Indwelling catheters can be used short-term or long-term.
Short-term: these are frequently inserted after an operation or if you are unable to pass urine due to obstruction. They may also be used to introduce therapeutic drugs or to record bladder pressures.
Long-term: These are only considered as a last resort. They are used to manage intractable urinary incontinence, where a chronic debilitating illness restricts ability to use the toilet or commode, in some cases where there is neurological disease or spinal cord injury or you are unfit to undergo an operation. Long term catheters can be urethral or suprapubic (inserted via the abdomen into the bladder).
You might need to have an indwelling catheter temporarily, after an operation, for example. However, generally an indwelling catheter generally stays in place for long periods of time. Sometimes people with significant bladder problems opt for an indwelling catheter after discussion with their healthcare professional agreeing that it is the best way to manage the problem, in which case you may have an indwelling catheter for a longer period of time / the rest of your life.
How is an indwelling catheter inserted? Will I need an operation?
Your healthcare professional will insert 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 to minimise any discomfort. Once inserted, indwelling catheters are held in place by inflating a small balloon at the tip of the catheter in the bladder with sterile water, either already in a pre-filled chamber within the catheter or by using a syringe, so it can’t fall out of the bladder.
If your indwelling catheter is going to be long term, then you may be considered for a suprapubic catheter. A suprapubic catheter is performed as a minor surgical procedure under a local anaesthetic or light general anaesthetic and involves making a small incision in the abdomen and passing a tube into the bladder. This type of catheter acts the same as a urethral indwelling catheter but is considered more comfortable once healed and more suitable for those who are sexually active. It may also be an easier to manage option for those with a spinal injury.
How often does a catheter need changing?
Indwelling catheters will need changing on a regular basis (around 4-12 week intervals depending on the type of catheter inserted). 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 indwelling catheter. You can use a catheter valve or a drainage bag.
A drainage bag connects to the catheter into which the urine can flow freely and collect Drainage bags come in a variety of sizes and can be worn either around your leg or around your waist (for suprapubic catheters).
Legs bags – these are held in place with either straps or a special holster and can hold up to around 500-700mls so will need to be emptied regularly. The bags have a tap attachment which makes emptying easier.
Waist bags – these are for use with a suprapubic catheter and are attached by using a belt. The urine flows into the bag the same way as a leg bag and can be emptied in the same way. It can be useful to wear a loose top to gain easier access to the drainage bag.
Night bags – these are larger capacity bags that can hold around 2 litres and I usually attached to a stand to allow urine to drain during the night. These bags are usually disposed of each morning and replaced each night to keep conditions sterile.
A catheter valve is a more discreet alternative to a drainage bag. The valve is connected to the end of the catheter and the will need to be released at regular times as the urine will be stored in the bladder. A catheter valve can be a good option to keep your bladder in regular working order but you will need to have the dexterity in your hands to open the valve and the option to regularly empty to avoid damaging your bladder or kidneys.
Contact the Bladder and Bowel Home Delivery Service for further information on indwelling catheters and to sign up to our discreet friendly service. Call the team on 0800 031 5406.
Read about the Bladder and Bowel Home Delivery Service Membership Benefits https://www.bladderandbowel.org/homedelivery/
If you need support or have questions/concerns about bladder or bowel conditions, call the Medical Helpline and speak to our expertly trained continence nurses on 0800 031 5412.