Catheter Nurse Q&A

At Bladder and Bowel Community, we don’t want anyone to struggle or feel lost with their catheter needs – so we put your most-asked questions to Val, our urology nurse.

The Community Asked… Our Catheter Nurse Answered!

We asked the members of our closed Facebook Group what questions they have about catheter care and Val, our experienced Urology Nurse has answered the most-asked questions. Catheter Nurse Q&A
Q:  How do I know what the right type of catheter is for me?  A:  When the nurse is assessing you for your catheter they will decide, based on your clinical information, which catheter is best for you. In terms of an indwelling catheter this will be either a latex catheter or a silicone catheter and the one selected will depend upon if you have a latex allergy or not. Indwelling catheters come in 2 lengths
  • standard – always used for men and sometimes for women especially if in a wheelchair or a larger lady
  • short – only ever used for females
Indwelling catheters can also be short term – up to 28 days and long term up to 12 weeks again the nurse will select which one is most appropriate for your needs. If you are using an intermittent catheter they will show you two or three different catheters that may be best suited to you based on your dexterity and mobility and which you find easiest and most comfortable to use. They can be made of different materials and have different coatings so you may find that one catheter is easier for you to use than another. If you are experiencing any problems talk to specialist nurse for further advice and support.
Q: I suffer with a lot of urinary tract infections with my catheter. Is there anything I can do to prevent these?  A: Is your catheter indwelling or intermittent? For indwelling:  First of all is your catheter really necessary? – could you have a trial without a catheter as this will then reduce your risk of getting infections as you will no longer have the catheter. If your catheter is needed there are a few simple steps, you can take to reduce your infection risk
  • Ensure that you clean the catheter tubing when having your daily wash/shower. Always wipe down the catheter tubing away from your body.
  • Only change your leg bags once a week and connect a new single use night bag into the bottom of the leg bag each night. In the morning disconnect the night bag, drain the urine into the toilet and throw the bag away. This is called a closed drainage system
  • Ensure your fluid intake is good to keep your catheter flowing easily and prevent blockages
  • Avoid constipation as this can affect the way the catheter drains
  • Ensure you are using all leg bag straps and fixation devices as this will reduce trauma from the catheter being pulled which could lead to infection
For Intermittent:
  • Ensure you are preparing your catheter the way instructed prior to using
  • Ensure you are washing your hands and genital area before catheterising
  • Check your technique with your nurse
  • Check with your nurse that you are catheterising the correct number of times per day based on how much urine your bladder is retaining
  • Try to relax when inserting your catheter as trauma can increase your risk of infection
  • Try an alternative product you may find that another product is more suitable for you and results in fewer infections
Speak to your specialist nurse if you have any concerns.
Q:  I’m having a suprapubic catheter fitted soon, what is the recovery time? A:  Suprapubic catheters are generally fitted under a local anaesthetic in day clinic and as such you will be able to go home after a few hours following the procedure. Some patients may have to have the procedure under general anaesthetic and may be allowed home the same day or the following day. Rest for the remainder of the day and then you will be able to carry on with your normal activities. It is advisable not to have a bath for the first 48 hrs but showering is fine. Care should be taken to avoid pulling on the catheter and should it come out contact your GP, urology nurse, or district nurses immediately. The hospital unit where you are having your catheter fitted will give you an instruction leaflet and discharge summary before you leave the hospital.
Q:  I’m having difficulty using my intermittent catheters. It’s extremely uncomfortable when removing the catheter and I experience bladder spasms. Do you have any tips on how I can alleviate the pain? A:  When you remove your catheter try to relax and not tense up, try humming a song to yourself, anything to help you relax more. Breath slowly and deeply this can also help to relax you. Different catheters have different coatings and some can dry out quicker than others which can result in some discomfort when removing the catheter – speak to a specialist nurse for advice on alternative products that you may find more comfortable.
Q:  I experience bleeding and a burning sensation after using an intermittent catheter, is this normal?  A:  Bleeding can indicate that there is some trauma to the urethra – the tube going to your bladder where you insert the catheter. This could be a result of your technique when inserting the catheter especially if you find it difficult to find the opening to your bladder or hard to insert the catheter, speak to your specialist nurse for support.  You may at times experience some bleeding when using the catheters but this should only be a small amount and should not continue or get heavier – if it does you should seek medical advice from your GP and speak to your specialist nurse. The burning sensation can be an indicator of an infection which could also be causing any bleeding – speak to your GP as you may require treatment especially if you are feeling feverish. You may find that a different catheter of a different material or coating may cause less irritation and soreness.
Q:  Is it possible to have sexual intercourse with an indwelling catheter in place?  A:  Yes, it is possible to have sex with an indwelling catheter however if you know that your catheter is to be long term and intermittent catheterisation is not an option for you then a suprapubic catheter may be a better choice. Speak to your GP for referral to a urologist to discuss this route. The most important thing is to reduce any infection risks or risk of the catheter pulling during sexual intercourse – hygiene and position.
  • For ladies with the catheter – fold the catheter up onto your abdomen and tape in place to keep it out of the way, your partner should use a condom. Try alternative positions that put less pressure on the catheter.
  • For men with the catheter – fold the catheter along the shaft of the penis and put a condom over the penis and catheter. Try alternative positions that put less pressure on the catheter.

Q:  My first supra pubic catheter change was very painful. Will it always be painful and will it get easier with each change?  A:  The first change of the catheter can be a little more painful as the tract which has been made to allow for the catheter to be inserted into the bladder has to heal from the trauma of creating the tract. There may have been some blood or debris on the catheter that had increased the discomfort on removal of the catheter. When you know your catheter is to be changed again plan to take some pain relief to allow the procedure to be more comfortable. The procedure should become less painful.
Q:  If you use an intermittent catheter, how often should you be self-catheterising throughout the day?  A:  The specialist nurse who instructed you on how to catheterise should have given advice on how often you should be catheterising. The frequency is determined by how your bladder is functioning – if your bladder is not emptying at all then you will have to catheterise as if you were going to the toilet normally. This could be between 4 – 7 times per day depending upon the volume and type of fluids you have had to drink. If you are concerned, keep a record of the volumes of urine you void and the volume of urine you drain with the catheter and discuss with your specialist nurse.
Q:  I have been using intermittent catheters for over 21 years but recently i find the catheter feels like it’s catching when I remove it. How do I get around this issue? A:  When you remove your catheter try to relax and not tense up, try humming a song to yourself, anything to help you relax more. Breath slowly and deeply this can also help to relax you. Different catheters have different coatings and some can dry out quicker than others which can result in some discomfort when removing the catheter – speak to a specialist nurse for advice on alternative products that you may find more comfortable. The catching sensation can also be a result of tissue of the urethra being sucked into the catheters eyelets as you remove the catheter. Different makes of catheters have different shaped eyelets which help to reduce this from happening. Some ladies find that folding the catheter over before they remove it helps. Q:  What’s the longest amount of time you can have an indwelling catheter in for? A:  The longest period a catheter should stay in is 12 weeks or according to the manufacturer’s advice. This is dependent upon the catheter material or coating. A big thank you to all who sent in their questions about catheter care, we hope that you have found this information useful.