Urinary catheters are hollow, flexible tubes used to collect urine from the bladder. Urinary catheters come in many sizes and types. Catheters can be made of rubber, silicone, or latex. The catheter tube leads to a drainage bag that holds collected urine.
Catheters are generally used when a patient is unable to empty his or her bladder. If the bladder is not emptied, urine can build up and lead to pressure in the kidneys. The pressure can result in kidney failure, which can be dangerous and may result in permanent damage to the kidneys.
Most catheters are used for a short period of time, until the patient regains the ability to urinate on his or her own. Elderly people and those with a permanent injury or severe illness may need to use urinary catheters for a much longer period of time.
A doctor may recommend the use of a catheter if you are unable to control when you urinate, if you are leaking urine (urinary incontinence), or if you are unable to empty your bladder when you need to (urinary retention).
Reasons why you may not be able to urinate on your own include:
- blocked flow of urine due to bladder stones, blood clots in the urine, or narrowing of the urethra (the tube that connects your bladder to the outside of your body)
- surgery on your prostate gland or in the genital area, such as a hip fracture repair or hysterectomy
- injury to the nerves of the bladder
- spinal cord injury
- a condition that impairs your mental function, such as dementia
- medications that impair the ability of your bladder muscles to squeeze, which causes urine to remain stuck in your bladder
There are three main types of catheters, described below.
Indwelling Catheters (Urethral or Suprapubic Catheters)
An indwelling catheter is a catheter that is left in the bladder. It may also be called a Foley catheter. This type can be used for both short and long periods of time. An indwelling catheter is usually inserted into the bladder through the urethra.
Sometimes, a doctor will insert the catheter into the bladder through a tiny hole in the abdomen. This type of indwelling catheter is called a suprapubic catheter.
A tiny balloon at the end of the catheter is inflated to prevent the tube from sliding out of the body. The balloon is deflated when the catheter needs to be removed.
External Catheters (Condom Catheters)
A condom catheter is a catheter that is placed outside the body. They are typically used for men who do not have urinary retention problems, but have serious functional or mental disabilities, such as dementia. The tube is not placed inside the penis. Instead, a device that looks like a condom is placed over the penis head. A tube leads from the condom device to a drainage bag.
These catheters are generally more comfortable and carry a lower risk of infection than indwelling catheters. Condom catheters need to be changed daily.
Short-Term (Intermittent) Catheters
A short-term catheter is recommended for short-term use when a patient needs one after surgery. It is typically removed right after the bladder is emptied.
Indwelling urinary catheters are the leading cause of healthcare-associated urinary tract infections (UTIs) (van den Broek, et. al., 2011). Therefore, it is important that catheters are routinely cleaned to prevent infections. Symptoms of a UTI may include:
- burning of the urethra or genital area
- leaking of urine out of the catheter
- blood in the urine
- foul smelling urine
- low back pain and achiness
Other complications of urinary catheter use include:
- allergic reaction to the material used in the catheter, such as latex
- bladder stones
- blood in the urine
- injury to the urethra
- kidney damage (with long-term indwelling catheters)
- infection of the urinary tract, kidney, or blood (septicemia)
Care must be taken to clean both the catheter and the area where the catheter enters the body with soap and water to reduce the risk of a UTI. In addition, you should drink plenty of water to keep your urine clear or only slightly yellow in color to help prevent infection.
The drainage bag used to collect the urine should be emptied at least every eight hours and whenever the bag is full. The drainage bag should be cleaned using a plastic squirt bottle containing a mixture of vinegar and water or bleach and water.