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 (the tube that allows urine to exit the body), 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
- Headaches
- Confusion
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.
Bladder spasms
Bladder spasms are also 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, frequent or painful you should speak to your healthcare professional about it as they prescribe some medication that should help to relieve the spasms.
Bypassing
Bypassing means that there’s urine leaking around your catheter. This can happen when there’s an obstruction or blockage somewhere and urine can’t leave your body via your catheter so it spills out. 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 healthcare professional 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 which can cause a kidney infection, kidney damage or, worst case, sepsis. So, if you notice that there’s no urine draining from your catheter or you spot large pieces of debris you should give your healthcare professional a call.
Encrustation
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.
Problems with the urethra – the tube that allows urine to exit the body
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, infections and conditions that cause swelling can lead to scarring of your urethra, 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. Often a dilation catheter will be used to clear the obstruction, allowing urine to flow.
Erosion: This indicates a tear in your urethra, most often right at the opening, and is commonly seen in long-term catheter users. Erosion is less likely to occur if a fixation device is used to secure your catheter in place.
Urethral fistulas: Fistulas (an opening that develops between your bladder and urethra) can develop if you are a 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 catheter problems
Bladder stones: These usually only develop when you can’t completely empty your bladder of urine.
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 when the catheter is accidentally pulled from standing up. The unintentional removal of a catheter can be a very traumatic event and can lead to injuries to the urethra.
References
1. https://www.nhs.uk/conditions/bladder-stones/
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Author |
Sam Hardcastle |
|
Clinically approved by |
Naomi Lisk, Clinical Lead Nurse |
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Published |
31/07/2024 |
| Last reviewed | 31/07/2024 |
| Next review due | 31/07/2025 |
