A urinary catheter is a thin, flexible tube inserted into the bladder, typically through the urethra, to allow for the continuous drainage of urine. This medical device manages urine flow when a woman is temporarily or chronically unable to empty her bladder voluntarily due to neurological conditions, physical obstructions, or post-surgical effects. While often used for short periods during hospitalization, a catheter may also be necessary for long-term management. The need for catheterization is determined by a physician and prevents the painful buildup of urine and potential kidney damage.
Need During Surgical Procedures
Catheters are frequently utilized during major surgery, especially procedures involving the abdomen or pelvic region, such as a hysterectomy. Keeping the bladder empty minimizes the risk of accidental injury by surgical instruments and provides the surgeon with a clearer view and more working space within the pelvic cavity.
A catheter is also employed to monitor the patient’s fluid balance with high precision. The urine output during lengthy procedures indicates kidney function and the patient’s overall hydration status.
A catheter may also be placed because general anesthesia and IV medications can temporarily impair the bladder’s ability to contract and empty itself. For surgeries lasting three hours or longer, a catheter is standard practice to manage fluid input and prevent bladder distension. The indwelling catheter is typically removed once the patient has recovered and can pass urine without difficulty.
Addressing Acute and Chronic Urinary Retention
Urinary retention occurs when the bladder cannot fully empty; this can be acute (sudden and painful) or chronic (long-term). Catheterization is the immediate and most effective treatment for both forms, relieving pressure and preventing complications like kidney damage or infection. Retention in women often stems from neurological or anatomical issues.
Neurological conditions interrupt the signals between the brain and the bladder, leading to poor muscle function and incomplete emptying. Illnesses such as multiple sclerosis, diabetes-related neuropathy, or spinal cord injury can cause this nerve damage. In these cases, the bladder muscle may not contract effectively, or the sphincter may fail to relax.
Anatomical obstructions are also a common cause, with pelvic organ prolapse being a notable example. Conditions like a cystocele (where the bladder bulges into the vagina) or a severe uterine prolapse can physically compress the urethra, blocking urine outflow. Temporary post-operative swelling or trauma can also cause acute retention requiring short-term catheter use. For women with chronic retention, long-term management often involves learning intermittent self-catheterization to regularly empty the bladder.
Specific Applications in Labor and Delivery
Catheterization is a common procedure during childbirth, primarily when pain management includes an epidural anesthetic. The epidural blocks nerve signals to the lower body, including those that control the bladder muscles and signal the need to urinate. An indwelling catheter is placed to prevent the bladder from becoming overfilled since the woman cannot feel or control it.
A full bladder during labor can physically obstruct the baby’s descent into the pelvis, potentially slowing or complicating delivery. The catheter ensures continuous drainage, keeping the birth canal clear. Catheterization is also routine practice during Cesarean sections, both before and after the surgery.
For a C-section, the catheter keeps the bladder out of the surgical field, minimizing the risk of injury during the abdominal incision. It also allows for continuous monitoring of urine output, which is important during any major surgical procedure. The catheter is generally removed once the woman is mobile and sensation has fully returned.
Types of Catheters and Duration of Use
The choice of catheter type relates directly to the duration and nature of the woman’s medical need. The most common type for short-term or continuous drainage is the indwelling catheter, often called a Foley catheter. This device is inserted through the urethra and held securely in the bladder by a small, inflated balloon, allowing it to remain in place for days or weeks.
For women with chronic retention due to nerve damage or long-term conditions, the preferred method is often intermittent catheterization. This involves the woman inserting a straight catheter multiple times a day, just long enough to empty the bladder, and then immediately removing it. This method closely mimics natural voiding and is associated with a lower risk of long-term complications.
A third option is the suprapubic catheter, which is a tube inserted directly into the bladder through a small incision in the lower abdomen, bypassing the urethra. Suprapubic catheters are used for long-term continuous drainage when the urethra is blocked, damaged, or when urethral catheterization is not practical. These devices are usually changed by a healthcare professional every four to twelve weeks.