1) Indwelling catheters
An indwelling catheter remains in the bladder permanently for an extended period of time and is generally changed by a healthcare professional every 4-8 weeks. To keep it in place, a tiny balloon at the end of your catheter will be filled with water once it’s inside your bladder. Every time your catheter is removed, the balloon needs to be deflated first. Removing it without doing that could lead to serious injuries and damage. Are all indwelling catheters the same? No, there are two options: Urethral catheters and suprapubic catheters. But let’s take a closer look!
As the name suggests, a urethral catheter is inserted into your bladder via your urethra. That’s the hollow tube that connects your bladder to the outside world and allows for urine to exit your body. There are many urethral catheters out there, however, most of them are made from natural or silicone rubber and they all come in various sizes. There’s no need for you to figure out which size you need, though. Your healthcare professional will work this out for you! Doctors and nurses will generally try to use the smallest size available that still allows for urine to be drained properly. This is to reduce the risk of damage to your urethra. However, if you’re getting a catheter inserted after surgery or an infection, you might get a bigger size for a while. This is because there is likely going to be some debris that can block the catheter and prevent drainage.
As opposed to a urethral catheter, a suprapubic catheter is inserted into your bladder via a little hole in your abdomen. The insertion is generally done in hospital, and you will likely get some form of anaesthetic, depending on your situation and the hospital you’re in. Every hospital has its individual process, so it’s best to speak with your continence nurse or doctor about any specific questions you have. Some healthcare professionals prefer suprapubic catheters because of the following reasons:
- There’s no risk of damage to the urethra or bladder neck
- There’s less risk of you developing a urinary tract infection
- The catheter is less likely to get blocked because a bigger size can be used
- You are less likely to accidentally pull it or sit on it
- It’s much easier for you to keep the entry site of your catheter clean
- There is no interference with any sexual activity
So, what can you expect when you have an indwelling catheter?
Any urine that is drained by your catheter will be collected in an externally worn bag. This can either be a leg bag that’s strapped to your thigh or calf or a larger overnight drainage bag that you can keep in a stand or hanger next to your bed or chair. If you opt for the latter, make sure that your bag is kept lower than your bladder at all times. Why? Because you will risk urine flowing back into your bladder causing nasty UTIs otherwise.
In some cases, a catheter valve is also an option which removes the need to wear an external bag. Your catheter valve is simply attached to the end of your catheter, causing your bladder to fill up. If your bladder is full and you want to drain the urine, you can just open your valve and, voila, your bladder will be emptied. Please speak to a healthcare professional before attempting to use a catheter valve as you will need to be assessed properly.
Side effects of indwelling catheters
Bladder spasms: Bladder spasms are unfortunately fairly common with indwelling catheters because your bladder naturally tries to pass the inflated balloon. Speak to your continence nurse or GP if your spasms are frequent or very painful. They might be able to prescribe something for it!
Blockage: Sometimes, particularly big pieces of debris can clog or fully block your catheter. This means that urine can’t leave your body and will sit in your bladder, ultimately flowing back into your kidneys. Please call your continence nurse or doctor immediately if this happens as it can cause serious infections.
Pain & discomfort: Generally, your indwelling catheter shouldn’t cause you any pain or discomfort. You might be in a little bit of pain right at the beginning. However, if you’ve had an indwelling catheter for a while, you might feel like it’s becoming a little bit sore. Speak to a healthcare professional about possibly getting some pain relief!
2) Intermittent catheters
Unlike indwelling catheters, intermittent catheters are inserted into the bladder whenever you want to empty it and removed again straight away. So, if you’re wanting to use an intermittent catheter your continence nurse will teach you how to catheterise yourself. This might sound a little scary to begin with, but it’s actually quite easy once you’ve got the hang of it! And if your hand function is limited, there are some handy aids out there to make your life easier. Please speak to a healthcare professional before attempting to use an intermittent catheter, as it isn’t suitable for everyone.
Using an intermittent catheter comes with many benefits for your health and personal life:
- Your bladder is fully emptied which means that urine doesn’t build up
- There’s less of a risk of urine flowing back into the kidneys because the bladder is emptied regularly
- It helps your bladder to learn how to empty by itself again
- It reduces the risks of indwelling catheters (like trauma to the urethra or encrustation)
- It gives you a feeling of independence
- It doesn’t interfere with your movement or sex life
Our top tips
- Avoid contamination of your catheter! This means washing your hands with water and soap and giving your downstairs a proper clean before catheterising.
- Don’t reuse your intermittent catheter! Most of them (all of the ones available in the UK, actually) are made for single-use and should be thrown away afterwards. Using it another time would risk an infection.
- Don’t force it! There will be times where your catheter just doesn’t want to play ball. If that’s the case, it’s best to step away from it, do something else for five minutes, and then try again. As with everything, it will take a little bit of time to learn so don’t give up too quickly!
- It’s super important that you empty your bladder completely every time you catheterise. If you don’t do that and a little bit of urine stays in your bladder, you’ll risk a urinary tract infection.
- Never reduce your fluid intake in order to reduce the number of times you have to catheterise per day!
3) Urinary Sheath
A urinary sheath, or condom catheter, is an external catheter designed for men. Why is it called a condom catheter? Simply because it looks very similar to a condom! It will cover the head of your penis, and your drainage bag can be connected to it via a tube. Men often prefer wearing a urinary sheath because it’s more comfortable to wear and doesn’t need to be inserted. It does need to be changed every day, however, which can lead to skin irritation. There are some options on the market that are designed to be worn for longer than 24 hours so if you happen to struggle with irritated skin you could give those a try. Please don’t use a sheath without speaking to a healthcare professional first.
There are many benefits to urinary sheaths:
- You’re much less likely to develop catheter associated urinary tract infections (CAUTIs) when wearing a sheath
- Application and removal are super easy and can usually be done by you in the comfort of your own home
- A urinary sheath doesn’t restrict movement anywhere near as much as an indwelling catheter
- They can be a great option if you usually use incontinence pads
Our top tips
- If your urinary sheath is leaking, it’s likely a sizing issue that’s to blame. Have a chat with your continence nurse about it; they will be able to assess the situation.
- To avoid urine flowing back into your bladder, make sure your drainage bag is always lower than your bladder.
- It’s important that you wash your hands properly with water and soap before removing and applying your sheath as you will risk contamination otherwise.
- If you’ve recently changed manufacturer, make sure to read the user instructions as sizes and fitting can be very different with different manufacturers.