A urinary catheter is a flexible, hollow tube designed to drain urine directly from the bladder into an external collection bag or container. This medical intervention is primarily used when a woman is unable to empty her bladder voluntarily or completely, a condition known as urinary retention. Catheterization is a common and safe medical procedure used to prevent complications like infection, bladder damage, and kidney issues that arise from retained urine. The specific reason for needing a catheter dictates the type of device chosen and the duration of its use.
Temporary Use During Acute Care and Surgical Procedures
Many women require a catheter for a short period, typically when they are unconscious, immobilized, or immediately following a procedure. This necessity often arises during major surgeries, especially those involving the abdomen or pelvis, like a hysterectomy or ovarian surgery. The catheter keeps the bladder empty during the operation, which helps surgeons see the pelvic organs more clearly and minimizes the risk of accidental bladder injury.
Catheters are also routine during childbirth, particularly for women who receive an epidural anesthetic. The numbing effect of the epidural can prevent the woman from feeling the urge to urinate, leading to a full bladder that can hinder the baby’s descent through the pelvis. It is also standard procedure during a cesarean section to keep the bladder deflated, preventing interference with the surgical site and reducing injury risk.
Short-term catheterization may also be necessary outside of surgery for acute, temporary urinary retention. Causes include certain medications, severe infection, or temporary swelling or nerve irritation following a medical procedure. In these cases, the catheter is removed as soon as the patient regains the ability to empty her bladder fully, which is often within a few days or weeks.
Long-Term Management of Urinary Retention and Dysfunction
For some women, catheterization is a long-term management strategy for chronic health issues that impair bladder function. Neurological conditions frequently affect the signaling between the brain and the bladder, leading to a condition known as neurogenic bladder. Diseases like Multiple Sclerosis, spinal cord injury, or severe neuropathy from diabetes can disrupt the nerve pathways that control the bladder muscles, causing chronic retention or incontinence.
Long-term catheterization is preferred when the bladder cannot empty sufficiently or when nerve damage prevents sensing the need to urinate. This ensures residual urine does not remain, preventing recurrent urinary tract infections or potential kidney damage. In women with severe, non-manageable urinary incontinence, a catheter may also be used to keep the skin dry and prevent breakdown, especially if mobility is limited.
Many women requiring long-term bladder management use intermittent self-catheterization (ISC). This approach allows the woman to insert a catheter several times a day, empty her bladder completely, and then immediately remove the device. ISC is recommended because it closely mimics the natural cycle of bladder filling and emptying, offering greater autonomy and a lower risk of complications than permanent devices.
Different Catheter Designs and Methods of Use
The choice of catheter design depends on the reason for its use and the required duration of drainage.
Indwelling (Foley) Catheters
The most common type for continuous, passive drainage is the indwelling catheter, often called a Foley catheter. This device remains in the bladder for an extended period, held in place by a small balloon that is inflated with sterile water once the tip is correctly positioned inside the bladder.
Indwelling catheters are typically used in acute care settings, such as during surgery or for patients with prolonged immobility. They connect to a closed drainage system, such as a leg bag or a bedside bag, allowing for continuous collection of urine. These devices require periodic replacement, often every few weeks or months, and are associated with a higher risk of urinary tract infections over time.
Intermittent Catheters
For women managing chronic urinary retention, the intermittent catheter is often chosen. These are straight, single-use tubes that are inserted through the urethra only long enough to drain the bladder and are then immediately discarded. This method, known as clean intermittent self-catheterization, gives the user control over their bladder management and is designed to minimize the risk of infection by not having a foreign object permanently residing in the body.
Suprapubic Catheters
A less common, but significant, design is the suprapubic catheter, which provides an alternative route into the bladder. This indwelling catheter is surgically inserted directly into the bladder through a small incision made in the lower abdomen, bypassing the urethra entirely. A suprapubic catheter may be chosen for long-term use when the urethra is damaged, blocked, or if a woman finds urethral insertion too difficult or uncomfortable to perform consistently.