Women receive urinary catheters when medically necessary, similar to men. A urinary catheter is a flexible, hollow tube inserted into the bladder to drain and collect urine. Catheterization is necessary when a person cannot empty their bladder naturally or when precise monitoring of fluid output is required. This process prevents complications like infection or kidney damage from urine buildup.
Common Medical Reasons for Catheter Use
The necessity for catheterization generally falls into a few specific medical situations. The most common reason is acute or chronic urinary retention, which is the inability to fully empty the bladder. This retention can be caused by nerve damage, certain medications, or an obstruction in the urethra, leading to a buildup of urine.
Catheters are also frequently used in connection with surgical procedures. For example, a catheter may be placed before, during, or immediately following extensive gynecological or abdominal surgery. This serves to keep the bladder empty during the operation and allows for accurate measurement of urine output during recovery.
In critical care settings or for patients who are severely ill or bedridden, a catheter may be temporarily required to monitor fluid balance. Catheters are sometimes used to drain the bladder during childbirth, particularly if an epidural anesthetic has been administered.
Types of Urinary Catheters Used
The type of catheter used depends on the medical necessity and the anticipated duration of use. The three primary types are intermittent, indwelling, and suprapubic catheters.
Intermittent catheters are “in-and-out” devices that are inserted to drain the bladder and then immediately removed. This method is often preferred for people who can manage self-catheterization several times a day, as it carries a lower risk of infection than indwelling options. These catheters are generally shorter for women, typically around six inches in length, to accommodate the shorter female urethra.
Indwelling catheters, commonly known as Foley catheters, are designed to remain in place for longer periods. They are secured by a small, water-filled balloon inflated inside the bladder and connected to a continuous drainage bag. They are typically used post-surgery or for patients who require long-term drainage due to chronic conditions.
The third type is the suprapubic catheter, which is an indwelling tube inserted directly into the bladder through a small incision in the lower abdomen, bypassing the urethra entirely. This method is reserved for specific cases, such as when the urethra is blocked or damaged, and it is also held in place by an inflated balloon.
Understanding the Insertion and Care Process
The insertion of a urinary catheter is performed by a trained healthcare professional, ensuring a sterile technique is maintained to minimize the risk of infection. The patient is typically positioned on their back with knees bent and hips flexed, allowing for clear visualization of the urethral opening. The genital area is thoroughly cleansed with an antiseptic solution before the catheter is introduced.
A sterile, lubricating jelly is applied to the catheter tip to reduce friction and minimize discomfort during insertion. For indwelling catheters, once the tube is advanced and urine begins to flow, it is pushed a few more centimeters to ensure the balloon is fully within the bladder before inflation. Once the balloon is inflated with sterile water, the catheter is secured against the bladder neck.
Ongoing care involves meticulous hygiene and management of the drainage system to prevent complications. The catheter and the area around the urethral opening should be cleaned twice daily using mild soap and water.
It is important to secure the catheter tubing to the thigh to prevent tension or pulling, which can cause trauma to the urethra. The drainage bag must be kept below the level of the bladder to prevent urine backflow, and it should be emptied at least every eight hours or when approximately two-thirds full.
Potential Side Effects and When to Seek Help
Using a urinary catheter carries certain risks, with the most common being a catheter-associated urinary tract infection (CAUTI). Bacteria can enter the urinary system along the catheter, potentially causing infection in the urethra, bladder, or kidneys. Symptoms of a CAUTI include pain in the lower abdomen or groin, cloudy or foul-smelling urine, and a fever or chills.
Other common side effects include bladder spasms, which feel like cramping in the lower stomach as the bladder attempts to expel the foreign object. Leakage of urine around the catheter can also occur, often due to a blockage in the tubing, constipation, or intense bladder spasms. Blood or sediment in the tubing is another possibility, which may indicate a blockage or irritation.
Immediate medical attention is necessary if urine is not draining into the bag, despite adequate fluid intake, as this suggests a possible blockage. Severe pain, the passage of large blood clots or debris, or any signs of systemic infection, such as a high temperature or confusion, also warrant urgent contact with a healthcare provider.