Care for an Indwelling Urinary Catheter

Topic Overview

A urinary catheter is a flexible plastic tube used to drain urine from the bladder when a person cannot urinate. A doctor will place the catheter into the bladder by inserting it through the urethra. The urethra is the opening that carries urine from the bladder to the outside of the body.

When the catheter is in the bladder, a small balloon is inflated to keep the catheter in place. The catheter allows urine to drain from the bladder into a bag that is usually attached to the thigh. Urinary catheters can be used in both men and women. An indwelling catheter is one that stays in for a longer period of time.

A catheter may be needed because of certain medical conditions. These include an enlarged prostate or problems controlling the release of urine. It may be used after surgery on the pelvis or urinary tract. Urinary catheters are also used when the lower part of the body is paralyzed.

If you are helping a loved one with a catheter, try to be as relaxed as possible. Caring for a catheter can be embarrassing for both of you. This may be especially true if you are caring for someone of the opposite sex. If you are not embarrassed or upset, the person may feel more comfortable.

Catheter care

Always wash your hands before and after handling a catheter. Follow all of the instructions the doctor has given. Also:

• Make sure that urine is flowing out of the catheter into the urine collection bag. Make sure that the catheter tubing does not get twisted or kinked.
• Keep the urine collection bag below the level of the bladder.
• Make sure that the urine collection bag does not drag and pull on the catheter.
• It is okay to shower with a catheter and urine collection bag in place, unless the doctor says not to.
• Check for inflammation or signs of infection in the area around the catheter. Signs of infection include pus or irritated, swollen, red, or tender skin.
• Clean the area around the catheter twice a day with water. Dry with a clean towel afterward.
• Do not apply powder or lotion to the skin around the catheter.
• Do not tug or pull on the catheter.
• Talk with your doctor about your options for sexual intercourse while wearing a catheter.
• At night it may be helpful to hang the urine collection bag on the side of the bed.

To empty the urine collection bag

You will need to empty the bag regularly. It is best to empty the bag when it's about half full or at bedtime. If the doctor has asked you to measure the amount of urine, do that before you empty the urine into the toilet.

• Wash your hands with soap and water. If you are emptying another person's collection bag, you may choose to wear disposable gloves.
• Remove the drain spout from its sleeve at the bottom of the collection bag. Open the valve on the spout.
• Let the urine flow out of the bag and into the toilet or a container. Do not let the tubing or drain spout touch anything.
• After you empty the bag, wipe off any liquid on the end of the drain spout. Close the valve and put the drain spout back into its sleeve at the bottom of the collection bag.
• Wash your hands with soap and water.

When to call a doctor

If the doctor has given instructions about when to call him or her, be sure to follow those instructions. Call the doctor if:

• No urine or very little urine is flowing into the collection bag for 4 hours or more.
• There is new pain in the belly or pelvic area.
• The urine has changed color, is very cloudy, looks bloody, has a bad smell, or has large blood clots in it.
• The place where the catheter goes into the body (the insertion site) becomes very irritated, swollen, red, or tender, or there is pus draining from the site.
• Urine is leaking from the insertion site.
• There are signs of a kidney infection, such as a fever of 100.4°F (38°C) or higher or back or flank pain.
• Symptoms such as nausea, vomiting, or shaking chills occur.

After the catheter is removed

After the catheter is taken out:

• A person may have trouble urinating. If this happens, try sitting in a few inches of warm water (sitz bath). If the urge to urinate comes during the sitz bath, it may be easier to urinate while still in the bath.
• Some burning may happen when urinating for the first few times. If the burning lasts longer, it may be a sign of an infection.
• Drink plenty of fluids. If fluids need to be limited because of kidney, heart, or liver disease, talk with the doctor before increasing the amount of fluids.
• If the catheter causes irritation or a rash, wearing loose cotton underwear may help.

Also, it is important to know when there is a problem and when to call the doctor. After catheter removal, call the doctor if:

• No urine comes out within 8 hours after the catheter is taken out.
• The bladder or belly feels full or is painful.
• You see signs of a urinary infection. Signs include:
  • Blood or pus in the urine.
  • Pain in the back just below the rib cage. This is called flank pain.
  • Fever, chills, or body aches.
  • Pain when urinating.