To “catheterize” a patient is to perform a medical procedure that involves inserting a thin, flexible tube, known as a catheter, into the body to drain fluids. This procedure is most commonly used to empty urine from the bladder when a person cannot do so independently. The catheter, a hollow tube made from materials like silicone or rubber, allows the bladder to be emptied continuously or at regular intervals under medical supervision.
Medical Reasons for Catheterization
A primary reason for urinary catheterization is a condition called urinary retention, where an individual is unable to empty their bladder completely. This may result from nerve damage affecting bladder control, such as from a stroke, or a physical blockage. Common obstructions include an enlarged prostate in men or scarring within the urethra, which can block the flow of urine.
Catheterization is also frequently used in surgical settings. A catheter allows for bladder drainage during and after an operation, as anesthesia can impair urination. It also helps manage urination for patients who are immobile after surgery. In intensive care, catheters are used to precisely measure urine output, which informs providers about a patient’s fluid balance and kidney function.
Catheterization can also deliver medication directly into the bladder for treatments like certain bladder cancers. It may be used to manage severe urinary incontinence when other treatments have failed, serving as a solution for both temporary and long-term needs.
Types of Catheterization
The most common type for continuous drainage is an indwelling catheter, also known as a Foley catheter. It is inserted into the bladder and left in place for days or weeks, held by a small, water-filled balloon that prevents it from slipping out. Urine drains through the tube into a collection bag.
Intermittent catheterization involves inserting a catheter to drain the bladder and then immediately removing it, a process repeated multiple times daily. Many individuals learn to perform this “in-and-out” procedure themselves, a technique called clean intermittent self-catheterization (CISC). This gives patients control over their bladder management without having a device continuously in place.
An external catheter is a non-invasive option for males, also known as a condom catheter. This device is a flexible sheath placed over the penis. A port at the tip connects via tubing to a drainage bag. This type is used for managing incontinence in men who do not have urinary retention or obstruction.
The Catheterization Procedure
Inserting a urinary catheter is a sterile procedure performed by a healthcare professional. The genital area is first cleaned with an antiseptic solution to reduce infection risk. A sterile, water-soluble lubricating gel, which often contains a local anesthetic, is applied to the catheter’s tip for smooth insertion and to numb the urethra.
The clinician guides the catheter through the urethral opening and into the bladder. The technique differs based on anatomy. The female urethra is short, about 1.5 to 2 inches, allowing for a direct insertion path. The male urethra is longer, around 7 to 8 inches, and follows a curve that requires careful navigation.
When urine begins to flow from the tube, it confirms the catheter has reached the bladder, and it is advanced slightly further. For an indwelling catheter, a clinician uses a syringe to inflate a small retention balloon near the tip with sterile water. This secures the catheter inside the bladder, and the outer end is connected to a drainage bag.
Living With and Caring for a Catheter
Proper hygiene is necessary to prevent infections for anyone with an indwelling catheter. This includes washing hands with soap and water before and after touching the catheter system. The skin where the catheter enters the body should also be cleaned daily with mild soap and water.
Correctly managing the drainage system is part of daily care. The collection bag must always be kept below the level of the bladder to allow gravity to assist drainage and prevent urine backflow. Ensure there are no kinks in the tubing, as this can block flow. Drainage bags should be emptied when about two-thirds full to prevent them from becoming heavy and pulling on the catheter.
Patients should be aware of potential complications and report them to a healthcare provider. These include symptoms of a urinary tract infection (UTI), such as fever, chills, or cloudy and strong-smelling urine. If no urine is draining into the bag, it could indicate a blockage that needs to be addressed immediately. Any significant pain, swelling, or leakage around the insertion site also requires medical attention.