An indwelling urinary catheter is a flexible, hollow tube inserted into the bladder to drain urine when a person cannot urinate independently. The tube is secured in the bladder by a small, inflated balloon and connects to an external collection bag. This system is a closed drainage system, designed to prevent bacteria from entering the urinary tract. Proper management, especially timely emptying of the collection bag, contributes to patient comfort and is a primary defense against serious complications, such as infection.
Establishing the Right Emptying Schedule
The most important rule for managing a catheter bag is to empty it based on volume, not time. The collection bag should be emptied when it is approximately half to two-thirds full. Emptying at this level prevents the bag from becoming heavy, which can cause discomfort or tension on the catheter insertion site. Preventing the bag from becoming completely full is necessary to prevent the backflow, or reflux, of urine into the catheter tubing. This backflow is a serious concern because it can reintroduce bacteria into the bladder, significantly increasing the likelihood of a urinary tract infection.
Mobile individuals typically use two types of bags: a leg bag during the day and a larger bedside bag at night. Leg bags are smaller, often holding less than a liter, and are worn discreetly beneath clothing, secured to the thigh or calf. Due to their limited capacity, these smaller bags often require emptying every two to four hours throughout the day.
The larger bedside drainage bags, sometimes called overnight bags, can hold up to two liters of urine and are used when the patient is resting. These bags are typically emptied once in the morning after waking. They must always be positioned below the level of the bladder to ensure continuous, gravity-assisted drainage and prevent backflow while sleeping.
Safe and Hygienic Emptying Procedure
Maintaining a clean environment is necessary when emptying the catheter bag to preserve the closed drainage system and reduce infection risk. The process must begin and end with thorough hand hygiene, using soap and water before and after handling the equipment. A clean container should be positioned directly beneath the drainage spout, located at the bottom of the collection bag.
Carefully open the drainage valve to allow the urine to flow into the receptacle. It is crucial to ensure that the tip of the drainage spout never touches the container or any other surface, as this contact can contaminate the spout with bacteria. The bag should be held steady with one hand while the other manages the drainage process.
Once the bag is empty, the valve must be closed securely to prevent leakage. After closing the tap, the tip of the drainage spout should be wiped with an alcohol wipe or clean tissue before being returned to its holder or sleeve. The collected urine can then be discarded into the toilet, and the receptacle should be cleaned or disposed of according to a healthcare professional’s instructions.
Warning Signs of Catheter Bag Management Issues
Physical and visual indicators can signal that the catheter drainage system is not functioning correctly. A sudden, strong urge to urinate or pain in the lower abdomen indicates the bladder is full but the catheter is not draining. This discomfort may also be caused by bladder spasms, which are painful contractions of the bladder muscle that occur when the catheter irritates the bladder wall.
If the bag is not draining, the tubing should be checked immediately for kinks, twists, or pinching that blocks urine flow. A visible backflow of urine into the catheter tubing is a clear sign that the bag is too full or has been lifted above the bladder level. This requires prompt correction to prevent infection.
Other warning signs relate to the quality of the urine itself, suggesting a possible infection or other complication. Urine that appears unusually cloudy, contains visible sediment or blood clots, or has a foul or strong odor may indicate a developing urinary tract infection. Accompanying physical symptoms, such as a fever, chills, or persistent pain in the lower back or sides, require immediate contact with a healthcare provider for evaluation.