What is a urethral catheter and why do I need to have one fitted?
A urethral catheter or foley catheter is a catheter that is held in place in the bladder by a water-filled balloon, this stops the catheter from falling out. There are many reasons why you might need a catheter fitted but your healthcare professional will talk you through exactly why you will need one.
What happens before having your urethral catheter fitted?
Your healthcare professional will have a detailed conversation with you prior to getting your catheter fitted. This conversation will usually include a discussion about the reasons for your catheter and why you’re getting a particular type of catheter fitted. You can find out more about the different types of catheters here. This conversation is also where you can ask any questions you might have. It might be a good idea to write your questions down as they pop into your head to make sure everything that was unclear has been cleared up before your catheter is inserted.
When it comes to the actual appointment where you get your catheter inserted, the healthcare professional carrying out the procedure will be trying to keep everything as clean and sterile as possible to minimise the risk of infection. This means that they’ll clean the area around your urethra opening (the tube that allows urine to leave the body) thoroughly before inserting the lubricating jelly, followed by the catheter.
Does inserting a catheter hurt?
Inserting the catheter via your urethra shouldn’t be painful, especially when a lubricating gel is used, although you might feel some discomfort. These lubricating gels come in syringes (don’t worry – no needles involved!). They’re specifically designed for catheterisation, so the gel coats the whole length of your urethra, making the process of inserting the catheter as smooth as possible. Many catheterisation gels also include some topical anaesthetic (numbing) for even more comfort.
The healthcare professional performing your catheterisation will usually give you a heads up when they’re about to insert the catheter. Try your best to stay relaxed by taking some deep breaths – easier said than done, we know!
How does urine drain with a urethral catheter?
Urethral catheters are connected to a leg bag that collects all the urine your catheter drains. Whether you want to wear your leg bag on your thigh or on your calf is totally up to you. Just always make sure that you’re wearing it lower than your bladder as, otherwise, you’ll risk urine not draining from your bladder or flowing back into your bladder which can cause urinary tract infections (UTI). To ensure that your leg bag is secured properly and doesn’t move you can either use specially designed leg bag straps or a leg bag sleeve.
It might take a while for you to find the perfect leg bag for your individual requirements. Why? Because they come with different taps, tube lengths, and volumes, so you can pick and choose which ones work best for you in different life situations. For example, if you’re out for a walk, you might want to use a smaller bag whereas for a longer car journey you might find a larger volume more helpful.
You don’t even need to do much with your leg bag while your catheter is draining urine, either! You just need to make sure that it’s emptied regularly. To drain your leg bag just switch the tap at the bottom of your leg bag from closed to open and, voila, your leg bag is emptying. The general recommendation is that you empty your leg bag when it’s about 2/3 full but if your healthcare professional has told you something different, always go with their advice!
How to prevent your urethral catheter from getting blocked
Stay hydrated: Make sure you drink plenty of fluid throughout the day as this will help prevent minerals from building up in your urine and generally keeps your bladder healthy. It would also be best to steer clear from alcohol, caffeine, or acidic juices like orange juice.
Consume enough fibre: Make sure that your diet features enough fibre to avoid getting constipated. This is important because full bowels can put a lot of pressure on your bladder which, in turn, can cause your catheter to become blocked.
Follow a good hygiene protocol: Before touching any part of your catheter, it’s important that you always wash your hands.
Keep an eye on the pH balance of your urine: Any pH between 4.5 and 8 is completely normal, however, anything below 6.7 can lead to a higher risk of encrustation. If you find your pH balance is too low, speak to your healthcare professional about taking citrates or sodium as both can help make your urine less alkaline.
Can I sleep with a urethral catheter?
If you don’t want to get up in the middle of the night to empty your leg bag, you might want to consider a larger overnight drainage bag. These usually come with a volume of 2 litres and are big enough to collect all the urine your catheter drains over night without you having to worry about it. The overnight bag can either be connected directly to your catheter or to your leg bag. Just make sure that the tap of your leg bag is open if you attach it! It’s also super important that you keep your overnight drainage bag lower than your bladder to avoid urine flowing back into your bladder or urine not draining at all. You can keep your overnight drainage bag in a drainage bag stand next to your bad on the floor or in a hanger that you can easily attach to your bedframe.
Do you have to be careful about your diet?
Catheters generally don’t come with a lot of dietary restrictions, so you pretty much just need to keep eating your healthy diet. If you tend to get constipated quite easily, try eating more fibrous foods.
How can I stay hydrated when living with a urethral catheter?
Staying hydrated is much more important than diet when it comes to your urethral catheter and it’s very important that you drink anywhere between 1 to 2 litres every day. Avoiding alcohol and caffeine as much as possible is also a good idea as these two are probably the most-consumed bladder irritants. Are you wondering how you know whether you’re hydrated enough? The colour of your pee should be anywhere between almost clear to a faint straw colour. If it’s yellow or orange that’s when you know that a couple of glasses of water should be next on your to do list. Never forget, though, that medication, food, and drink can effect the colour of your pee. So, if you’ve eaten a bunch of beetroot, don’t panic when your pee has got a pink or red tinge to it. If you want to find out more about variations in urine colour, and what your urine should look like – check out this article.
Can I go running with a urethral catheter?
If you’ve been an avid runner all your life and suddenly find yourself having a urethral catheter, you might ask yourself if you can still go for your daily jog. And the short answer to this is: Yes, you absolutely can! There are just a few things that you might have to be a little more cautious about now that you’re living the catheter life:
Don't overdo it! Especially in the beginning, when you’re still getting used to your urethral catheter and everything that comes with it, it’s a good idea to take it slow and steady. You might find going for a run a bit difficult at the start, especially if you’re suffering from bladder spasms too. Try going for a brisk walk around the block or a super gentle jog. Try a few things and see what works best for you!
Proper fixation is everything. Once you’re feeling more comfortable with your catheter and you feel ready to run again, there’s no reason why you shouldn’t or couldn’t do so. It’s just super important that you try to avoid any tugging as this can cause quite a bit of discomfort and can even lead to injuries. How do you avoid it? Easy, by using fixation devices to make sure everything is kept in place.
Leg bag sleeves. Leg bag sleeves are designed to hold your leg bag in place – either on your calf or on your thigh. Whatever you prefer! And it doesn’t matter what type of catheter you have either; a leg bag sleeve is a great fixation device for suprapubic catheters, urethral catheters, and you can even use it if you’re wearing a urinary sheath.
Leg bag straps. If a leg bag sleeve isn’t quite what you’re looking for, you can always give some leg bag straps a try. With leg bag straps, you have the choice of whether you want to position the bag on your thigh, just above your knee, or on your shin. Whatever is most comfortable for you.
Catheter straps. You can use a catheter strap to either support your urethral catheter or the tubing of your leg bag – whatever you think needs more support. And it doesn’t matter whether you’re living with a urethral or suprapubic catheter either, as they can be worn with both.
Catheter clips. If you want to secure your urethral catheter in place, you can use a catheter clip. This is a device that will help you to position your catheter in a way that’s most comfortable for you.
Can I go swimming with a urethral catheter?
Generally, we would strongly recommend that you speak to a healthcare professional before entering the water. This is just to be 100% certain that you can go ahead without increasing your risk of infection.
You might even be able to swap your catheter leg bag for a catheter valve which can be a more discreet and comfortable option for you. It’s super important that you don’t just go ahead and attempt to use one, though! Always make sure to speak to a healthcare professional before. Why? As with everything, a catheter valve isn’t right for everybody, and you’ll need a certain level of bladder tone and capacity to be able to use one. If your healthcare professional determines that a catheter valve isn’t for you and you’re going swimming with your catheter leg bag, it’s a good idea to empty it before you’re entering the water.
Our nurses’ top tips for going swimming with a urethral catheter:
- Always check that the skin around your catheter looks healthy. If you can find any wounds or signs of infection, it’s best to postpone your swim until it’s all healed again.
- Always make sure that your catheter, the catheter tubing, and your leg bag or catheter valve are properly secured in place.
- If you feel uncomfortable getting changed make use of the changing room for disabled people.
- Before diving in, make sure the water is clean.
- After your dip, always clean and dry the entry site of your catheter to reduce any risk of infection.
Travelling with an urethral catheter
When it’s time for your first trip after having your catheter inserted, you might feel a little overwhelmed and scared but don’t worry, you’re not alone with this. And travelling with a catheter isn’t actually any scarier than it is without one! It just takes a little more planning than it used to. It’s always best that you get all your catheter supplies well in advance of your holiday to make sure you have everything you need. This way, you’ll know for sure that you don’t run out of anything you need, and it’ll ultimately help you to feel less nervous.
The airport security process can be stressful at the best of times. Going through scanners, potentially setting them off (yes, it’s happened to all of us!) and being patted down isn’t exactly how any of us like to spend their time. But with a catheter, this can be even more uncomfortable.
Did you know that you can request to be searched in a private room? You can bring a note from your GP to help with your request if you’d prefer not to talk about your catheter in front of other people.
You may be asked to empty your leg bag to go through security. We know, it’s super easy to forget about it but the fluid restriction rules also apply to urine!
And, lastly, always keep in mind that your bag might not make it to the right destination on time.
You’ll know that feeling especially well if you’ve been unfortunate enough to have been that person waiting at the baggage carousel, only to find that your bag isn’t going to show. Now this can be inconvenient if you don’t have a catheter, but if all your catheter supplies are in this one bag this can quickly become a problem.
So why not send some of your supplies to your destination ahead of your trip? Or split your supplies between your hand and main luggage so you have some with you? If you opt for the latter option, bear in mind that your hand luggage may be searched when going through security. However, if you prefer, you can get the contents of your bag checked discreetly in a different room.
How is a urethral catheter removed?
Prior to your catheter removal
Always follow any guidance given to you from your healthcare professional. You should usually be able to eat and drink normally beforehand. Once your catheter has been removed, you’ll be monitored closely by a healthcare professional to ensure that you’re able to empty your bladder properly without your catheter inserted. This can take a little while, so you might want to bring a good book to your appointment to pass the time!
During your catheter removal
The healthcare professional in charge of removing your catheter will explain the procedure to you and you can ask any questions you might have during this conversation. When the catheter is removed, you’ll likely be in a lying down position as the procedure is happening. The nurse removing your catheter will start by deflating the little balloon that’s been holding your catheter in your bladder. This is something you probably won’t be able to feel – very much like you couldn’t feel it when the balloon was inflated upon insertion of your catheter. When the balloon is fully deflated, your catheter will be removed which can feel a little uncomfortable. Don’t worry, though, it’ll be over in about 5 seconds; this is how long the removal of a catheter takes on average.
References
1. https://bmjopenquality.bmj.com/content/6/1/u209593.w7966
2. https://www.nhs.uk/conditions/urinary-catheters/
3. https://www.nhs.uk/conditions/urinary-catheters/living-with/
