Care for an Indwelling Urinary Catheter

Overview

A urinary catheter is a flexible plastic tube that's used to drain urine from the bladder when a person can't urinate. The catheter is placed 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 used to keep the catheter in place. The catheter lets urine drain from the bladder into a collection bag. Urinary catheters can be used in both men and women. A catheter that stays in place for a longer period of time is called an indwelling catheter.

A catheter may be needed because of certain medical conditions. These include an enlarged prostate or problems controlling 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.

When helping someone with a catheter, try to be relaxed. Caring for a catheter can be embarrassing for both of you. If you are calm and don't seem embarrassed, the person may feel more comfortable.

Catheter care

Wear disposable gloves when handling someone's catheter. Make sure to follow all of the instructions the doctor has given. And always wash your hands before and after you're done.

Here are some other things to remember when caring for someone's catheter:

• Make sure that urine is running out of the catheter into the urine collection bag. And make sure that the catheter tubing does not get twisted or bent.
• Keep the urine collection bag below the level of the bladder. At night it may be helpful to hang the bag on the side of the bed.
• Make sure that the urine collection bag does not drag and pull on the catheter.
• It's okay to shower with a catheter and urine collection bag in place, unless the doctor says not to.
• Check for swelling or signs of infection in the area around the catheter. Signs of infection include pus and irritated, swollen, red, or tender skin.
• Clean the area around the catheter daily with soap and 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.
• Sexual intercourse may still be possible for people who wear a catheter. It's best to talk with a doctor about options.

Emptying the catheter bag

The urine collection bag needs to be emptied regularly. It's 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.

When you are ready to empty the bag, follow these steps:

1. Put on disposable gloves.
2. Remove the drain spout from its sleeve at the bottom of the collection bag. Open the valve on the spout.
3. 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.
4. After you empty the bag, close the valve and put the drain spout back into its sleeve.
5. Remove your gloves, and throw them away.
6. Wash your hands with soap and water.

After the catheter is removed

After your indwelling urinary catheter is removed, there are things you can do to take care of yourself.

• 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 some irritation or a rash, wearing loose cotton underwear may help.

Be sure to contact your doctor if you notice any problems or if you are unable to urinate at all.

When to call for help

Call your doctor now or seek immediate medical care if:

• You have symptoms of a urinary infection. These may include:
  • Pain or burning in your lower belly or urethra.
  • A frequent need to urinate without being able to pass much urine.
  • Pain in the flank, which is just below the rib cage and above the waist on either side of the back.
  • Blood in your urine or cloudy urine.
  • A fever.
• Your urine smells bad.
• You see large blood clots in your urine.
• No urine or very little urine is flowing into the bag for 4 or more hours.

Watch closely for changes in your health, and be sure to contact your doctor if:

• The area around the catheter becomes irritated, swollen, red, or tender, or there is pus draining from it.
• Urine is leaking from the place where the catheter enters your body.