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Urinary Catheters Explained

Catheters Commonly Used After Surgery

A catheter is a general term for a tube that is inserted into the body. A urinary catheter is a tube that is inserted into the bladder to drain urine. Multiple types of urinary catheters are used for a variety of conditions, and the right catheter for one person is not necessarily right for another person. A patient's condition that makes the catheter necessary often guides the decision of what type of catheter is necessary. Disposable Silicone Manual Resusitator Adult

Urinary Catheters Explained

A urinary catheter is used when the patient is unable to control their bladder because of illness, incontinence, a condition that makes urination difficult (such as a spinal cord injury), or unconsciousness.

For example, a catheter is often placed at the beginning of certain surgeries because the patient will not be conscious for the procedure. Without the catheter, the patient might urinate during the procedure and potentially contaminate the sterile field, or their bladder may become distended with urine during a long procedure.

To prevent infections, catheters are used only when necessary. In hospitalized patients, intensive care patients typically have a catheter in place for longer than a day. For other patients who have one in place, the catheter is removed as soon as they are conscious or well enough to urinate independently.

Urinary retention is an issue where the bladder fails to empty completely. Depending on the severity of the issue, a temporary catheter, called a straight catheter, may be used to drain the bladder.

The primary risk of short-term catheterization is a urinary tract infection. In addition, the urethra (the tube that carries urine out of the bladder) can become irritated. The skin surrounding the insertion site might also be injured and should be inspected regularly for signs of breakdown.

In rare cases, a urinary tract infection can lead to urosepsis, a systemic infection that can be very serious.

A catheter is placed using a sterile technique and sterile lubricant to prevent infection. Most catheters are inserted into the urethra, then gently threaded through the urethra into the bladder.

A catheter is typically very easy to remove. If there is a balloon at the tip of the catheter, the balloon is deflated, then the catheter is gently pulled to remove it from the body. The process is typically painless unless there is irritation present in the urinary tract. If the process is painful, a topical medication can be used to numb the area.

If you are caring for an indwelling catheter at home, catheter care can be performed in the shower or bath. After gently cleaning your genital area as you normally would, the catheter tube can be gently cleaned with a washcloth and mild soap. Take care not to tug or pull on the catheter, or try to push the catheter further into the body, as this can cause irritation. Be sure to rinse the soap off completely.

A catheter and the attached drainage bag should only be touched after washing your hands with soap and water, this can help prevent infection.

Urinary catheters are common in the hospital setting, but recent research and guidelines encourage hospital staff to remove catheters as quickly as is reasonably possible. This is done to prevent urinary tract infections and to decrease the risk of side effects such as difficulty urinating.  

Urinary catheters are rarely allowed to stay in place for convenience like they once were, and are typically only allowed when necessary for the patient's health.

Håkansson MÅ. Reuse versus single-use catheters for intermittent catheterization: what is safe and preferred? Review of current status. Spinal Cord. 2014;52(7):511-6. doi:10.1038/sc.2014.79

National Clinical Guideline Centre (UK), Royal College of Physicians (UK). Long term urinary catheters. In: Infection: prevention and control of healthcare-associated infections in primary and community care. London: National Clinical Guideline Centre.

Willette PA, Coffield S. Current trends in the management of difficult urinary catheterizations. West J Emerg Med. 2012;13(6):472-8. doi:10.5811/westjem.2011.11.6810

Cortese YJ, Wagner VE, Tierney M, Devine D, Fogarty A. Review of catheter-associated urinary tract infections and urinary tract models. J Healthc Eng. 2018;2018:2986742. doi:10.1155/2018/2986742

Urinary catheter types and being part of the insertion team. Agency for Healthcare Research and Quality.

Guide to implementing a program to reduce catheter-associated urinary tract infections in long-term care. Agency for Healthcare Research and Quality.

Infection control: catheter-associated urinary tract infections. Summary of recommendations. Centers for Disease Control and Prevention.

Feneley RC, Hopley IB, Wells PN. Urinary catheters: history, current status, adverse events and research agenda [published correction appears in J Med Eng Technol. 2016;40(2):59]. J Med Eng Technol. 2015;39(8):459–470. doi:10.3109/03091902.2015.1085600

Meddings J, Saint S, Fowler KE, et al. The Ann Arbor criteria for appropriate urinary catheter use in hospitalized medical patients: results obtained by using the RAND/UCLA appropriateness method. Ann Intern Med. 2015;162(9 Suppl):S1-34. doi:10.7326/M14-1304

By Jennifer Whitlock, RN, MSN, FN Jennifer Whitlock, RN, MSN, FNP-C, is a board-certified family nurse practitioner. She has experience in primary care and hospital medicine.

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Urinary Catheters Explained

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