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Indwelling Urinary Catheter: Types, Care and Risks

An indwelling urinary catheter is a flexible tube inserted into the bladder to continuously drain urine. It is used when normal bladder emptying is not possible due to illness or surgery.

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Things worth knowing about "Indwelling Urinary Catheter"

An indwelling urinary catheter is a flexible tube inserted into the bladder to continuously drain urine. It is used when normal bladder emptying is not possible due to illness or surgery.

What Is an Indwelling Urinary Catheter?

An indwelling urinary catheter is a thin, flexible tube that is inserted through the urethra or the abdominal wall into the urinary bladder, where it remains in place for an extended period. It allows continuous drainage of urine into a collection bag and is used when a patient is unable to empty the bladder independently.

Types of Indwelling Catheters

Transurethral Indwelling Catheter

The most commonly used type, inserted through the urethra into the bladder. A small balloon at the tip of the catheter is inflated with sterile fluid after insertion to hold it in place. This type is widely known as the Foley catheter.

Suprapubic Catheter

This type is inserted through a small incision in the lower abdomen directly into the bladder, above the pubic bone. It is preferred for longer-term use or when transurethral access is not suitable, such as after certain surgeries or in cases of urethral injury.

Indications

Indwelling urinary catheters are used in a variety of medical situations, including:

Urinary retention: Inability to empty the bladder, e.g., due to an enlarged prostate or neurological conditions
Severe urinary incontinence: When other management strategies are insufficient
Postoperative care: To monitor urine output following pelvic or abdominal surgery
Critical illness or unconsciousness: When patients are unable to use the toilet independently
Palliative care: To improve comfort and quality of life in seriously ill patients

Care and Hygiene

Proper daily care of the catheter is essential to prevent complications. Key measures include:

Daily cleaning of the catheter entry site with water and mild soap
Adequate fluid intake to reduce the risk of urinary tract infections
Regular replacement of the urine collection bag under aseptic conditions
Monitoring for signs of infection, such as redness, swelling, or cloudy and foul-smelling urine

Possible Complications

The most common complication associated with indwelling urinary catheters is catheter-associated urinary tract infection (CAUTI). Other potential complications include:

Bladder spasms and discomfort
Blockage or kinking of the catheter
Injury to the urethra or bladder
Bladder stone formation with long-term use
Skin irritation around the suprapubic insertion site

When to Seek Medical Advice

Patients with an indwelling catheter should contact their healthcare provider if:

Urine stops draining into the bag (possible blockage)
Fever, pain, or a burning sensation develops
Urine becomes cloudy, blood-stained, or foul-smelling
The catheter becomes dislodged or falls out

References

World Health Organization (WHO): Report on the Burden of Endemic Health Care-Associated Infection Worldwide. Geneva, 2011.
Centers for Disease Control and Prevention (CDC): Guidelines for Prevention of Catheter-Associated Urinary Tract Infections. Atlanta, 2009.
Hooton T. M. et al.: Diagnosis, Prevention, and Treatment of Catheter-Associated Urinary Tract Infection in Adults. Clinical Infectious Diseases, 2010.

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