Catheter problems

What is a catheter?

A catheter is a tube that is inserted into your bladder, allowing urine (wee) to drain freely. The catheter tube is attached to a drainage bag (a catheter bag), where the urine can be collected.

Catheters are usually inserted through the urethra (the narrow tube that connects your bladder to the outside).

Some people with urinary problems need catheters permanently, but more often people need them for a short time.

What are the different types of catheters?

There are several different types of catheters.

• Short-term indwelling catheter: catheter that is passed through the urethra and left in place for a short time. For example, during surgery.
• Long-term indwelling catheter: The catheter is inserted in the same way as a short-term catheter, but is used for longer. It needs to be changed regularly (usually every 4-6 weeks).
• Intermittent catheter: A catheter that is used at regular intervals to empty the bladder. After the bladder is emptied, the catheter is removed. Some people are able to do this themselves — this is called self-catheterisation.
• Suprapubic catheter: A catheter that is inserted into the bladder through a tiny hole in the abdomen. This type of catheter needs to be changed regularly (usually every 4-6 weeks).
• External catheter: A device that is placed over the penis to collect urine.

Why might I need to use a catheter?

There are many reasons why you may need to have a catheter. Some reasons include:

• bladder problems (including problems with the muscles controlling the bladder)
• problems with the nerves controlling the bladder. For example, if you have a spinal injury
• urinary retention (when you can’t pass urine even though you feel the need to)
• during labour and childbirth if an epidural has been used
• some types of bladder tests and treatments
• having certain types of surgery
• people who are very unwell in hospital

Catheter problems — what to do

There are several problems you might encounter with your catheter.

There is no urine draining — intermittent catheter

If urine is not draining after inserting an intermittent catheter, try coughing to help start the flow of urine.

Check you have inserted the catheter correctly into the urethra.

Blocked catheter

If you have an indwelling catheter, check there are no kinks in the drainage bag tubing or that the leg bag straps aren’t blocking the flow. Make sure the bag is below your bladder when you are lying, sitting or standing.

If you still can’t get the urine to flow, see your doctor. The catheter may have to be flushed or replaced. Use clean towels or pads to keep yourself dry while you wait to see a healthcare professional.

If you have a full bladder or are in discomfort, you will need to go to a hospital emergency department for treatment.

Catheter leakage

Sometimes urine can bypass the catheter and leak out. This can happen if the catheter is not placed properly. It can also be caused by:

• constipation
• bladder muscle spasms (sudden, involuntary contractions of the bladder muscle)
• a blocked catheter

Seek advice from your doctor or continence advisor if you have catheter leakage.

Catheter has fallen out

If you have an indwelling urinary catheter and it falls out, call your doctor or nurse immediately or go to a hospital emergency department for treatment.

Infection

Symptoms that may mean you have a urinary tract infection (UTI) include:

• cloudy or strong-smelling urine
• a burning feeling around the catheter, or itching or soreness
• blood in your urine
• abdominal (stomach) pain

You may also feel unwell, have a fever or have discomfort in your lower back or around your sides.

See your doctor straight away if you suspect you have a urinary tract infection (UTI). If you have an infection, you may need antibiotics. It’s also usually a good idea to drink more water, to flush the bacteria away.

When should I see my doctor?

Always see your doctor if you notice any blood in the urine or have symptoms of a urinary tract infection.

You should see your doctor or continence advisor if your catheter keeps getting blocked or if you have any pain due to your catheter.

General catheter care

• Keep the area where the catheter is inserted clean. You should wash it gently using mild soap. Rinse well and dry thoroughly afterwards.
• Wash your hands before and after touching the area where the catheter is inserted.
• Avoid the use of talcum powder.
• Try to avoid constipation.
• Drink plenty of water as it will help to flush bacteria from your bladder and urinary tract, unless you have a medical condition which means this is not possible.