A Foley catheter is a flexible tube inserted through the urethra into the bladder to allow for continuous urine drainage, often necessary during surgery, acute illness, or for chronic conditions. The experience involves sensations during three distinct phases: insertion, indwelling, and removal. While rarely acutely painful when performed correctly, the procedure is virtually always accompanied by discomfort and unusual sensation. Knowing what to expect at each stage can help demystify the process and alleviate anxiety.
Sensation During Catheter Placement
The process of placing the catheter is often the most feared part, but it is generally a sensation of intense pressure rather than sharp pain. A lubricating jelly, often containing a local anesthetic like lidocaine, is used to minimize friction as the tube passes through the narrow urethral channel.
As the catheter advances, especially in male anatomy, a distinct pressure sensation may be felt as it navigates the curves of the urethra and passes the prostate. Once the catheter tip enters the bladder, a small balloon is inflated with sterile water to secure it against the bladder neck. This inflation causes a brief feeling of fullness or a mild, internal sting, which quickly subsides once the balloon is seated. If the balloon is accidentally inflated within the urethra, it causes immediate and severe pain, signaling a problem that requires prompt correction.
Day-to-Day Discomfort While Indwelling
Once the Foley catheter is correctly positioned and secured, the daily experience is marked by persistent discomfort related to the presence of a foreign body. Individuals report a constant awareness of the tube, feeling it exit at the meatus, which can cause minor irritation or a mild burning sensation at the opening. This irritation is largely mechanical, resulting from the tube resting against the sensitive urethral lining.
Movement often exacerbates this discomfort, as walking or shifting position can cause the catheter to tug or rub internally. Securement of the catheter to the leg or abdomen is particularly important. The retention balloon, situated at the base of the bladder, can rest near the trigone, a highly sensitive area that signals the urge to urinate. This can result in a continuous sense of needing to empty the bladder, even though it is draining continuously.
When Pain Signals a Problem
While some discomfort is expected, certain types of pain are abnormal and require immediate attention, as they can signal complications such as infection or blockage.
Bladder Spasms
One common abnormal issue is the occurrence of bladder spasms, which feel like sudden, intense cramping in the lower abdomen or suprapubic area. These spasms are caused by the bladder muscle attempting to contract and expel the retention balloon and may require medication to relax the muscle.
Infection or Blockage
A Catheter-Associated Urinary Tract Infection (CAUTI) is a serious complication, often presenting with symptoms beyond typical irritation. Signs of a CAUTI include fever, chills, pain in the lower back or groin, and urine that is cloudy, foul-smelling, or contains blood. Pain can also result from a blockage if the catheter is not draining properly, leading to a painful backup of urine and a full bladder sensation. Accidental traction, or pulling on the catheter, is also a cause of sudden, severe pain and can result in significant internal injury.
The Experience of Catheter Removal
Catheter removal is generally much less distressing than the initial insertion, typically causing a strange sensation rather than pain. Before withdrawal, the sterile water holding the retention balloon in place is fully drained through the inflation port. This deflation is often felt as a gentle release of internal pressure inside the bladder.
The lubricated catheter is then smoothly and quickly pulled out of the urethra. Most people feel a brief, mild pulling or tickling sensation as the tube slides out, which is over within a few seconds. Following removal, a common side effect is a temporary burning or stinging sensation upon the first few times urinating, known as dysuria. This post-removal irritation usually resolves completely within 24 to 72 hours.