Urinary Catheter: Types, Care & When to Seek Help

What Is a Urinary Catheter and Why Might You Need One?

A urinary catheter is a thin, flexible tube inserted into the bladder to drain urine when you cannot urinate naturally. You may need a catheter temporarily after surgery, during certain medical procedures, or long-term for conditions like enlarged prostate, neurological disorders, or bladder dysfunction.

A urinary catheter serves as an artificial pathway for urine to leave your body when the normal process of urination is impaired or impossible. The catheter is typically made of medical-grade silicone, latex, or a combination of materials designed to be biocompatible and minimize irritation to the delicate tissues of the urinary tract.

The need for catheterization arises from a wide variety of medical situations. Understanding why you need a catheter can help you better manage the experience and cooperate effectively with your healthcare team. Catheters are not just a medical necessity—they often significantly improve quality of life for people who would otherwise suffer from urinary retention or incontinence.

Temporary catheterization is common during and after surgical procedures, particularly those involving the pelvic region, spine, or urinary system. The catheter ensures accurate monitoring of urine output during critical recovery periods and prevents bladder distension while the patient is under anesthesia or recovering from surgery.

Common Reasons for Needing a Catheter

Medical professionals recommend catheterization for numerous conditions. Benign prostatic hyperplasia (BPH), commonly known as enlarged prostate, is one of the most frequent reasons men require catheterization. As the prostate grows, it can compress the urethra and obstruct urine flow, sometimes leading to acute urinary retention—a medical emergency requiring immediate catheterization.

Neurological conditions such as multiple sclerosis, Parkinson's disease, spinal cord injuries, and stroke can disrupt the nerve signals that control bladder function. Patients with these conditions may lose the ability to sense when their bladder is full or may be unable to initiate or control urination. For these individuals, catheterization becomes an essential tool for maintaining bladder health and preventing complications.

Post-operative care frequently involves catheterization, especially after surgeries involving the bladder, prostate, kidneys, or other pelvic organs. Women may need temporary catheters after childbirth, particularly following cesarean sections or difficult vaginal deliveries where regional anesthesia has temporarily affected bladder sensation.

• Urinary retention: Inability to empty the bladder completely or at all
• Post-surgical monitoring: Accurate measurement of urine output during recovery
• Neurological disorders: MS, Parkinson's, stroke, spinal cord injury
• Enlarged prostate: Obstruction of urine flow in men
• Post-childbirth: Temporary bladder dysfunction after delivery
• Severe incontinence: When other treatments are ineffective
• Bladder or urethral injury: Protection during healing

Children and Catheterization

Children may also require urinary catheters, though the approach differs from adult care. Pediatric catheters are smaller and specially designed for children's anatomy. Parents typically receive thorough training in catheter care and, when appropriate, older children can learn to perform self-catheterization with proper instruction and support.

What Are the Different Types of Urinary Catheters?

There are three main types of urinary catheters: intermittent (single-use) catheters that are inserted to empty the bladder and then removed; indwelling (Foley) catheters that remain in place held by a balloon; and suprapubic catheters that are inserted through the abdominal wall directly into the bladder.

Choosing the right type of catheter depends on your specific medical situation, lifestyle needs, and how long you'll need the catheter. Each type has distinct advantages and considerations that your healthcare team will discuss with you. Understanding these options empowers you to participate in decisions about your care.

Catheter sizes are measured using the French (Fr) scale, where one French unit equals approximately 0.33 millimeters in diameter. Most adult catheters range from 12 to 16 French, with the appropriate size determined by your healthcare provider based on your anatomy and the reason for catheterization. Using the correct size minimizes discomfort and reduces the risk of complications.

Intermittent Catheters (Clean Intermittent Catheterization)

Intermittent catheterization, also known as clean intermittent catheterization (CIC), involves inserting a catheter through the urethra to empty the bladder, then removing it immediately afterward. This method most closely mimics the body's natural process of periodic bladder emptying and is considered the gold standard for long-term bladder management when feasible.

The technique is called "clean" rather than "sterile" because studies have shown that strict sterile technique is not necessary for self-catheterization at home. This makes the process more practical for daily life. However, proper hand hygiene before and after the procedure remains essential for preventing infections.

Most people using intermittent catheters need to catheterize four to six times per day—essentially whenever they would normally urinate. Your healthcare provider will help establish an appropriate schedule based on your fluid intake, kidney function, and bladder capacity. Consistent timing helps the bladder maintain its natural ability to store urine between catheterizations.

Modern intermittent catheters feature hydrophilic coatings that become slippery when wet, eliminating the need for additional lubricant and making insertion smoother and more comfortable. Some catheters come pre-lubricated or packaged with sterile water for activation, making them convenient for use away from home.

Indwelling Catheters (Foley Catheters)

An indwelling catheter, commonly called a Foley catheter after its inventor Dr. Frederic Foley, remains in the bladder continuously and is held in place by a small balloon filled with sterile water. This balloon, called a cuff or retention balloon, inflates inside the bladder after insertion, preventing the catheter from slipping out.

The outer end of an indwelling catheter connects to a drainage bag that collects urine. During the day, a smaller leg bag can be strapped to the thigh under clothing, allowing mobility while remaining discreet. At night, a larger bedside drainage bag provides sufficient capacity for overnight urine collection without needing to empty frequently.

Indwelling catheters can be managed with either continuous drainage (always connected to a bag) or valve-controlled drainage. With a catheter valve, the catheter remains clamped between bathroom visits, allowing the bladder to fill and maintain some of its natural capacity. You open the valve to drain the bladder at regular intervals, typically every 3-4 hours.

Healthcare professionals insert indwelling catheters, typically nurses or physicians. The procedure involves local anesthetic gel applied to the urethra, waiting for it to take effect, then gently advancing the catheter until urine flows. The retention balloon is then inflated with sterile water. While the insertion may cause brief discomfort, the anesthetic ensures it isn't painful.

Suprapubic Catheters

A suprapubic catheter is inserted directly into the bladder through a small surgical incision in the abdominal wall, just above the pubic bone. This bypasses the urethra entirely, which offers significant advantages for certain patients. The procedure is performed by a physician, often a urologist, and requires local anesthesia and sometimes mild sedation.

The suprapubic approach is particularly beneficial for people who need long-term catheterization, have urethral damage or strictures, or who find urethral catheters uncomfortable. Because the catheter doesn't pass through the urethra, it's generally more comfortable for extended use and poses less risk of urethral trauma.

For sexually active individuals, suprapubic catheters offer a major advantage: they don't interfere with the genitals. This makes intimacy more natural and comfortable. The catheter site on the abdomen can be managed discretely during sexual activity, and the catheter itself doesn't affect sexual function.

Initial insertion of a suprapubic catheter requires a minor surgical procedure, but subsequent changes are typically straightforward and can often be performed by trained nurses. The bladder should be reasonably full during insertion to make it easier to locate and access safely.

How Do You Prepare for Getting a Catheter?

Preparation depends on the catheter type: for intermittent catheters, wash your hands thoroughly and have clean supplies ready. For indwelling or suprapubic catheters, shower and clean the genital or abdominal area before your appointment. Your healthcare team will explain the specific procedure and answer your questions.

The preparation process varies depending on which type of catheter you'll receive and whether you're learning self-catheterization or having a healthcare professional insert the catheter for you. Regardless of the type, understanding what to expect helps reduce anxiety and ensures a smoother experience.

For any catheterization procedure, wearing loose, comfortable clothing that provides easy access to the lower body is helpful. You'll only need to undress from the waist down during the procedure. Bringing a list of questions for your healthcare provider ensures you don't forget important concerns in the moment.

Preparing for Intermittent Self-Catheterization

If you're learning to perform intermittent self-catheterization, your healthcare provider—usually a nurse specialist called a continence nurse or urotherapist—will schedule a teaching session. This training covers the anatomy involved, proper technique, and troubleshooting common issues.

Before each self-catheterization at home, the preparation is straightforward: wash your hands thoroughly with soap and water for at least 20 seconds. While you don't need to wash the genital area each time, keeping generally clean through regular daily hygiene is important. Have all your supplies—catheter, lubricant if needed, and disposal materials—within easy reach before you begin.

Preparing for an Indwelling Catheter

Before having an indwelling catheter inserted through the urethra, you'll be asked to clean the genital area thoroughly. This can be done with soap and water or an antiseptic cleanser. Your healthcare facility will provide specific instructions, but showering or washing immediately before your appointment is typically recommended.

The insertion usually takes place in a clinic, hospital ward, or sometimes at home with a visiting nurse. You'll lie down on an examination table, and the area will be cleaned again with antiseptic solution. A sterile drape covers the surrounding area to maintain cleanliness during the procedure.

Preparing for a Suprapubic Catheter

Suprapubic catheter insertion requires more preparation because it's a minor surgical procedure. You'll be asked to shower and clean the lower abdomen thoroughly beforehand. It's helpful to arrive with a full bladder, as this makes the bladder easier to locate and reduces the risk of complications during insertion.

For children receiving suprapubic catheters, the process may involve sedation or brief general anesthesia to ensure their comfort and cooperation. Parents are typically allowed to stay with their child before and after the procedure, and the healthcare team will provide age-appropriate explanations.

How Do You Perform Intermittent Self-Catheterization?

Clean intermittent self-catheterization involves washing hands, preparing the catheter with water or lubricant, positioning yourself comfortably (usually sitting on the toilet), gently inserting the catheter through the urethra until urine flows, allowing complete bladder drainage, then slowly removing and disposing of the catheter.

Learning to perform intermittent self-catheterization may seem daunting at first, but most people master the technique quickly with proper instruction. Healthcare professionals report that patients often become proficient within just a few training sessions. The key is patience, practice, and following proper hygiene protocols.

Self-catheterization gives you independence and control over your bladder management. Unlike indwelling catheters that require healthcare visits for changes, intermittent catheterization can be performed anywhere—at home, work, school, or while traveling. This flexibility makes it the preferred option for many people requiring long-term bladder management.

Step-by-Step Self-Catheterization Technique

Begin by gathering all necessary supplies: a single-use catheter, lubricant if your catheter isn't pre-lubricated, and hand washing materials. Find a private, clean location—a bathroom is ideal. You can perform the procedure sitting on the toilet, standing (for men), or lying down, depending on what works best for your mobility and comfort.

Step 1: Wash your hands thoroughly with soap and water for at least 20 seconds. This is the single most important step for preventing infection. Dry your hands with a clean towel.

Step 2: Prepare the catheter according to its type. For hydrophilic-coated catheters, wet the catheter with clean water to activate the slippery coating. For standard catheters, apply water-based lubricant to the tip and several inches of the catheter length.

Step 3: Position yourself comfortably. Men typically stand or sit and hold the penis at a slight upward angle to straighten the urethra. Women may use a mirror initially to locate the urethral opening, though most learn to find it by feel with practice.

Step 4: Gently insert the catheter into the urethral opening. Use steady, gentle pressure—never force the catheter if you meet resistance. For men, the catheter needs to advance further (about 7-8 inches) to reach the bladder; women's urethras are shorter (about 2 inches). Continue until urine begins to flow.

Step 5: Allow the bladder to drain completely. This typically takes 1-3 minutes. Coughing, changing position slightly, or pressing gently on the lower abdomen can help ensure complete emptying.

Step 6: Once urine flow stops, slowly withdraw the catheter. The slow removal allows any remaining urine in the urethra to drain. Dispose of single-use catheters properly.

Step 7: Wash your hands again after the procedure.

Tips for Successful Self-Catheterization

Consistency helps develop muscle memory and makes the process easier over time. Try to catheterize at similar times each day, coordinating with your fluid intake and activity patterns. Most people find that 4-6 catheterizations per day maintains comfortable bladder volumes.

When traveling, pack extra supplies in case of delays or emergencies. Pre-lubricated or water-filled catheters are convenient when clean water isn't readily available. Many people keep a small supply of catheters at their workplace, in their car, or at locations they visit frequently.

Parents can learn to perform catheterization for children who need it, and older children can often learn self-catheterization themselves. The training process is similar but adapted for the child's age, cognitive ability, and anatomy.

How Do You Care for an Indwelling Catheter?

Indwelling catheter care includes: washing hands before handling, cleaning the genital area daily, keeping the drainage bag below bladder level, emptying the bag regularly, drinking at least 2 liters of fluid daily, and having the catheter changed every 2-3 months. Never disconnect the catheter from the bag except when changing bags.

Living with an indwelling catheter requires attention to daily care routines, but most people adapt well and maintain normal activities. The key principles are maintaining cleanliness, ensuring proper drainage, staying well-hydrated, and knowing when to seek medical help. With good care, complications can be minimized.

Your healthcare team will provide detailed instructions specific to your situation before you leave the hospital or clinic. Don't hesitate to ask questions or request written materials you can reference at home. Many healthcare systems also offer phone support lines where you can get advice about catheter-related concerns.

Daily Hygiene and Cleaning

Wash your hands thoroughly before and after any contact with the catheter or drainage system. This simple step is your most effective defense against infection. When helping someone else with their catheter, caregivers should wear disposable gloves.

For urethral indwelling catheters, clean the genital area daily with mild soap and water, including the first few inches of catheter tubing closest to the body. Gently clean away any secretions that may accumulate around the catheter entry site. Women should always wipe from front to back to prevent fecal bacteria from reaching the urethral area.

For suprapubic catheters, clean the skin around the insertion site two to three times weekly, or more often if there's discharge. Check the site for signs of infection such as redness, swelling, or unusual drainage. Once the site is fully healed (usually 2-4 weeks after insertion), showering and bathing are permitted.

Managing the Drainage Bag

The drainage bag must always be kept below the level of your bladder to ensure urine flows downward by gravity and doesn't flow back into the bladder. Backflow of urine significantly increases infection risk. When lying down, hang the bag from the bed frame, not on the floor.

Empty the drainage bag regularly—at least every 8 hours or when it's about two-thirds full. Use the drainage tap at the bottom of the bag, letting urine flow into the toilet. Avoid letting the tap touch the toilet bowl or any surface. After emptying, wash your hands.

Leg bags (smaller, daytime bags) should be changed to larger night bags before sleep to avoid overnight interruptions. When switching bags, clean the connection point with an alcohol swab before reconnecting. Replace drainage bags every 5-7 days, or sooner if they become discolored, develop odor, or show signs of sediment buildup.

Maintaining Bladder Function

If your healthcare provider recommends it, keep the catheter clamped (closed) between bathroom visits rather than allowing continuous drainage. This helps the bladder maintain some of its natural capacity to hold urine. You open the catheter or valve every 3-4 hours, or when you feel the urge to urinate.

This intermittent drainage approach is beneficial if you may eventually have the catheter removed, as it preserves bladder muscle tone. However, some medical conditions require continuous drainage—follow your healthcare provider's specific recommendations.

Fluid Intake and Diet

Drinking adequate fluids is crucial when you have a catheter. Aim for at least 2 liters (about 8 glasses) of fluid daily, unless your doctor has advised otherwise for medical reasons. Good hydration keeps urine dilute, helps flush the bladder and catheter, and reduces the risk of sediment buildup and blockages.

All fluids count toward your daily intake, including water, tea, coffee, juice, and milk. Foods with high water content like fruits and vegetables also contribute. Spread your fluid intake throughout the day rather than drinking large amounts at once.

What Problems Can Occur With Urinary Catheters?

Common catheter complications include urinary tract infections (most common), catheter blockages, urine leakage around the catheter, bladder spasms, and, rarely, urethral injury. Most problems are preventable with proper care, and prompt attention to warning signs prevents serious complications.

While complications can occur with any type of catheter, understanding potential problems helps you recognize early warning signs and take appropriate action. Many issues are minor and easily resolved, but some require prompt medical attention. Knowing the difference can prevent serious health consequences.

The risk of complications varies by catheter type. Intermittent catheterization generally has the lowest complication rate, particularly for infections, which is one reason it's preferred for long-term use when possible. Indwelling catheters carry higher infection risk because they provide a continuous pathway for bacteria and create a surface for bacterial biofilm formation.

Catheter-Associated Urinary Tract Infections (CAUTI)

Bacteriuria (bacteria in the urine) is essentially universal in people with indwelling catheters—studies show that nearly all patients develop it within 30 days. However, this doesn't always mean infection requiring treatment. True catheter-associated urinary tract infection (CAUTI) involves bacteria plus symptoms, and this distinction matters for treatment decisions.

Signs of CAUTI include fever (over 38°C/100.4°F), new or worsening pain in the lower abdomen, back, or sides, cloudy or foul-smelling urine, blood in the urine (new onset), increased confusion or agitation (especially in elderly patients), and general malaise or feeling unwell.

Prevention strategies include meticulous hand hygiene, maintaining a closed drainage system (minimizing disconnections), ensuring adequate fluid intake, regular catheter changes, and removing the catheter as soon as medically possible. If you develop symptoms suggesting infection, contact your healthcare provider promptly—CAUTI typically requires antibiotic treatment.

Catheter Blockages

Blockages occur when sediment, crystite deposits, blood clots, or debris obstruct the catheter lumen, preventing urine flow. You might notice that no urine is draining into the bag despite normal fluid intake, or you may feel bladder fullness and discomfort. Blockages require prompt attention to prevent bladder overdistension.

Risk factors for blockage include insufficient fluid intake, infrequent catheter changes, and alkaline urine pH (which promotes crystal formation). Drinking adequate fluids helps prevent blockages by keeping urine dilute. If a blockage occurs, healthcare professionals can flush the catheter with sterile solution, but if this fails, the catheter must be replaced.

Leakage Around the Catheter

Urine leaking around the catheter rather than draining through it has several possible causes. The catheter may be blocked, causing pressure buildup. Bladder spasms can force urine around the catheter. The catheter may be too small for your anatomy, or the retention balloon may have partially deflated.

First, check that the drainage system isn't kinked or blocked and that the bag isn't overfull. If the drainage pathway is clear but leaking continues, contact your healthcare provider. Solutions might include changing to a different catheter size, treating bladder spasms with medication, or addressing an underlying cause.

Bladder Spasms

Bladder spasms are involuntary contractions of the bladder muscle that can cause cramping pain, urgency, and leakage around the catheter. The bladder essentially "objects" to the foreign body and tries to expel it. Spasms are more common with indwelling catheters than with intermittent catheterization.

Medications called anticholinergics or antimuscarinics can help control bladder spasms. These include oxybutynin, tolterodine, and solifenacin. If you experience significant spasms, discuss treatment options with your healthcare provider.

When Is a Suprapubic Catheter a Better Choice?

Suprapubic catheters may be preferred for long-term catheterization, when urethral insertion is problematic, for people who sit in wheelchairs most of the day, for those with an active sex life, and when urethral trauma or strictures prevent urethral catheterization.

While urethral catheters (through the urethra) are more common, suprapubic catheters offer distinct advantages for certain populations. Understanding these benefits helps patients and healthcare providers make informed decisions about the most appropriate catheterization approach.

The suprapubic route bypasses the urethra entirely, eliminating urethral trauma and irritation associated with indwelling urethral catheters. For people requiring permanent or very long-term catheterization, this can significantly improve comfort and reduce complications over time.

Advantages for Wheelchair Users

For individuals who spend most of their time sitting, particularly wheelchair users, suprapubic catheters offer significant comfort advantages. Urethral catheters can cause pressure and irritation in the seated position, while suprapubic catheters avoid this issue entirely. The abdominal placement also makes catheter management easier from a seated position.

Benefits for Sexual Activity

Sexual intimacy is possible with all types of catheters, but suprapubic catheters cause the least interference. Because the catheter doesn't pass through the genitals, it doesn't affect erection capability, vaginal access, or genital sensation. The catheter can be taped out of the way during sexual activity, making intimacy more natural and comfortable.

When Urethral Catheterization Isn't Possible

Certain conditions make urethral catheterization difficult or impossible: urethral strictures (narrowing), previous urethral surgery, pelvic trauma affecting the urethra, or anatomical abnormalities. In these cases, suprapubic catheterization provides an alternative route for bladder drainage.

When Should You Contact a Healthcare Provider?

Contact your healthcare provider if you experience fever, severe abdominal or back pain, significant blood in urine, blocked catheter, persistent leakage, or symptoms that don't match the information you've been given. Call emergency services for difficulty breathing, severe bleeding, or signs of sepsis.

Knowing when problems require professional attention is crucial for catheter users. While minor issues can often be managed at home with the techniques you've learned, certain symptoms warrant prompt medical evaluation to prevent serious complications.

Contact Your Healthcare Provider For:

• Pain in the lower abdomen, pelvis, or back (especially new or worsening)
• Fever above 38°C (100.4°F)
• Blood in urine (after the catheter has been in place for some time)
• Catheter blockage that you cannot resolve
• Persistent urine leakage around the catheter
• Unusual discharge from around the catheter site
• Symptoms that don't match the information you were given
• For children: lethargy, refusal to eat, unusual fussiness

In emergency situations—severe pain, significant bleeding, signs of systemic infection (high fever, chills, rapid heartbeat, confusion), or breathing difficulties—call emergency services immediately. Do not wait to see if symptoms improve.

What Is Daily Life Like With a Urinary Catheter?

Most people adapt well to living with a catheter and maintain normal activities including work, travel, exercise, and social life. Key adjustments include planning for catheter care, wearing accommodating clothing, staying well-hydrated, and being prepared with supplies. Sexual activity remains possible with all catheter types.

Adjusting to life with a urinary catheter involves both physical and psychological adaptation. Initially, many people feel self-conscious or worry that others will notice their catheter. In reality, catheters and drainage bags are easily concealed under normal clothing, and most people go about their daily activities without others being aware of their catheter.

The psychological adjustment varies by individual. Some people feel relief that their urinary problems are finally managed; others grieve the loss of normal bladder function. Both reactions are valid. Support groups, both in-person and online, connect catheter users with others who understand their experience and can share practical advice.

Clothing and Discretion

Leg bags can be worn strapped to the thigh or calf, hidden under pants, skirts, or dresses. Specialized underwear and leg bag holders are available that make wearing a catheter more comfortable and secure. Many people find that slightly looser-fitting pants accommodate the drainage tubing more comfortably.

For suprapubic catheters, the abdominal tubing can be routed under clothing to a leg bag or, when sitting for extended periods, directly to a larger bag placed discreetly at ground level. High-waisted pants or skirts easily conceal the catheter site.

Work, Travel, and Activities

Most people with catheters continue working normally. If your job involves physical activity, ensure the catheter and bag are secured to prevent pulling or displacement. Office workers may find it helpful to have spare supplies at their workplace.

Travel requires planning but is entirely manageable. Pack more supplies than you think you'll need, and carry essential items in your hand luggage when flying. Airlines are generally accommodating of medical needs, and special security screening procedures exist for medical devices. Notify airport security if you have a catheter to ensure a dignified screening process.

Exercise and physical activity are encouraged with appropriate precautions. Swimming is possible with proper waterproof covers for drainage bags. Contact your healthcare provider for specific guidance based on your catheter type and overall health.

Sexual Activity

Sexual intimacy is possible with all types of catheters, though some adjustments may be needed. For urethral catheters, men can fold the catheter along the penis and use a condom over both, or temporarily remove an intermittent catheter before activity. Women can tape the catheter out of the way.

Suprapubic catheters interfere less with sexual activity since they don't involve the genitals. The catheter can be taped to the side of the abdomen, and neither partner's genital access is impeded. Intermittent self-catheterization has no impact on sexual function, as the catheter is only present during the brief drainage procedure.

Open communication with your partner about what works comfortably helps maintain intimacy. If you have questions or concerns about sexual activity with your catheter, discuss them with your healthcare provider.