Urethral catheterization is a medical procedure involving the insertion of a flexible tube, known as a catheter, into the bladder through the urethra. This facilitates the drainage and collection of urine, or allows for the introduction of fluids for diagnostic or treatment purposes. It is a common intervention used to manage various urinary issues.
Understanding Urethral Catheterization
The urethra is the tube that carries urine from the bladder out of the body. Urethral catheterization involves guiding a catheter through this tube into the bladder. Once inside the bladder, the catheter permits urine to drain, either continuously into a collection bag or intermittently as needed. This helps manage situations where individuals cannot empty their bladder naturally, whether temporarily or long-term. The procedure is a routine medical practice performed by healthcare professionals, though self-catheterization is also possible for some individuals.
Reasons for Catheterization
Urethral catheterization serves several medical purposes. One common reason is acute urinary retention, where a person cannot empty their bladder, often due to conditions like an enlarged prostate or blood clots. It can also be employed for chronic obstruction that leads to hydronephrosis, a swelling of the kidney due to urine backup.
Catheterization is also used to monitor urine output accurately, particularly in individuals who are critically ill, or to collect uncontaminated urine samples for diagnostic tests. Furthermore, it can facilitate the delivery of medication directly into the bladder, such as during chemotherapy for bladder cancer, or for continuous bladder irrigation. It also assists in bladder management during certain surgeries, childbirth with an epidural, or for individuals with conditions affecting bladder control, such as spinal cord injury, multiple sclerosis, or neurogenic bladder.
Catheter Types and Insertion Overview
Urethral catheters come in various types. Intermittent catheters are for temporary use; they are inserted to drain the bladder and then immediately removed. These are single-use and can be made from materials like polyvinyl chloride (PVC), silicone, or rubber. Many intermittent catheters are pre-lubricated or hydrophilic-coated to reduce friction and discomfort during insertion.
Indwelling catheters, often called Foley catheters, remain in the bladder for longer periods, typically weeks or months. A small, water-filled balloon at the catheter’s tip is inflated after insertion to hold it securely in place within the bladder. These catheters are usually made of silicone or latex, with silicone being preferred for long-term use due to potential latex sensitivities.
The insertion of a urethral catheter is a sterile procedure performed by trained medical professionals. Before insertion, the perineal area is cleaned with antiseptic solution to minimize the risk of infection. A lubricating or anesthetic gel is applied to the catheter tip to ease its passage through the urethra. The catheter is gently advanced until urine begins to flow, indicating it has reached the bladder. For indwelling catheters, the balloon is then inflated with sterile water, and the catheter is gently pulled back until resistance is felt, confirming proper placement at the bladder neck.
Living with a Urethral Catheter and Potential Concerns
Living with a urethral catheter requires consistent hygiene practices to prevent complications. Daily cleaning of the area where the catheter enters the body with mild soap and water is recommended. Hands should always be washed thoroughly before and after touching the catheter or drainage bag. Drainage bags should be emptied when they are about half to three-quarters full, and leg bags are changed every 5 to 7 days, with night bags often being single-use.
Certain issues can arise. Bladder spasms, feeling like stomach cramps, are common as the bladder tries to expel the balloon holding the catheter in place. Medication can help alleviate these spasms. Leakage around the catheter, known as bypassing, can occur due to bladder spasms, constipation, or a blocked catheter.
The most common complication is a urinary tract infection (UTI), particularly with indwelling catheters. Symptoms of a UTI include pain in the lower abdomen or groin, a high temperature, chills, and confusion. Other potential concerns include blockages caused by debris or blood clots in the tubing, or even blood in the urine. It is important to ensure the drainage bag is always kept below the bladder level and that the tubing is free of kinks or twists to maintain proper flow and reduce infection risk.
Individuals with a catheter should seek medical attention if they experience:
- Symptoms of a UTI
- No urine draining despite feeling a full bladder
- New pain in the abdomen or back
- Cloudy, foul-smelling, or bloody urine
- Irritation, swelling, or tenderness at the catheter insertion site
If an indwelling catheter accidentally falls out, immediate medical advice should be sought.