An indwelling catheter is a flexible, hollow tube used for the continuous drainage of urine from the bladder. The term “indwelling” means the device is designed to remain in place within the body for an extended period. These devices are frequently utilized across various healthcare environments, including hospitals, long-term care facilities, and home settings. The use of an indwelling catheter allows healthcare providers to monitor fluid balance precisely and manage conditions where natural urination is compromised.
Defining Indwelling Catheters and Their Purpose
The core function of an indwelling catheter is to provide an unobstructed pathway for urine to exit the bladder and collect in an external drainage bag. This is important for patients experiencing urinary retention (the inability to fully empty the bladder) or those requiring continuous monitoring of urinary output, such as in cases of critical illness or major surgery. The device is a closed, sterile system designed to minimize the introduction of outside contaminants into the urinary tract.
The mechanism that keeps the catheter secured within the bladder is a small, fluid-filled balloon located near the tip. Once the catheter is properly positioned inside the bladder, a healthcare professional inflates this balloon with sterile water. This inflated balloon rests against the bladder wall, preventing the catheter from accidentally sliding out of the body. Indwelling catheters are typically used for short-term drainage, but they also serve patients with chronic conditions or those undergoing specific urological procedures.
Common Types and Insertion Methods
The two primary types of indwelling catheters are distinguished by their insertion route: urethral and suprapubic. The most common type is the urethral catheter, often called a Foley catheter, which is inserted through the urethra to reach the bladder. This procedure is generally straightforward and is performed using sterile techniques to prevent infection.
A suprapubic catheter, in contrast, is inserted directly into the bladder through a small incision in the lower abdomen, typically above the pubic bone. While this insertion requires a more involved procedure, it is often preferred for long-term use, following certain surgeries, or when the urethra is obstructed or damaged. Both methods require the expertise of a trained healthcare professional to ensure proper placement and minimize complications.
Essential Daily Management and Hygiene
Proper daily care is fundamental to maintaining the function of the indwelling catheter and preventing infection. The catheter tubing must always be secured to the body, often to the thigh or abdomen, to prevent accidental pulling or tugging, which can cause trauma to the urethra or bladder neck. Keeping the drainage system closed and maintaining an unobstructed flow is equally important; this means checking regularly for any kinks or bends in the tubing that could block the urine flow.
The attached drainage bag must always be kept below the level of the bladder to allow gravity to assist in continuous, one-way drainage of urine. Bags should be emptied when they are about half full, or at least twice a day, to prevent the weight from causing discomfort or pulling on the catheter. Hygiene around the insertion site is also a necessary daily practice, involving gentle washing with mild soap and water where the catheter enters the body. Careful hand washing before and after handling the catheter or drainage bag is a simple yet effective measure for reducing the risk of contamination.
Recognizing and Preventing Common Issues
The most frequent complication associated with indwelling catheters is a Catheter-Associated Urinary Tract Infection (CAUTI), which accounts for a large percentage of hospital-acquired infections. Recognizing signs of a CAUTI is important, and these may include a fever, chills, pain in the lower back or pelvis, or urine that appears cloudy or has a strong, foul odor. Discharge or drainage around the catheter insertion site can also signal an infection.
Prevention focuses on maintaining the closed drainage system and ensuring continuous urine flow. Adequate hydration is a simple preventative action, as drinking plenty of fluids helps to continuously flush the urinary drainage system. Leakage around the catheter may indicate a blockage in the tubing, such as sediment or a kink, or it may signal bladder spasms, which require clinical attention. Skin irritation at the insertion site should be managed by cleaning with soap and water, avoiding the use of powders or lotions near the area, which can trap moisture and bacteria.