A catheter drainage bag is a collection device that attaches to an indwelling urinary catheter, a flexible tube placed into the bladder to drain urine. The primary goal of managing this system is to maintain a sterile, closed pathway to prevent infection. Improper handling or infrequent emptying significantly increases the risk of Catheter-Associated Urinary Tract Infection (CAUTI). CAUTI is a common healthcare-associated infection, making diligent care of the drainage system important. Understanding the correct maintenance schedule helps reduce the chance of bacteria traveling up the tubing and into the bladder.
Understanding the Two Main Bag Types
The management of a catheter system typically involves alternating between two different types of collection bags. The smaller type is the urinary leg bag, worn discreetly on the thigh or calf during the day for greater mobility. Leg bags have a smaller capacity (500 ml to 1200 ml), requiring more frequent emptying throughout the day.
The second type is the overnight or bedside drainage bag, which is substantially larger (2000 ml to 4000 ml). This large capacity and longer extension tubing allows the user to sleep through the night without needing to empty the bag. The bag is hung on a stand or hook next to the bed, and the switch from a leg bag to a bedside bag is performed daily before sleep. The physical bags themselves are often cleaned and reused multiple times before being replaced.
Daily Routine: When and How to Empty the Bag
The contents of the drainage bag must be emptied multiple times daily to prevent problems, regardless of the bag type. A bag should never be allowed to become full, as this can put pressure on the catheter and the bladder. The most important guideline is to empty the contents when the bag is approximately half to two-thirds full.
Allowing the bag to overfill causes the weight of the urine to pull on the catheter, which can cause trauma to the urethra or bladder. A full bag also increases the risk of urine backflow, or reflux, into the tubing and potentially back into the bladder. Before emptying, wash your hands thoroughly with soap and water to minimize bacteria transfer.
To empty the bag, hold the drain spout over a clean container or the toilet, ensuring the spout does not touch any surface. Open the valve and allow the urine to drain completely, then close the valve securely. After closing the valve, the end of the drain spout should be wiped clean with an alcohol pad or a fresh tissue. The drainage bag must always be kept below the level of the bladder to ensure gravity assists the flow and prevents backflow.
Replacement and Cleaning Schedule
Drainage bags should be replaced according to manufacturer guidelines and a standard schedule, typically every five to seven days. Bags must be replaced immediately if they become damaged, discolored, stiff, brittle, or if a persistent odor remains even after cleaning.
For reusable bags, a daily cleaning protocol is necessary to maintain hygiene and reduce sediment buildup. Once emptied, the bag should be disconnected from the catheter and flushed with cool tap water, swishing the water around and draining it through the spout. The next step involves soaking the bag in a sanitizing solution to kill germs and neutralize odor.
A common homemade solution is a mixture of one part household bleach to ten parts tap water, or a solution of two parts white vinegar to three parts water. This solution should be swished around and allowed to soak for 15 to 20 minutes before being emptied. After soaking, the bag must be rinsed thoroughly with cool water to remove all traces of the cleaning solution. Finally, the bag must be hung up to air dry completely, ensuring the open spout or connector tubing does not touch any contaminating surfaces before its next use.