Catheter-associated urinary tract infections (CAUTIS)
CAUTIs are probably the most common complication you will experience if you’re using an indwelling urinary catheter. How does it happen? When bacteria get into your urinary tract, often via your catheter, they will cause an infection in your urethra, bladder, or even your kidneys. To spot a CAUTI, look out for the following symptoms:
- Cloudy, bloody, or foul-smelling pee
- Pain in your lower abdomen, around your groin, and in your lower back
- General achiness
- Burning sensation in your urethral or genital area
- High temperature
A CAUTI doesn’t differ much from a common urinary tract infection (UTI), except for the fact that you probably wouldn’t have the infection without your catheter. If you want to know more about UTIs, you can read our comprehensive article here.
Bladder spasms are also fairly common in the world of urinary catheters. They generally feel something like stomach cramps and happen when your bladder is trying to squeeze out the little balloon that’s securing your catheter inside your bladder. If your bladder spasms are super strong or frequent, you should speak to your nurse or doctor about it as they can prescribe some medication for you. If you want to know more about bladder spasms and how exactly they can be treated, read our article here.
Bypassing means that there’s urine leaking around your catheter. This generally happens when there’s an obstruction or blockage somewhere and urine can’t leave your body via your catheter. So, if you are experiencing bypassing, always start by checking that there are no kinks or obvious obstructions somewhere in the catheter tubing. If you can’t find anything, make sure to give your nurse or doctor a call as soon as possible as this needs to be investigated.
Blockage or obstruction
If you are using an indwelling catheter, debris and the occasional bit of blood are not at all uncommon. However, if the pieces of debris become too big, there’s a chance that they can obstruct the urine flow or fully block your catheter. It’s very important that you get any catheter blockage sorted out quickly as it can lead to urine backing up all the way into the kidneys. There it can cause a kidney infection or, worst case, sepsis. So, if you realise that there’s no urine draining from your catheter or you spot large pieces of debris, give you nurse or doctor a call.
Encrustation is another common complication if you’re wearing an indwelling urinary catheter. It’s actually so common, that almost half of all long-term catheter users will experience it at some point. But what does it mean? It means that mineral salts from your urine are encrusting your catheter, ultimately leading to a catheter blockage (which needs fixing immediately, as we’ve already learned). The deposits can form either on the little balloon inside your bladder, obstruct the eye holes of your catheter, or block the whole catheter, making it impossible for urine to leave your body. Eventually, you will either experience bypassing, or urine will flow back into your kidneys where it can cause kidney infections and sepsis.
Problems with the urethra
Urethral trauma: This means that your urethra has been injured, for example when your catheter was inserted or by accidentally pulling it. Symptoms of urethral trauma include swelling, inflammation, infection, not being able to pass urine, bloody urine, or pain in your abdomen.
Urethral stricture: Old injuries to your urethra can lead to scarring, also called a urethral stricture. They are much more common in men and can make it harder to insert catheters. A urethral stricture can potentially also block the urine flow from the penis, leading to urinary retention.
Urethritis: This is an inflammation of the opening of your urethra which can happen due to frequent catheter insertion or if the catheter has been inserted with too much force.
Erosion: This indicates a tear in your urethra, most often right at the opening, and is commonly seen in long-term catheter users.
Urethral fistulas: Fistulas can develop if you are a long-term catheter user. They are especially common in women and most often develop between the bladder and the anterior vaginal wall which will lead to urine leaking from the vagina.
Less common problems
Bladder stones: These usually only develop after many years of using an indwelling urinary catheter and often form on the little balloon that’s sitting inside your bladder.
Unintentional catheter removal: This means that the catheter is being removed when it shouldn’t be, generally with the retention balloon still inflated. It can happen when the balloon inside the bladder deflates just enough to slip out or it can be caused by conditions like dementia or Alzheimer’s where the person forgets why the catheter is there. The unintentional removal of a catheter can be a very traumatic event and can lead to injuries to the urethra.