Catheter Care: Indications and Management

What Is a Urinary Catheter?

A urinary catheter is mainly a hollow and tube-like structure that collects urine from the urinary bladder and transports it to the urine collection bag at the other end. The urinary catheters are available in different shapes and sizes. They are usually made of silicone, plastic, and rubber. Catheters are generally required when someone cannot empty the bladder or the urine buildup increases pressure on the kidneys. This pressure can cause kidney failure, which can be harmful, resulting in permanent kidney damage. The catheters are only required temporarily. They can be removed once the patient starts urinating on their own. However, elderly patients and those suffering from chronic conditions might require the catheter for prolonged periods.

Why Should One Use a Urinary Catheter?

The doctor might recommend the urinary catheter under the following circumstances:

• Urinary incontinence (urine leakage).

• Urinary retention.

• Restricted urine flow due to kidney stones and enlargement of the prostate gland.

• Prostate surgery.

• Surgery of the genitals, including hysterectomy (a surgical procedure that involves uterus removal).

• Injury to the bladder nerves.

• Conditions that impair the mental health of a person, including dementia (a group of condition leading to memory and behavioral issues).

• Spina bifida (a congenital defect that affects the spine).

How Should One Take Care of the Catheter?

The patient will have to do the following to take care of their catheter:

1. Clean the catheter.

2. Change the drainage bags at regular intervals.

3. The patient must wash their drainage bags daily.

4. Drinking sufficient quantity of water daily.

The patient might observe urine or blood when the catheter enters their body. This usually happens during walking or passing stools. However, it is normal unless the urine gets collected in the drainage bag. Therefore, the patient must consult the doctor only if they do not notice the urine collecting in the drainage bag. Then, the patient can follow the steps mentioned below to clean their catheter:

A. The patient must avoid taking a bath if the catheter is in place. This is because there are higher chances of infection and other complications.

B. The patient will usually require the following things to wash the catheter:

• Mild soap.

• A tube holder.

• Water.

C. The patient must wash their hands with soap and warm water or an alcohol-based sanitizer to reduce the chances of infections.

D. Make sure the hands are dry before the patient touches the catheter.

E. The patient can clean their genitals using a mild soap:

• For Male Patients - The patient must retract the foreskin and clean the penis.

• For Females - Separate the folds around the vagina and wipe it from front to back.

F. Clean the urethra before inserting the catheter. This is because the urethra is the site where the catheter enters the urinary tract.

G. Clean the end of the catheter from where it enters the body. Hold it away from the body to avoid undue tension on the catheter.

H. Rinse the area thoroughly and dry it.

I. Use a tube holder to secure the catheter in place.

How Should One Change the Drainage Bag Attached to the Catheter?

The patient must change their drainage bag twice daily. In addition, the patient must take care of their drainage bag in the following manner.

• The patient can change their night bag to a leg bag in the morning.

• Similarly, the leg bag can be changed to a night bag before bed.

• The patient would require the following to clean their drainage bag:

  • Gauze or a clean washcloth, preferably the one not used for bathing.

  • Night leg or drainage bag.

  • Two alcohol pads.

• The patient must wash their hands with soap and warm water or a sanitizer.

• Empty the drainage bag into the toilet, keeping in mind that the spout of the drainage bag does not touch the sides of the toilet.

• Place the gauze or the washcloth beneath the connector to prevent leakage.

• Disconnect the used bag from the catheter.

• Use an alcohol pad to wipe the end of the catheter.

• Connect a clean bag to the catheter.

• Check whether the drainage bag is adequately connected to the catheter or not.

How Should One Take Care of the Drainage Bag?

Taking Care of the Leg Bag:

• The tubing from the leg bag should fit down to the patient’s calf. In case there is extra tubing, the doctor will provide instructions on how to cut it.

• The patient must wear the leg bag beneath their knees to allow urine drainage.

• The patient must secure the leg bag on their calf with the help of velcro straps provided by the doctor.

• Empty the drainage bag into the toilet every two to three hours. Do not let the bag become full.

• Avoid lying down while wearing the leg bag.

• Do not keep the velcro straps too tight as it might cause marks on the legs and interfere with the blood flow.

Taking Care of the Night Bag:

• The patient must always keep the night bag below bladder level.

• The night bag should be placed in a clean wastebasket and allowed to hang while the patient is asleep.

How Should the Patient Clean the Drainage Bag?

• The patient will need cool water and white vinegar to clean the drainage bag.

• Washing hands with the soap solution and water or an alcohol-based sanitizer for 20 seconds.

• Rinse the drainage bag with cool water. Avoid using hot water as the plastic equipment attached to the bag might get damaged.

• To reduce the foul odor, fill half the bag with a mixture of water and vinegar. Shake the bag and allow it to remain for 15 minutes.

• Finally, rinse the bag and hang it up for drying.

When Should the Patient Consult the Doctor?

The patient must consult the doctor immediately under the following situations:

1. The catheter has got displaced from its position.

2. High-grade fever.

3. Decreased urinary output.

4. The urine is not draining into the drainage bag.

5. The urine smells bad.

6. Presence of blood or blood clots in the urine.

7. Abdominal pain.

Conclusion:

A urinary catheter is essential for patients diagnosed with urinary problems or after prostate surgery. It helps them to pass urine and prevents urinary retention. However, it is necessary for the ones using the catheter to clean it regularly to avoid infections and other complications. Therefore, the tube, drainage bag, and other components attached to the catheter must be disinfected from time to time. The patient can consult the doctor to obtain information about the methods used to clean a catheter.