What is a urinary catheter?
A foley catheter, is a small, soft tube that is inserted into the bladder through the urethra (communication channel between the bladder and the outside).
The catheter’s tip inside the bladder is surrounded by an inflatable balloon which, once filled with saline, ensures that the catheter doesn’t slip out of place.
The outer end of the catheter, outside the body, is attached to a bag where the urine
can spill out automatically, by gravity.
There are two different types of collection bag:
- a smaller, portable bag, which can be hidden under the clothes and allows you to move around freely.
- A larger bag, which is generally used either at night or for bedridden patients, and is attached to the bed.
What are the indications for placing an indwelling catheter?
Catheters are usually positioned when a person can’t empty their bladder. This problem can be due to issues that involve the urethra or the bladder.
There are various alternatives which can be evaluated in alternative to placing an indwelling catheter, and they should always be considered before taking a decision.
For example, in cases of Incontinence, a bedside commode or continence garments can be used. In cases of one-time, intermittent or chronic voiding needs, a straight catheter can be considered, while for cooperative meno without urinary retention or obstruction, an external “condom” catheter can be positioned.
However, there are cases in which there is a clear indication for the positioning of a foley catheter, for example:
- Acute urinary retention due to a malfunction of the bladder muscles as happens for example in diabetic neuropathy, after a stroke or even after a urinary tract infection. Some medications, such as neuroleptics, anaesthetics and antidepressants, can lead to a weakening of the bladder
- Acute urethra obstruction e.g., urethral compression in men with prostate enlargement, radiotherapy or stones
- to monitor urinary functions in critically ill patients
- to help healing processes of perineal wounds in incontinent patients
- when the patient requires strict prolonged immobilization (e.g., lumbar spine injuries or multiple traumatic injuries)
- In some surgical cases, such as surgery on adjacent structures of the genitourinary tract, prolonged surgery, Large volume infusions or diuretics anticipated during surgery or the need for intra-operative monitoring of urinary output
How is the catheter placed?
There is no need to be hospitalized for the procedure. The catheter can easily be positioned also at home.
Your caregiver will clean your genital area. He will then lubricate the tip of the catheter with a special jell, so as to help it go in smoothly. He will insert the end of the catheter with the deflated balloon into your urethra and will slowly and gently push it until it reaches your bladder.
To reduce discomfort you should take slow, deep breaths and gently push as if you were trying to urinate while the catheter is being inserted.
- When your caregiver sees urine flowing from the catheter, he will fill the balloon so that it stays in place. The open end of the catheter will then be attached to a sterile drainage bag.
Many catheters are made in latex, so it is very important to alert your doctor if you have an allergy to latex so that a latex-free catheter can be used.
How to handle the catheter at home:
Here are some basic rules to make life more comfortable and safe.
1- Never remove the catheter on your own. If the catheter is causing you excessive discomfort or if you feel it’s time to remove it you, have to call a doctor or a nurse. Removing the catheter yourself may cause damage to the urethra and bladder.
2- Do not pull on the catheter.
3- Check that the pipe doesn’t kink or fold.
4- Do not obstruct the catheter in any way. Be careful not to walk on it, pinch it or place heavy objects on it. The system should be maintained constantly open so that urine can flow freely.
5- Always wash your hands with soap before and after touching the catheter.
6- Keep skin and catheter clean . Clean the skin around the insertion, with soap and water at least twice a day and after every discharge of feces.
7- Empty the bag every 4-8 hours or more frequently if necessary. If the bag is too full, urine can make its way back into the bladder.
8- Make sure the urine bag is at a lower level than the rest of the body. This reduces the risk of reflux of urine from the bag back into the bladder. The urine in the bag is not sterile, and if it enters the bladder it can lead to infections.
9- Drink plenty of water. Unless you receive other indications from your doctor, you should drink at least 8 glasses of water a day. Fluids help “wash” the bladder and reduce the risk of building up deposits that may clog the catheter. Furthermore, it is advisable to avoid caffeine because it has dehydrating effects.
10- Maintain a regular bowel function. Constipation is associated with an increased risk of urinary tract infections and the strain applied at discharge can lead to leakage from the catheter.
11- Opt for cotton for your underwear as it allows the genital area skin to breathe.
12- Sexual intercourse should be avoided with a urinary catheter.
13- Avoid foods and drinks that can disrupt the bladder such as caffeine, spicy foods, alcohol, carbonated drinks and chocolate.
14- Do not take a bath while wearing a catheter. It is better to wash with a shower, if is possible.
15-You should always keep two extra catheters at home, so as to have a ready substitution in case of an emergency.
How to clean for urinary catheter:
1-bowl with warm soapy water
2- damp clean cloth
3-Clean dry towel
4- Waterproof bed sheet if the patient is bedridden
1-Wash your hands with warm water and soap
2-gently hold the catheter near the insertion with one hand while performing cleaning operations. This will avoid tractions on the urethra and bladder.
3- wash the genital area around the catheter with soap and warm water. The washing must be done with a circular movement, starting from the area closest to the catheter insertion and moving away gradually. Leave the area around the anus for last.
4- Set aside the cloth used for washing and don’t use it again untila it has been properly washed in a washing machine, possibly at high temperatures.
5- Dry with a clean towel, following the same direction as for the cleaning process (start near the insertion and move away, leaving the perianal area for last).
6- use a clean container to empty the bag and clean it every time you use it so that it can always ready and available.
A little tip: if more than one person take care of the catheter, we recommend setting up a written care diary in which all carers can report the time and procedure performed at each intervention (ex. At 08.30 cleaning and emptying). This will help ensure that hygiene and the maintenance are carried regularly.
What problems may arise with your foley catheter ?
The most important risk is the developing of a urinary infection caused by bacteria. The application of correct rules for the maintenance of hygiene is essential for the prevention of the problem.
Urine Leaks from the catheter
Occasional episodes of leakage from the catheter should not worry you. However, if the problem persists, if it happens too frequently or brings to a significant loss of urine, it is advisable to seek the assistance of a nurse or doctor.
No urine is draining in the bag
Before calling for help you should try:
changing the position of the body
checking that there are no obstructions or kinks in the pipe
check that the bag is lower than the bladder
If none of the above works, you should seek medical assistance.
When to contact your doctor or nurse:
excessive or continuous leakage from the catheter
foul-smelling or cloudy urine or crystals in the tubing
blood in the urine
fever above 38 ° C
lower back pain
swelling around the access area, especially in men
sudden confusion or signs of disorientation in the patient
Failure to fill the urine bag
What NOT to do :
In any case, the first rule when going home with a catheter is to take notes of your healthcare provider’s instructions and contact details and ask as many questions as possible in case of doubts.
Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you. The above information is an educational aid only. If you have any suggestions or requests regarding these contents please feel free to let us know.