Understanding your catheter

What is a catheter?

A catheter is a hollow, flexible tube which is inserted into the bladder to collect urine. It is usually passed up the urethra into the bladder. The urethra is a tube that carries urine from your bladder to the opening where you pee from. In some cases, a catheter can also be inserted through your lower tummy directly into the bladder.

There are several different types of catheter. Which one to use will depend on why you need a catheter and how long you will be using it for. A healthcare professional should discuss your options with you to make sure you get the best fit. 

Your catheter is held in place by a small, water-filled balloon which sits at the tip of the catheter. This balloon makes sure the tube stays in the bladder. The catheter carries urine out of the body, where it is connected to a valve, often with a drainage bag attached to the leg by straps or a pouch.  

Why do I need a catheter?

Catheters are used when a person has difficulty peeing. It is very important to make sure urine does not build up in the bladder as this can cause kidney damage. Sometimes catheters are also used before and after surgery.

Some of the reasons why someone needs a catheter include:

  • to empty the bladder of urine before and after surgery 
  • to check kidney function when someone is very unwell
  • during childbirth (if a woman has a strong anaesthetic called an epidural)
  • to help you pee if you suffer from bladder weakness or nerve damage 
  • to empty the bladder if a urinary tract infection is stopping you from passing urine
  • to put medicine in the bladder, such as chemotherapy to treat cancer
  • a blockage in the tube that carries urine from your bladder, such as an enlarged prostate or kidney stones 
  • to treat urinary incontinence (urine leaking from the bladder) when other treatments haven’t worked 
[Source: Urinary catheters – NHS (www.nhs.uk)]

Types of catheter

There are two main types of urinary catheter: intermittent catheters and indwelling catheters. 

Intermittent catheters

These catheters are for short term, single-use only. They are also sometimes referred to as a straight catheter. One end of the catheter has a lubricated tip to make insertion easier. The other end opens like a funnel so you can empty urine into the toilet or collect it in a drainage bag. 

Intermittent catheterisation is a procedure which you can learn yourself so you can empty your bladder whenever you need to. 

Your healthcare professional will teach you how to use an intermittent catheter. Once your bladder is empty, you can remove the catheter and throw it away. You may need to insert catheters several times a day. 

Intermittent catheterisation reduces your chances of urinary tract infections. Some people prefer this technique because they feel they have more control over their body, and they don’t have to wear a catheter all the time.  

Indwelling catheters

These catheters are long-term, which means they are kept in the bladder for at least 4 weeks. They are most often called “Foley catheters”. Indwelling catheters are held in place by a small water filled balloon which is inflated after the catheter is inserted. A numbing gel is used to make insertion more comfortable. These catheters can be drained using a valve at the end of the catheter, or attached to a drainage bag which has a tap at the bottom so you can empty it. 

There are two types of indwelling catheters. A urinary indwelling catheter is inserted through the tube (urethra) which leads to your bladder.

The other type of catheter is called a suprapubic catheter. This is inserted into the bladder during a surgical procedure which is done in hospital.  The procedure makes a small hole in the lower part of your tummy. Suprapubic catheters are used when the urethra is blocked or damaged. 

There is a higher chance of getting an infection with a long-term catheter. However, some people find them easier to use than intermittent catheters as they do not require so many frequent insertions. Indwelling catheters need to be changed by your healthcare professional at least every 12 weeks, or sometimes sooner depending on your personal needs.  

[Source: Types of urinary catheters – NHS (www.nhs.uk)]

Foley catheters come in different sizes. French measurements, called Charriere, or French gauge, are used to show how thick the catheter tube is. For example, 12ch is 4 millimetres. The recommended size for long-term urinary catheters are:

Women: 12-14Ch for women.

Men: 12, 14 or 16ch. 

Suprapubic catheters: 16ch or 18ch.

[Catheter Care: RCN Guidance for Health Professionals, Royal College of Nursing]

  • Other types of catheter 

There are also external catheters, known as sheath or condom catheters. They are most often used by men who struggle to control their bladder. External catheters attach to the penis like a condom. They connect to a tube with a drainage bag.

They are only suitable for men who can pee but need help controlling their flow of urine. Some people prefer them because they don’t need to be inserted inside the body and can be easily changed at home. 

How to look after your catheter

Having a catheter can be a big adjustment. You may feel worried about how to care for your catheter, and what daily activities you can carry out. Have a look at these FAQ to learn more about living with an indwelling catheter:

Common catheter questions 

How can I prevent infection? 

Although having a long-term catheter increases your chances of getting an infection, there are simple steps you can take to reduce the chances of this happening:

  • Always wash your hands with soap and water before and after touching your catheter
  • Clean the skin where the catheter enters your body with mild soap and water each day
  • Try to drink enough fluids. Aim to drink 8 to 10 cups of water a day to help prevent bladder stones and waste materials building up in your bladder
  •  Eat lots of fruit, vegetables and whole grain foods like brown bread to prevent constipation. Being constipated can stop your bladder from being able to empty properly 
  • Make sure you have a good urine flow by regularly checking your catheter for any bends or kinks 
  • Keep your drainage bag at least 30 centimetres below your bladder to make sure your catheter is able to drain

Signs of infection to look out for include a high temperature, feeling cold and shivery, blood-tinged or cloudy urine, pain in your lower tummy or groin area, and confusion. Always speak to your doctor if you are feeling unwell.

Will a catheter stop me doing my regular activities? 

You will be able to do many of your usual activities when you have a catheter. Things like going to work, bathing and showering, exercising, swimming, travelling and having sex are still possible. 

Sometimes you may need to make some adjustments and plan more carefully when you are out and about. If you have any doubts or questions, seek advice from your GP or nurse. 

Why do I still feel the urge to pee with a catheter? 

It is normal to experience some bladder spasms or stomach cramps, especially after a new catheter has been inserted. Sometimes a bladder spasm can cause urine to leak around the outside of the tube. This should settle after a few days.

However, if the spasms continue and become worse, or your catheter keeps leaking, contact your community nurse straight away.  

What do I do if my catheter is blocked? 

Check there are no kinks in the tubing to make sure the urine is flowing properly. Also make sure your drainage back is emptied, as a full bag will prevent any more urine from draining down the tube. Your catheter should always be positioned below your bladder to allow gravity to pull urine down the tube. It’s also important to make sure you are drinking enough fluids. 

If your catheter is blocked, call your local community nurse. Never try to remove your catheter yourself, as this could injure your bladder and urethra and cause pain and bleeding. If your catheter falls out, you need to call your community nurse straightaway to come and reinsert a new one. 

How do I use my catheter bag?

Your catheter drainage/ collection bag collects urine and needs to be emptied when it is two thirds full. 

You need to change your catheter bag once a week, making sure you wash your hands with soap and water beforehand. If you have a carer, they may be able to assist you with this. 

Your catheter collection bag is designed to be strapped to your thigh or calf to hold it safely in place. The tube should not be pulled too tightly. Your catheter bag needs to be below your bladder, but never touching the floor. 

During the night, your catheter bag can be attached to a larger night bag which holds more urine so you don’t need to keep emptying it overnight. 

Sometimes, you may not have a catheter bag. Instead, you will use the valve at the end of the catheter to empty your bladder when you feel it is full, or every 3-4 hours.