Urinary catheterisation – Uses, types and complications

What is a urinary catheter?

A urinary catheter is a thin and flexible tube (catheter) placed in the body to collect urine. The collected urine gets stored in a drainage bag and drained out later.

Urinary catheters are made of rubber, plastic or silicone and are available in any size.

When does a urinary catheter become necessary?

Urinary catheterisation becomes necessary when a person suffers from the following conditions,

• Urinary retention (unable to empty the bladder)
• Urinary incontinence (unable to control the urine)

The function of urinary catheterisation is to drain out the urine stored inside the bladder. So, the need for urinary catheterisation rises due to urinary or bladder problems in the body. It is also needed to drain out the urine from the body before and after specific surgery.

At times urinary catheterisation is also used to measure the amount of urine in case of critical illness. The following risk factors also bring forth the need for urinary catheterisation,

• Blockage in the urinary tract
• Inflamed, infected or injured urethra
• Nerve damage (that affects bladder and kidney function)
• Bladder weakness or injury
• Enlarged prostate in male
• Infection in the urinary tract
• Kidney, bladder or ureter stones
• Other health complications

What are the types of urinary catheterisation?

Indwelling catheter, external catheter and short-term catheter are the three major types of urinary catheterisation.

Size of urinary catheterisation

The urinary catheter comes in various sizes. The size of a urinary catheter relates to the thickness and diameter of the catheter.

Charriere (Ch) or French Gauge (FG) is used to measure the diameter of the catheter. The French gauge or French size is applied only for intermittent and indwelling catheters. Usually, the French size is calculated according to the diameter of the catheter.  

Catheter French sizes typically start small, at 5 or 6 French, and increase in size to as large as 24 French.

Indwelling catheter

Another name for the Indwelling catheter is foley catheter. Indwelling catheter benefits for both long-term and short-term usage. An indwelling catheter is inserted temporarily in the bladder through the urethra.

An indwelling catheter comes with a deflated balloon. The catheter is inserted into the bladder with a deflated balloon. Later, the balloon is inflated with sterile water. The inflated balloon helps in holding the catheter in a correct position and prevents it from sliding out.

Do not worry about the inflated balloon because the balloon is deflated when the catheter is removed. The indwelling catheter has the following two insertion ways:

Urethral catheter: The insertion process takes place through the person’s urethra.

Suprapubic catheter: This insertion process involves mild surgery. The insertion of the catheter into the bladder takes place through a small hole in the stomach.

Foley catheter usage arises for the following needs:

• Urine retention
• Before and after surgery
• For monitoring urine output
• Nerve-related bladder dysfunction
• Bladder or Kidney problems
• Urethra injury or problems

External catheter

The external catheter is also known as a condom catheter. It may be a convenient option for men. Most people prefer an external catheter because they are easy to use, adaptable and flexible. Moreover, the external catheter can be changed at home, which provides more convenience for the user.

Unlike indwelling catheters, they are noninvasive and require nothing to be inserted into the body. The external catheter gets fitted around the penis and the catheter comes with an attached drainage bag. External catheters are not recommended for long use because of their side effects. It is necessary to change it every day.

Short-term catheter

A short-term catheter is also known as an intermittent catheter. The name itself gives a clue that this catheter is used for the short-term under necessary conditions.

A short-term catheter is temporarily inserted into the bladder through the urethra. This temporary insertion of the catheter will be removed once the urine in the bladder drains out completely.

Non-hydrophilic and hydrophilic catheters are the two types of intermittent catheters that are commonly used. Non-hydrophilic catheters are non-coated catheters and hydrophilic catheters are coated catheters.

The hydrophilic (coated) catheters are designed to reduce skin irritation and minimize the risk of urinary tract infection (UTI).

What are the side effects of urinary catheterisation?

Long-term usage of urinary catheterisation causes some side effects, which are listed as follows:

• Urinary tract infection
• Skin irritation
• Allergic reaction
• Urethra injury
• Formation of Bladder stones and Kidney damage (in long-term use of an intermittent catheter)
• Block in the urethra
• Epididymitis

Traumatic injury to the urinary tract or urethral tearing is one contraindication of urethral catheterisation in men and women. In men, the contraindication is associated with pelvic or straddle-type injury.

What causes leakage in a urinary catheter?

The factors that lead to the leakage around urinary catheters include the following:

• Block in catheter
• Using the wrong catheter size
• Improper balloon size

Conclusion

Urinary catheterisation is a medical advancement that helps people with urinary problems or difficulty in urinating. The doctor will recommend a suitable type and the correct size based on a person’s health condition. It is advisable to talk with the doctor to indicate the abnormalities or discomfort faced during or after using a urinary catheter.