Care for an Indwelling Urinary Catheter

A urinary catheter is a flexible plastic tube used to drain urine from your bladder when you cannot urinate by yourself. A doctor will place the catheter into the bladder by inserting it through the urethra, 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. Indwelling urinary catheters can be used in both men and women.

A catheter may be needed because of certain medical conditions, such as an enlarged prostate, the inability to control the release of urine, or after surgery on the pelvis or urinary tract. Urinary catheters are also used when the lower part of the body is paralyzed.

Catheter care

Always wash your hands before and after handling your catheter. Follow all of the instructions your doctor has given you. 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 your bladder.
• Make sure that the urine collection bag does not drag and pull on the catheter.
• Unless you have been told not to, it is okay to shower with your catheter and urine collection bag in place.
• 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 using 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.
• Do not have sexual intercourse while wearing a catheter.
• At night you may wish to hang the urine collection bag on the side of your bed.

To empty the urine collection bag

You will need to empty the bag regularly, whenever it is half full, and at bedtime. If your doctor has instructed you to measure the amount of urine, do so 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 wish 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 your doctor has given you instructions about when to notify him or her, be sure to follow those instructions. Call your doctor if:

• No urine or very little urine is flowing into the collection bag for 4 or more hours.
• No urine or very little urine is flowing into the collection bag and you feel like your bladder is full.
• You have new pain in your abdomen, pelvis, legs, or back.
• Your urine has changed color, is very cloudy, looks bloody, or has large blood clots in it.
• The insertion site becomes very irritated, swollen, red, or tender, or you have pus draining from the catheter insertion site.
• Your urine has a foul odor.
• Urine is leaking from the insertion site.
• You have a fever of 100°F (37.8°C) or higher, or you have back or flank pain.
• You develop nausea, vomiting, or shaking chills.

After catheter removal

After your catheter is taken out:

• You may have trouble urinating. If this happens, try sitting in a few inches of warm water (sitz bath). This may help you relax. If you feel the urge, it may be easier to urinate while you are still in the bath.
• You may have some burning the first few times you urinate. If the burning lasts longer, it may be a sign of an infection.
• Drink plenty of fluids, enough so that your urine is light yellow or clear like water. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.
• Wear loose cotton underwear if you have irritation or a rash from your catheter.

Also, it is important to know when you are having a problem and when to call your doctor. After catheter removal, call your doctor if:

• You do not urinate within 8 hours after the catheter is taken out.
• You have a feeling of fullness or pain in your bladder or belly.
• You have signs of a urinary infection. For example:
  • You have blood or pus in your urine.
  • You have pain in your back just below your rib cage. This is called flank pain.
  • You have a fever, chills, or body aches.
  • It hurts to urinate.
  • You have groin or belly pain.

Credits

By	Healthwise Staff
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	J. Curtis Nickel, MD, FRCSC - Urology
Last Revised	March 5, 2012