Attach a new drainage device to the catheter while you clean the old one.
Clean and deodorize the drainage bag by filling it with a mixture of vinegar and water. Or, you can use chlorine bleach instead. Let the bag soak for 20 minutes. Hang it with the outlet valve open to drain and dry.
HOW TO CARE FOR A CATHETER
To care for an indwelling catheter, clean the area where the catheter exits your body and the catheter itself with soap and water every day. Also clean the area after every bowel movement to prevent infection.
If you have a suprapubic catheter, clean the opening in your belly and the tube with soap and water every day. Then cover it with dry gauze.
Drink plenty of fluids to help prevent infections. Ask your health care provider how much you should drink.
Wash your hands before and after handling the drainage device. Do not allow the outlet valve to touch anything. If the outlet gets dirty, clean it with soap and water.
Sometimes urine can leak around the catheter. This may be caused by:
- Catheter that is blocked or that has a kink in it
- Catheter that is too small
- Bladder spasms
- Constipation
- The wrong balloon size
- Urinary tract infections
POSSIBLE COMPLICATIONS
Complications of catheter use include:
- Allergy or sensitivity to latex
- Bladder stones
- Blood infections (septicemia)
- Blood in the urine (hematuria)
- Kidney damage (usually only with long-term, indwelling catheter use)
- Urethral injury
- Urinary tract or kidney infections
Call your health care provider if you have:
- Bladder spasms that do not go away
- Bleeding into or around the catheter
- Fever or chills
- Large amounts of urine leaking around the catheter
- Skin sores around a suprapubic catheter
- Stones or sediment in the urinary catheter or drainage bag
- Swelling of the urethra around the catheter
- Urine with a strong smell, or that is thick or cloudy
- Very little or no urine draining from the catheter and you are drinking enough fluids
If the catheter becomes clogged, painful, or infected it will need to be replaced immediately.
References
Moy ML, Wein AJ. Additional therapies for storage and emptying failure. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Sauders Elsevier; 2007:chap 70.
Wierbicky J, Nesathurai S. Spinal cord injury (thoracic). In: Frontera WR, Silver JK, Rizzo Jr TD, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 147.
Resnick NM. Incontinence. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 25.
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; and Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
