Definition Urinary catheters are flexible tubes placed in the bladder to drain urine. Catheters may be placed through the urethra or directly through the skin of the lower abdomen.
Who is a candidate for the procedure? The most common reason for urinary catheterisation is to monitor the output of urine. This may be needed during surgery or a hospital stay for severe illness. For the long term, it is better to have people catheterise themselves when needed, if possible. Short-term urinary catheterisation has few risks or side effects.
How is the procedure performed? Catheters that are placed through the urethra have a smooth tapered tip and two outlet ports. The larger port drains the urine, and the other is for inflating the balloon that keeps the catheter from slipping out. Catheters are made of several materials, which vary in slipperiness.
The genital area is first cleansed with a sterile solution. The catheter is then lubricated and passed gently through the urethra into the bladder. Its proper placement is indicated when urine is returned to the catheter. The balloon is inflated with a small amount of fluid. The catheter is then taped or strapped into place. When the person is in bed, a large bag is used to collect the urine. If a person is walking around, bags that are smaller and easier to use are strapped to the leg.
Sometimes it is better to go directly through the skin of the lower abdomen into the bladder. This might be done when the urethra is damaged, infected, or blocked by cancer. The catheter is placed with a needle and wire through the skin, or a very small incision over the bladder is made. This might be performed under local, regional, or general anaesthesia.
The catheter is held in place with a balloon or by the shape of the catheter. The catheter is often sewn into place on the skin, as well. This kind of tube through the lower abdomen is more commonly used when people need long-term catheterisation and cannot catheterise themselves when necessary.
What happens later at home? Care should be taken to avoid pulling the catheter out accidentally. It is important to be aware of the tubes and straps. Careful cleansing of the site where the tube exits the body, either at the urethra or at the skin of the abdomen, helps to prevent infection and irritation.
What are the potential complications after the procedure? Catheterisation for less than 3 to 4 days rarely causes problems. If a catheter is left in longer than a week, bacteria are likely to grow in the bladder. In these cases, antibiotics may be given when the catheter is removed to help clear the infection.
Catheterisation for years may result in skin erosions where the catheter exits. Chronic inflammatory changes in the bladder, which rarely can induce a form of cancer, and chronic urinary tract infections are also possible.
Author: Stuart Wolf, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 12/06/2005 Contributors Potential conflict of interest information for reviewers available on request
