Urinary catheters are sometimes recommended as a way to manage urinary incontinence and urinary retention in both men and women. Catheters may also be used to drain the bladder.

Your health care provider may recommend a catheter for short-term or long-term use. Long-term use catheters are called indwelling catheters.
Catheters come in a large variety of sizes, materials (latex, silicone), and types (Foley's catheter, straight catheter, coude tip catheter). For example, a Foley's catheter is a soft plastic or rubber tube that is inserted into the bladder to drain the urine.

Experts recommend that the smallest possible catheter be used. Some people may need larger catheters to control urine leakage around the catheter or if the urine is thick and bloody or contains large amounts of sediment.

LONG-TERM (INDWELLING) URETHRAL CATHETERS

A catheter that is left in place for a period of time may be attached to a drainage bag to collect the urine. There are two types of drainage bags.

One type is a leg bag. It is a smaller drainage device that attaches by elastic bands to the leg. A leg bag is usually worn during the day, because it fits discreetly under pants or skirts. It is easily emptied into the toilet.

The other type of drainage bag is a larger drainage device (down drain). It may be used during the night. This device is usually hung on the bed or placed on the floor.

HOW TO CARE FOR YOUR CATHETER

If the catheter is clogged, painful, or infected it may need to be replaced immediately.

To care for the indwelling catheter, cleanse the urethral area (where the catheter exits the body) and the catheter itself with soap and water every day. Also thoroughly cleanse the area after all bowel movements to prevent infection. Experts no longer recommend using antimicrobial ointments around the catheter, because they have not been shown to actually reduce infections.

Increase your fluid intake to reduce the risk of developing complications (unless you have a medical condition that prohibits large amounts of fluid intake). Discuss this issue with your health care provider.

The drainage bag must always stay lower than the bladder to prevent urine from flowing back up into the bladder. Empty the drainage device at least every 8 hours, or when it is full.

Take care to keep the outlet valve from becoming infected. Wash your hands before and after handling the drainage device. Do not allow the outlet valve to touch anything. If the outlet becomes obviously dirty, clean it with soap and water.

HOW TO CLEAN YOUR DRAINAGE BAG

Some experts recommend cleaning the drainage bag periodically. Remove the drainage bag from the catheter (attach the catheter to a second drainage device during the cleaning).

Cleanse and deodorize the drainage bag by filling the bag with two parts vinegar and three parts water. You can substitute chlorine bleach for the vinegar and water mixture. Let this solution soak for 20 minutes. Hang the bag with the outlet valve open to drain and dry the bag.

WHAT TO DO FOR A LEAKING CATHETER

Some people have occasional leakage of urine around the catheter. This may be caused by a catheter that is too small, improper balloon size, or bladder spasms.

If bladder spasms occur, check to see that the catheter is draining properly. If there is no urine in the drainage bag, the catheter may be blocked by blood or thick sediment. Or, there may be a kink in the catheter or drainage tubing.

If you have been instructed on an irrigation (flushing the catheter) procedure, try to irrigate the catheter and see if this helps. If you have not been instructed on irrigation and urine is not flowing into your collection device, contact your health care provider immediately.
Other causes of urine leakage around the catheter include:

• Constipation or impacted stool
• Urinary tract infections

POTENTIAL COMPLICATIONS

Contact your health care provider if you develop any of the following:

• Bleeding into or around the catheter
• Catheter draining little or no urine despite enough fluid intake
• Fever, chills
• Leakage of large amounts of urine around the catheter
• Urine with a strong smell or becomes thick or cloudy
• Urethral swelling around the catheter

SHORT-TERM (INTERMITTENT) CATHETERS

Some people may only need catheterization on an occasional basis. These people can be taught to catheterize themselves to drain the bladder when needed. They don't have to constantly wear an external device.

People who may benefit from intermittent catheterization include:

• Anyone who is unable to properly empty the bladder
• Men with large prostates
• People with nervous system (neurological) disorders
• Women after certain gynecological surgeries

The process is similar to the procedures described above. However, the balloon inflation is not performed, and the catheter is removed after the flow of urine has stopped.