Foley / Urethral Catheter

Suprapubic Catheter

Intermittent Self Catheterization

Getting an indwelling urinary catheter can be overwhelming! Whether it is temporary, such as after a procedure while your body heals, or permanent such as a treatment for a neurogenic bladder diagnosis,  Quality Home Health Care Services of Michigan has caring and knowledgeable nursing staff with many years of managing indwelling urinary catheters.  Quality Home Health Care Services of Michigan will provide you with step-by-step instructions on how to live with the catheter and be available to you any time you have questions, concerns, or difficulty with the catheter functioning.

Under the guidance of your physician, Quality Home Health Care Services of Michigan’s nursing staff can work with the following:

• Urethral indwelling urinary catheter 
• Suprapubic indwelling urinary catheter 
• Intermittent self catheterization 

What is an indwelling catheter? 

An indwelling urinary catheter is a tube that drains urine from the bladder into a bag. The tube is usually placed into the urethra (the part of the body that drains the bladder) and up into the bladder. For long term use of an indwelling urinary catheter, surgery may be performed to insert the catheter directly into the bladder from the abdominal wall. This is known as a suprapubic catheter.

The most common indwelling catheter is called a Foley catheter. It is a tube with a balloon on one end and a drainage outlet on the other. The balloon end is inserted into the bladder and the balloon is inflated with sterile water to keep the catheter in the bladder. An indwelling catheter is used when you can't urinate normally. This may happen with some medical conditions such as prostate enlargement or after surgery on the pelvis or urinary tract. In these cases, catheters are usually needed for only a few days or weeks, depending on your situation. Another reason you might need a catheter is incontinence, which means you can't control your urine. If contact with uncontrolled urine has caused breakdown in the skin, use of a catheter can help prevent more irritation or injury. 

How do I care for an indwelling catheter? 

When you have an indwelling catheter, you or someone caring for you needs to make sure urine is flowing into the catheter. Additionally, check for signs of skin irritation or infection and make sure that the urine collection bag is always below the level of the bladder. 

The steps for good catheter care are: 

1. Check the tubing to make sure it is in good condition and does not have any kinks. 
2. Make sure the bag is being kept below the level of the bladder whether you are sitting, lying, or walking. This will help prevent infection. After urine passes through the catheter into the collection bag, it can become infected. The bag must be lower than the bladder so the urine can't flow back into the bladder and infect the urinary tract. 
3. If the bag is attached to the thigh, check that the straps are not too tight or irritating. Inspect the area where the catheter goes into the body (the urethra) to look for redness, raw areas, swelling, cracks in the skin, or drainage. 
4. Gently clean all around the area where the catheter enters the body. Also clean the top few inches of the catheter. Use the antibacterial soap or solution recommended by your healthcare provider to clean the catheter. 
5. If you notice any of the following problems, report them to the health care provider according to the instructions you were given: 

• Too little urine is being collected. Normally adults make 1 to 2 quarts (or liters) of clear, yellow urine each day. 
• The catheter does not seem to be working right. 
• You see signs of irritation or infection of the skin.
• Urine is leaking around the catheter or the catheter is accidentally pulled out. 

6. If the amount of urine draining into the bag is less than normal, there are several possible reasons, including: you are drinking less fluid, your drainage system is blocked, you are not correctly measuring the amount of urine collected in the bag or your kidneys are not functioning properly. 

What are common complications of indwelling catheters? 

The area where the catheter enters the body may become irritated and raw eventually becoming infected. In women the tube enters the urethra near the opening of the vagina. The opening of the urethra and the skin around the vagina can become red and raw from the rubbing of the tube. In men the end of the penis can become red, swollen, and sore from the catheter. If a man is uncircumcised, the foreskin can become irritated. If a suprapubic catheter is being used, the skin around the abdominal stoma may become red, irritated, swollen, or break open and drainage might be present.

Indwelling catheters can cause urinary tract infections. If you have a catheter and you develop 2 or more of the e following symptoms, you should see your health care provider because you may have a urinary tract infection: fever, shaking, chills, sweats, lower abdominal pain, back pain, cloudy around the urethra, or  bad-smelling urine. 

Catheters may injure the urethra. For example, the urethra could be injured from tugging on the catheter tubing or bag. You may see a very small amount of blood making the urine look red or pink in the catheter if there has been a slight injury to the urethra. If this goes away quickly and there are no other symptoms, it is usually safe just to watch to make sure it doesn't happen again. However, if there continues to be blood in the urine inside the tubing for an hour or more, contact your healthcare provider.