Indwelling Catheters

Originally published on: November 21st, 2017. Last modified on May 25th, 2023

What is an Indwelling Catheter?

The indwelling catheter, designed by Dr Foley in 1937, is retained in the bladder by a balloon which can be inflated and deflated. Short-term (less than 30 days) or long-term (more than 30 days) drainage can be maintained. Still, the end of the catheter should either be connected to a catheter valve, which can be opened and closed, or to a urine collection bag to create what is termed closed drainage to reduce the risk of bacterial infection.

Indwelling Catheters: Short-term or Long-term use

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 or the rest of your life.

Short-term: these are frequently inserted after an operation or if you cannot 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 the ability to use the toilet or commode, in some cases where there is a 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).

What is an Indwelling Catheter?

The indwelling catheter, designed by Dr Foley in 1937 is retained in the bladder by a balloon which can be inflated and deflated. Short-term (less than 30 days) or long-term (more than 30 days) drainage can be maintained but the end of the catheter should either be connected to a catheter valve, which can be opened and closed, or to a urine collection bag to create what is termed closed drainage to reduce the risk of bacterial infection.

Indwelling Catheters – Short-term or Long-term use

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 or the rest of your life.

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).

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How Is An Indwelling Catheter Inserted? Will I Need An Operation?

Your healthcare professional will insert a urethral catheter for you 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.

Indwelling Catheter - Bladder & Bowel Community
Diagram of Indwelling Catheter in situ (female)

Suprapubic Catheter

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. It involves making a small incision in the abdomen and passing a tube into the bladder. This type of catheter acts the same as an indwelling urethral 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 their surgery or urology department. You, or a family member, 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 for draining urine from your indwelling catheter. You can use a catheter valve or a drainage bag.

What Is A Drainage Bag?

A drainage bag connects to the catheter into which the urine can flow freely and collect urine. Drainage bags come in various 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 like a leg bag and can be emptied similarly. 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 are usually attached to a stand to allow urine to drain during the night. These bags are disposed of each morning and replaced each night to keep conditions sterile.

Catheter Valves

A catheter valve is a more discreet alternative to a drainage bag. The valve is connected to the end of the catheter and they 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 it to avoid damaging your bladder or kidneys.

Got A Question?

Our goal at Bladder and Bowel Community is to ensure everyone feels comfortable and confident regarding their catheter needs. So we have put their most-asked questions on the table with Val, our urology nurse. 

Catheter FAQ’s

You can also contact the Bladder and Bowel Home Delivery Service for further information on indwelling catheters and to sign up for our discreet, friendly service. Call the team on 0800 031 5406.

Click here for the Bladder and Bowel Home Delivery Service Membership Benefits.