Urinary catheterisation

Living with a urinary catheter

Its possible to live a relatively normal life with a long-term urinary catheter, although it may take some getting used to at first.

Before being discharged from hospital, a specialist nurse will give you detailed advice about looking after your catheter.

Catheter equipment

You will be given a supply of equipment to take with you when leaving hospital, and told where to get further supplies in the future. In most cases, catheter equipment is available on prescription from pharmacies.

You will also be shown how to empty and change your equipment.

Self-catheterisation

If you have been taught to use intermittent catheters, you should insert them several times a day to drain urine into a toilet or bag. These catheters are usually designed to be used once and then thrown away.

How often intermittent catheters need to be used differs from person to person. You may be advised to use them at regular intervals spaced evenly throughout the day, or only when you feel you need the toilet.

The British Association of Urological Surgeons (BAUS) website has more detailed leaflets on self-catheterisation inmen (PDF, 158kb) and self-catheterisation in women(PDF, 160kb) .

Indwelling catheters

Indwelling catheters can either drain into a bag attached to your leg, which has a tap on the bottom so it can be emptied, or they can be emptied into the toilet or suitable receptacle directly using a valve.

Bags should be emptied before they become completely full (around half to three-quarters full). Valves should be used to drain urine at regular intervals throughout the day to prevent urine building up in the bladder.

Both bags and valves should be replaced and thrown away about every five to seven days.

At night, you will need to attach a larger bag to your valve or regular bag. This should be placed on a stand next to your bed, near the floor, to collect urine as you sleep. Depending on the type of night bag you have, it may need to be thrown away in the morning or it may be emptied, cleaned and reused for up to a week.

The catheter itself will need to be removed and replaced at least every three months. This will usually be done by a doctor or nurse, although sometimes it may be possible to teach you or your carer to do it.

The BAUS website has a more detailed leaflet on the management of urethral catheters (PDF, 173kb) .

Preventing infections and other complications

Having a long-term urinary catheter increases your risk of developing urinary tract infections (UTIs) , and can also lead to other problems, such as blockages.

You will be advised about measures to take to minimise these risks, such as:

regularly washing your hands, body and catheter with warm water and soap its particularly important to clean your hands before and after touching your equipment
ensuring you stay well hydrated you should aim to drink enough fluids so that your urine stays pale
preventing constipation staying hydrated can help with this, as can eating high-fibre foods such as fruits, vegetables and wholegrain foods
avoiding kinks in the catheter and making sure any urine collectionbags are kept below the level of your bladder at all times

You will be advised about when it is safe for you to go to work, exercise, go swimming, go on holidays, and have sex.

If you have an intermittent or suprapubic (inserted through your tummy) catheter, you should be able to have sex as normal.

Indwelling catheters can be more problematic, but its still usually possible to have sex with them in place. For example, men can fold the catheter along the base of their penis and cover them both with a condom.

In some cases, you may be taught how to remove and replace the catheter so you can have sex more easily.

When to seek medical advice

You should contact a district nurse or nurse practitioner (you may be given a phone number to call before discharge from hospital) or your GP if:

you develop severe or persistent bladder spasms (similar to stomach cramps)
your catheter is blocked, or urine is leaking around the edges
you have persistent blood in your urine , or are passing large clots
you have symptoms of a UTI, such as pain, a high temperature (fever) and chills
your catheter falls out (if its indwelling and you havent been taught how to replace it)

If your catheter falls out and you cant contact a doctor or nurse immediately, go to your nearest accident and emergency (A&E) department .