Urinary catheterisation 

Introduction 

Urinary incontinence

Stress, childbirth and age can all cause incontinence. Get expert advice on treatments, including pelvic floor exercises, medication and surgery.

Media last reviewed: 18/03/2013

Next review due: 18/03/2015

The urinary tract

The urinary tract is the area in the body where urine is made and got rid of (excreted). It's made up of the:

  • kidneys – these extract waste materials from the blood and convert it into urine
  • ureters – the tubes that run from the kidney to the bladder
  • bladder – the organ that stores urine
  • urethra – the tube that conducts urine from the bladder to outside the body. In men it passes through the penis and in women its opening is just above the vagina

Urinary catheterisation is a medical procedure used to drain and collect urine from the bladder.

A thin, flexible tube called a catheter is inserted into the bladder, usually along the tube urine naturally passes through (urethral catheter), or through a hole in your abdomen directly into the bladder (suprapubic catheter).

The catheter usually remains in the bladder, allowing urine to flow through it and into a drainage bag.

Why is urinary catheterisation needed?

A urinary catheter can be used on a short or long term basis.

Short-term catheterisation

Short-term catheterisation may be needed to remove urine from the bladder for a short period of time if there is something stopping you emptying your bladder normally.

For example, this could be because the bladder cannot empty if there is an obstruction (blockage) or it is unable to generate enough force to propel urine down the waterpipe.

If the urethra has become blocked, it may be because of scarring (stricture), prostate enlargement, or, rarely, a stone. A catheter will be fitted until the underlying condition can be treated.

Short-term catheterisation may also be used in preparation for some types of surgery, such as operations on the womb or ovaries and procedures involving the large bowel. It may also be used for other operations where a long period of recovery is anticipated.

Other situations where a catheter may be used include during childbirth (to drain the woman's bladder), and to clear the bladder of any blood clots and debris following an injury to the bladder or after surgery to that area.

Long-term catheterisation

A urinary catheter may be needed for a long time if it's not possible to treat the underlying condition that prevents the bladder from emptying naturally.

Long-term catheterisation can be used when a person is confined to bed and is too weak to go to the toilet. It is also sometimes used as a treatment for urinary incontinence when other types of treatment have failed.

If a person is unable to empty their bladder because of bladder weakness (detrusor hypocontractility) or nerve damage (neurogenic bladder), long-term catheterisation is a possible treatment option.

If you require urinary catheterisation for a long time, you may be trained to insert a catheter when needed. This is known as self-catheterisation and involves catheterisation for a short period to allow the bladder to empty before the catheter is removed. This is likely to be carried out several times a day and avoids the problems associated with permanent catheterisation.

Other uses

In some cases, catheters can be used to obtain a clean urine sample to test for bacterial infections. This is a sample that has not been contaminated by bacteria from your hands or genitals.

A catheter can also be used to deliver medication directly into the bladder, such as chemotherapy medications used to treat cancer of the bladder

Types of catheters

There are two main types of catheter. They are:

  • intermittent catheter – where the catheter is temporarily inserted into the bladder and removed once the bladder is empty
  • indwelling catheter – where the catheter remains in place for many days or weeks and is held in position by a water-filled balloon in the bladder

Many people prefer to use an indwelling catheter because it is more convenient. However, indwelling catheters can be complicated by problems such as bladder spasm, infection, blockage and leakage around the catheter. These problems are reduced if intermittent catheterisation is used.

Read more about how urinary catheterisation works and the risks of catheterisation.

The website of The British Association of Urological Surgeons (BAUS) provides more information about the management of a urethral catheter.

Page last reviewed: 26/03/2013

Next review due: 26/03/2015

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Comments

The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Sprout01 said on 25 July 2014

I've recently had surgery, and went in to retention. I needed a catheter to be inserted, and to say it was a relief was an understatement!
My problem was, after each time a catheter was removed, I went into retention again. I've now got my 3rd one in.
It seems my body doesn't like anaesthetics. When my gall bladder was removed, exactly the same thing happened then!
I've got this catheter for 2 weeks now, but compared to the pain of when you can't go, it's a small price to pay.
Anyone who's concerned if they need one, they're pretty self explanatory, easy to care for if kept clean and aren't really that uncomfortable. Just need to be careful with positioning, strapping the leg bag carefully and relaxing as much as possible. They don't stop me doing things, and I can still wear normal clothes!

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Jochen Maydt said on 25 September 2013

Yes, I have a neuropathic (or neurogenic) bladder and yes, my bladder sometimes is quite pathetic when it comes to emptying. But I didn't know there was a medical word for that now: the "neuropathetic bladder [sic]". :o)

That made my day! It's really good to laugh about a condition that stays with you all day long...

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User668548 said on 22 April 2012

Am I able to select the sex of the person prvoiding this medical procedure? Can I ask for a chaperone?

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Easterenders said on 31 May 2011

very helpfull in understanding the way stones are made and the reason why they form
thank you for this information

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TommyG said on 20 April 2010

http://www.nhs.uk/conditions/urinary-catheterization/Pages/Introduction.aspx#toggler-div

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luke warmbath said on 14 February 2010

Julian seems to be confusing incontinence with retention - these are about as diametrically opposed as you can get!

It would be good to separate these conditions and provide clear guidance for each.

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