Indwelling Catheter Care

What is an indwelling catheter?

An indwelling urinary catheter is a tube that drains urine from the bladder into a bag. The tube is placed into the urethra (the part of the body that drains the bladder) and up into the bladder.

An indwelling catheter is used when you can't urinate normally. This may happen with some medical conditions such as prostate enlargement or after surgery on the pelvis or urinary tract. In these cases catheters are usually needed for only a few days or weeks, depending on your situation. Another reason you might need a catheter is incontinence, which means you can't control your urine. If contact with uncontrolled urine has caused breakdown in the skin, use of a catheter can help prevent more irritation or injury.

How do I care for am indwelling catheter?

When you have an indwelling catheter, you or someone caring for you needs to:

Make sure urine is flowing into the catheter.
Check for signs of skin irritation or infection.
Make sure that the urine collection bag is always below the level of the bladder.

The steps for good catheter care are:

Each time the bag is emptied, record the amount of urine in the bag. This is especially important if more than one person is responsible for the care of the catheter.
Check the tubing to make sure it is in good condition and does not have any kinks.
Make sure the bag is being kept below the level of the bladder whether you are sitting, lying, or walking. This will help prevent infection. After urine passes through the catheter into the collection bag, it can become infected. The bag must be lower than the bladder so the urine can't flow back into the bladder and infect the urinary tract.
If the bag is attached to the thigh, check that the straps are not too tight or irritating.
Inspect the area where the catheter goes into the body (the urethra) to look for redness, raw areas, swelling, cracks in the skin, or drainage.
Gently clean all around the area where the catheter enters the body. Also clean the top several inches of the catheter. Use the antibacterial soap or solution recommended by your health care provider.
If you notice any of the following problems, report them to the health care provider according to the instructions you were given:
- Too little urine is being collected. Normally adults make 1 to 2 quarts (or liters) of clear, yellow urine each day.
- The catheter does not seem to be working right.
- You see signs of irritation or infection of the skin.
- Urine is leaking around the catheter or the catheter is accidentally pulled out.

If the amount of urine draining into the bag is less than normal, there are several possible reasons, including:

You are drinking less fluid.
Your drainage system is blocked.
You are not correctly measuring the amount of urine collected in the bag.
Your kidneys are not functioning properly.

What are the complications of indwelling catheters?

The area where the catheter enters the body may become irritated and raw. It may become infected. In women the tube enters the urethra near the opening of the vagina. The opening of the urethra and the skin around the vagina can become red and raw from the rubbing of the tube. In men the end of the penis can become red, swollen, and sore from the catheter. If a man is uncircumcised, the foreskin can become irritated.

Indwelling catheters can cause urinary tract infections. If you have a catheter and you develop 2 or more of the following symptoms, you should see your health care provider because you may have a urinary tract infection:

fever
shaking chills
sweats
lower abdominal pain
back pain
pain around the urethra
cloudy, bad-smelling urine.

Catheters may injure the urethra. For example, the urethra could be injured from tugging on the catheter tubing or bag. You may see a very small amount of blood making the urine look red or pink in the catheter if there has been a slight injury to the urethra. If this goes away quickly and there are no other symptoms, it is usually safe just to watch to make sure it doesn't happen again. However, if there continues to be blood in the urine inside the tubing for an hour or more, contact your health care provider.

These instructions are intended to support the instructions from your health care provider and should not be used in place of those instructions.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File URI5355F.HTM Release 9.0/2006