Indwelling Catheters

A catheter is a hollow tube that is used to drain urine from the bladder. An indwelling catheter stays in place for long periods of time. There are two kinds of indwelling catheters: urethral and supra pubic. A urethral catheter is inserted into the bladder through the urethra. A supra pubic catheter is inserted into the bladder through a hole in the abdomen, a few inches below the tummy button. ( Incontact has a factsheet on suprapubic catheters - contact us for your copy).

• Why might I need an indwelling catheter?

You might need to have an indwelling catheter temporarily, after an operation, for example. Or you, together with your healthcare professional, might decide that this is the best method to deal with your bladder problem, in which case you may require it for a longer period or perhaps even for the rest of your life

• How is an indwelling catheter inserted? Will I need an operation?

Your healthcare professional will insert either a urethral catheter for you. It is inserted without the need for an operation. It is inserted into your bladder through your urethra which is a little opening above the vagina in women and through the penis in men. It is not usually a painful procedure but can be a little uncomfortable - a local anaesthetic gel is generally used. Once inserted, indwelling catheters are held in place by inflating a small balloon at the tip of the catheter in the bladder with air or a saline solution using a syringe, so it can't fall out of the bladder.

• How often does a catheter need changing?

Indwelling catheters will need changing on a regular basis (around 4-12 week intervals). Your healthcare professional can change the catheter in your home, or in their surgery or urology department. You, or a member of your family, may also be taught how to change it at home. You must not try to remove your catheter without medical advice.

• What happens to the urine?

There are two choices when it comes to draining the urine from your bladder. You can use a catheter valve or a drainage bag. If you use a valve, urine will be stored in your bladder and you can empty it through the catheter straight into a toilet. The other option is to allow the urine to flow freely, through the catheter and into a drainage bag which can be secured to your leg or kept on a stand by your bed. Your health professional will advise you on the best method that will suit you.

When the urine flows straight through the catheter into a drainage bag, your bladder will shrink as it gets used to not storing as much urine. So, your continence advisor might recommend that you clamp the catheter for some time during the day. This will help to keep a level of urine in your bladder and prevent shrinkage.

• What do I do with the drainage bag?

There are two kinds of bags: a leg bag and a bag used while you are in bed. A leg bag is worn under your normal clothes during the day - it is held in place by straps or a 'holster'. There are different makes of leg bags available - Incontact has a factsheet on the different types (see below for contact details). A night drainage bag is much larger and is attached to the leg bag to hold all the urine that drains from the bladder overnight. It is a good idea to place a basin under the night drainage bag in case of leakage.

• Will I still be able to have sex?

Yes. An indwelling catheter can be taped out of the way during sex. Discuss how to do this with your health professional.

• What kind of problems should I watch out for?

Here are some of the problems to watch for:

• The catheter falls out
• Urine is not draining out of the catheter
• You are still wet even though your catheter is still draining urine into the drainage bag
• You have pain in your bladder area
• You have a temperature and generally feel unwell

If you notice something unusual, contact your doctor or continence advisor.

• Does having a catheter increase the risk of bladder infection?

Catheters for men are longer than catheters for women. Because of the location and shorter length of the catheter, women with a urethral catheter are generally more susceptible to urinary tract infections (UTIs) as bacteria from the anus can be passed easily up the urethra with the insertion of the catheter. But, men and people with supra pubic catheters are still at risk of UTIs.

It is therefore important to drink 1 and a half to 2 litres of fluids daily (unless advised differently by health professionals) as this can help prevent UTIs. You might also find it beneficial to drink cranberry juice. Cranberry juice lines the bladder and makes it harder for bacteria to thrive. Please note that people with diabetes, interstitial cystitis and those taking Warfarin (blood thinning medication) should consult their doctor before drinking cranberry juice.

"Having an indwelling catheter and wearing a leg bag was very unusual at first, but I quickly got used to it. I find it offers the best solution for my problem."

Incontact, SATRA Innovation Park, Kettering, Northants, NN16 9JH.

Tel: 0870 770 3246

Website: www.incontact.org

Email: info@incontact.org