Urinary catheters – NHS

A urinary catheter is a flexible tube used to empty the bladder and collect urine in a drainage bag.

Urinary catheters are usually inserted by a doctor or nurse.

They can either be inserted through the tube that carries urine out of the bladder (urethral catheter) or through a small opening made in your lower tummy (suprapubic catheter).

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

When urinary catheters are used

A urinary catheter is usually used when people have difficulty peeing (urinating) naturally. It can also be used to empty the bladder before or after surgery and to help perform certain tests.

Specific reasons a urinary catheter may be used include:

• to allow urine to drain if you have an obstruction in the tube that carries urine out of your bladder (urethra). For example, because of scarring or prostate enlargement
• to allow you to urinate if you have bladder weakness or nerve damage that affects your ability to pee
• to drain your bladder during childbirth if you have an epidural anaesthetic
• to drain your bladder before, during or after some types of surgery
• to deliver medicine directly into the bladder, such as during chemotherapy for bladder cancer
• as a last resort treatment for urinary incontinence when other types of treatment have been unsuccessful

Depending on the type of catheter you have and why it’s being used, the catheter may be removed after a few minutes, hours or days, or it may be needed for the long term.

Types of urinary catheter

There are 2 main types of urinary catheter:

• intermittent catheters – these are temporarily inserted into the bladder and removed once the bladder is empty
• indwelling catheters – these remain in place for many days or weeks, and are held in position by an inflated balloon in the bladder

Many people prefer to use an indwelling catheter because it’s more convenient and avoids the repeated insertions needed with intermittent catheters. However, indwelling catheters are more likely to cause problems such as infections.

Inserting either type of catheter can be uncomfortable, so anaesthetic gel may be used on the area to reduce any pain. You may also experience some discomfort while the catheter is in place, but most people with a long-term catheter get used to this over time.

Read more about the types of urinary catheter.

Looking after your catheter

If you need a long-term urinary catheter, you’ll be given detailed advice about looking after it before you leave hospital.

This will include advice about getting new catheter supplies, reducing the risk of complications such as infections, spotting signs of potential problems, and when you should get medical advice.

You should be able to live a relatively normal life with a urinary catheter. The catheter and bag can be concealed under clothes, and you should be able to do most everyday activities, including working, exercising, swimming and having sex.

Read more about living with a urinary catheter.

Risks and potential problems

The main problems caused by urinary catheters are infections in the urethra, bladder or, less commonly, the kidneys. These types of infection are known as urinary tract infections (UTIs) and usually need to be treated with antibiotics.

You can get a UTI from using either a short-term or a long-term catheter. However, the longer a catheter is used, the greater the risk of infection. This is why it’s important that catheters are inserted correctly, maintained properly, and only used for as long as necessary.

Catheters can also sometimes lead to other problems, such as bladder spasms (similar to stomach cramps), leakages, blockages, and damage to the urethra.

Read more about the risks of urinary catheterisation.

Page last reviewed: 03 February 2023
Next review due: 03 February 2026

The Hidden (And Not-So-Hidden) Dangers Of Treating Incontinence With Urinary Catheters

This is the second in a 3-part series on urinary incontinence in men suffering with benign prostatic hyperplasia. Dr. Richard Roach, of Advanced Urology in Oxford, FL, discusses the challenges of using urinary catheters to treat men with BPH-related incontinence, and the drawbacks of long-term catheterization.  

In my last BHEALTH blog post, we touched on the peculiar, yet common link between BPH and incontinence. Among other topics, we reviewed the progression of BPH disease state, to the point that symptoms begin to manifest themselves through urge and stress incontinence. Likewise, we also discussed the role that urinary catheters play in men who are not good candidates for BPH therapies.

So let’s now take a closer look at this population of men who must rely on urinary catheters to manage BPH-related incontinence symptoms, and examine the shortcomings of long-term catheter use:

Losing the ability to void naturally

The first (and most obvious) drawback of chronic catheter use is losing the ability to urinate at-will. Of course, managing supplies and components can be a hassle, but there are also health concerns associated with preventing your bladder to fill and empty on its own. Chronic catheterization, particularly with an indwelling catheter, can increase the risk for deterioration in overall bladder health, which can lead to a permanent inability to store and drain urine naturally, or even cancer.

Heightened infection risk

Perhaps the most immediate health concern with chronic catheter use is the heightened risk of infection. According to the Centers for Disease Control, more than 500,000 patients each year in the U. S. develop urinary tract infections (UTIs) while in the hospital, and indwelling urinary catheters (commonly known as Foley catheters, which reside inside the bladder for either a short or long period of time) are the leading cause. And the CDC numbers only count UTIs acquired while in the hospital; many others develop infections from long-term indwelling catheter use at home.

Compromises to quality of life

The last, but no less important, drawback of chronic catheter use is the impact on quality of life. Many men are simply unable to perform day-to-day activities inside and outside the home. The embarrassment or inconvenience of a drainage bag is a commonly lamented life-limiter, and some types of catheterization restrict a man’s ability to be sexually active, which can strain relationships.

These challenges represent the key reasons that healthcare professionals around the world are seeking alternatives to long-term catheter use. And though it’s not always feasible to have a catheter removed, it’s important to point out that there are alternatives to long-term catheterization.

The final post in this series will highlight the story of one such patient who stopped using a catheter after several challenge-fraught years, and gained back his ability to urinate when he wanted to – without components or supplies, without infections and (most importantly for him) without any significant compromises to his everyday life.

Read part 3 of this series here.

Dr. Richard Roach attended the University of Wisconsin-Madison Medical School and completed his residency at the University of Wisconsin-Madison Hospital and Clinics. After graduation, Dr. Roach moved to Minocqua, Wisconsin and joined the Marshfield Clinic, where he practiced for the next 26 years. In 2013, he moved to Florida and is currently a partner in Advanced Urology Institute. He is certified by the American Board of Urology. His specialties include plasma vaporization for BPH, treatment of female stress incontinence and penile prosthesis for ED. He is also an expert in laser & laparoscopic surgery.

What to do after removing a catheter due to prostate surgery

This information will help you know what to do after removing a catheter due to prostate surgery.

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What to do after prostate surgery

Control urinary problems

Your bladder and urethra will be weak for 2 days after your catheter is removed. Don’t try to push while urinating or force yourself to urinate. Let the urine come out on its own. Do not strain when emptying your bowels.

Limit your daily fluid intake to 4-6 glasses (8 ounces or 240 ml) of fluid per day. This will help reduce urine leakage. If you are leaking urine, limit the amount of alcohol and caffeine you drink.

Limit fluids after 7:00 pm and empty your bladder before bed. This will help you avoid having to get up at night to urinate.

You may notice blood or blood clots in your urine for several weeks after your catheter is removed. This is because the incisions (surgical cuts) inside your body heal, and the crusts that form on them are excreted in the urine. If you notice blood in your urine, drink more fluids until your urine clears. If there is still blood in the urine after 24 hours, call your surgeon.

Do Kegel exercises

Start Kegel exercises (pelvic floor exercises) 3 days after catheter removal. Discuss with your healthcare provider which exercises are safe for you. For more information, read the resource Pelvic Floor Exercises (Kegel Exercises) for Men.

Take your medication

Finish your antibiotics.

Get your results

Results will be available approximately 10 business days after surgery. Call your doctor for results.

Schedule prostate specific antigen (PSA) blood tests

Do a PSA blood test according to the following schedule:

• 6–8 weeks after surgery;
• 3–6 months after surgery;
• 12 months after the operation.

After 12 months of surgery, do a PSA blood test every 6 months. With this frequency, the analysis should be performed within 5 years after surgery.

After 5 years of surgery, have a PSA blood test every 12 months. It is recommended to perform throughout life.

Your doctor may ask you to test your PSA blood more often.
In this case, the nurse will provide you with additional information.

Get your PSA blood tested at MSK if possible. If this is not possible, you can contact the health care center at your place of residence. Ask for the results to be faxed to your doctor at MSK.

Follow your sexual activity plan

Talk to your health care provider about when it is safe for you to resume sexual activity after your procedure.

You can start your erection medication on the evening of the day your catheter is removed. You may need to take one of these medicines daily for up to 1 year after surgery. Discuss with your surgeon how long you will need to take these drugs.

Your doctor or nurse will give you information about your medication schedule. Follow this schedule until your post-op appointment with your surgeon.

The following are options for this schedule:

Bolting dose information

Bolting dose is the maximum dose of the drug. This is most likely the dose needed to achieve an erection (the hardening of the penis needed for intercourse). When you take a loading dose, take it on an empty stomach (on an empty stomach). Drink the medicine about 2 hours before dinner.

The medicine starts working after 30-60 minutes. Its effect will remain in the body for up to 8 hours. At any time during these 8 hours, try to achieve sexual arousal from contact with a partner or from self-stimulation. Write down what happened and tell your doctor about it at your next appointment.

If you haven’t had an erection after 4 weeks of loading dose, call your doctor. He can refer you to our sexual health specialists.

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When to call your surgeon

Call your surgeon immediately if you have:

• there was a strong (very strong) pain in the lower part of the abdominal cavity (belly) when urinating;
• no urination.

These symptoms may indicate that the catheter needs to be reinserted. If you are unable to come to MSK, you can have a catheter placed at your local urologist or at the nearest emergency room. Report that you have recently had prostate surgery. Tell your MSK doctor the next business day that you went to your community or emergency room for care.

Call your surgeon if you have:

• burning sensation at the tip of the penis that does not go away after 3 days or gets worse;
• lack of erection after taking a loading dose for 4 weeks;
• blood in the urine, which is still observed 24 hours after drinking more liquid.

If you have any questions or concerns, please discuss them with your healthcare team. You can contact a specialist from Monday to Friday from 9:00 to 17:00. After 5:00 pm, on weekends and holidays, call 212-639-2000. Ask to be connected to the urologist on duty.

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Urinary incontinence in women, causes and treatment

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Urinary incontinence in women

More than half of women worldwide experience urinary incontinence. Incontinence (another name for incontinence) occurs in young women, for example, after childbirth, and in elderly patients, and in some women this delicate problem appears even in adolescence and does not go away for a long time. In any case, this negatively affects the quality of life, causes a lot of inconvenience, and therefore requires special attention.

Treatment of urinary incontinence in women largely depends on the form of the disease. Only a professional can establish the true cause and choose an effective method of treatment. If you are faced with the problem of incontinence, seek qualified help from the specialists of our clinic.

Types of incontinence and their characteristics

Age-related urinary incontinence

Urinary incontinence in women after 40

Over the years, the pathology progresses. One in two 40-year-old women complains of incontinence at:

• coughing;
• sneezing;
• laughter
• jumping.

The causes of urinary incontinence in women over 40 may be postpartum consequences and gynecological complications. Also, the reason may be a reduction in the synthesis of collagen in the body. The function of collagen is to maintain the elasticity of the tissues of the pelvic floor organs, urethral sphincters. Frequent stress, malnutrition, chronic lack of sleep, a sedentary lifestyle lead to hypovitaminosis and provoke the development of weakness in the pelvic floor muscles. As a result, the internal organs are displaced and lowered.

Urinary incontinence in women over 50

After 50 years, the female body begins to work differently – the hormonal background changes, the pressure can be unstable.

Causes of incontinence in women over 50:

• Diabetes mellitus, thyroid disease, overactive bladder;
• Age-related hormonal changes;
• Difficult childbirth in history;
• Chronic inflammation of the pelvic organs;
• Hypertension and medication;
• Lifting weights, straining the pelvic floor muscles, prolapsing organs.

Urinary incontinence in women over 60

Urinary incontinence in women over 60 years of age is quite common. Menopause comes, the reproductive system ceases to function, as a result, female sex hormones are not produced. Age-related changes become more noticeable, the pelvic muscles lose their tone, the walls of the urinary tract coarsen and become less elastic, the lack of female sex hormones leads to a reduced tone of the bladder. All of these can lead to incontinence.

Stress incontinence

The most common form of incontinence. The main reason for uncontrollable urination in this case is dysfunction of the urethral sphincter. Due to muscle weakness, increased intra-abdominal pressure causes uncontrolled leakage of urine.

Symptoms:

• leakage of urine even with slight exertion, sneezing, coughing, while laughing;
• there are no irresistible urges to urinate.

Causes of stress incontinence:

• Pregnancy: due to hormonal changes and increased uterine pressure on the pelvic organs, many women suffer from small urine leaks (especially often this problem manifests itself in the last stages).
• Childbirth: spontaneous childbirth with a particularly large fetus often causes damage to the muscles and ligaments of the pelvic floor, this leads to sphincter dysfunction and frequent uncontrolled urine leakage.
• Operations on the pelvic organs: the adhesive process that begins after any intervention violates the anatomical relationship of the organs and provokes an increase in pressure in the small pelvis, which can cause uncontrolled urination.
• Age-related changes: a decrease in the level of estrogen produced leads to a loss of elasticity of the ligaments and a decrease in muscle tone, which negatively affects the functioning of the sphincter.

The likelihood of problems with uncontrolled urination is also influenced by factors such as heredity, neurological diseases, obesity, urinary tract infections.

Stress incontinence causes a lot of trouble and significantly worsens the lives of patients. In order to solve the problem once and for all, it is important not to delay going to the doctor, and at the doctor’s appointment, do not be shy and tell in detail about the symptoms so that the specialist can choose the most effective treatment for urinary incontinence.

Stress incontinence treatment features

In stress incontinence, surgical treatment is preferable. Drug therapy is effective only in some cases, while the following drugs are used: adrenomimetics (Gutron), anticholinesterase drugs (Ubretide), antidepressants (Cymbalta).

Urgent incontinence

The reason for the imperative urge to urinate frequently is the high reactivity of the bladder.

Normally, the urge to urinate occurs when a certain amount of urine accumulates in the bladder. At the same time, a woman can easily restrain her urges until the next visit to the toilet room. In the case of an overactive bladder, even a minimal amount of urine causes strong, unbearable urges.

The occurrence of urge incontinence is influenced by the same factors as in the case of stress incontinence, in addition, these two forms of incontinence often combine, giving the woman additional inconvenience.

Symptoms of urge incontinence include:

• frequent, unbearable urge to urinate;
• urges are usually determined by external factors;
• The urge to urinate is almost always sudden.

Treatment of urge urinary incontinence

To eliminate frequent imperative urge to urinate, non-drug, general methods of treatment, in particular therapeutic exercises, are preferred. Surgical intervention in this case is ineffective, and drug treatment is used only if the general methods did not give the desired result.

Drugs for the treatment of urinary incontinence in women:

• drugs that relax the bladder wall, minimize the frequency of its contractions: Vesicar, Driptan, Spasmex, Detruzitol.
• medicines that improve the blood circulation of the bladder and at the same time relax it in the filling phase: Omnic, Kaldura, Dalfaz.
• hormone replacement therapy in case of estrogen deficiency in menopausal women.

If drug therapy is not effective enough, it is also possible to use botulinum toxin type A preparations (for example, Lantox) to treat an overactive bladder.

During cystoscopy, using an endoscopic needle, a solution of the Lantox drug is injected into the wall of the bladder, which temporarily blocks the contraction of muscle fibers, reducing the reactivity of the bladder.

Drug incontinence

Otherwise, iatrogenic incontinence. This type of disease can occur as a result of taking certain drugs: adrenomimetics, diuretics, colchicine, and some sedatives.

Other forms of urinary incontinence

Uncontrollable urge to urinate and leakage of urine can also cause multiple sclerosis, damage to the brain or spinal cord, and other organic damage.

Diagnostics

Finding out the causes of incontinence and developing an effective treatment plan are impossible without a comprehensive examination, which includes the following steps:

• specialist advice

At the doctor’s appointment, the patient should be as detailed as possible about the problem and complaints. Particular attention should be paid to the factors that provoke incontinence, the severity of symptoms and the time of their onset, and possible additional complaints.

It is also proposed to fill out a questionnaire created specifically for people suffering from urinary incontinence.

• urination diary

Detailed, regular records of urination and incontinence will help the doctor more accurately determine the cause of the disease and prescribe effective treatment.

• PAD test

Used to assess the severity of the disease. The pad test helps to more accurately determine the amount of urine lost, which is necessary for a correct diagnosis.

• gynecological examination

A standard examination of the external genital organs and the vagina with the help of a gynecological mirror allows you to exclude the presence of other diseases. During the examination, a cough test is also used, when the doctor checks whether urine is excreted from the urethra when coughing.

• urinalysis

Urine analysis is carried out in order to identify inflammatory processes in the organs of the genitourinary system, which can also be the cause of incontinence of small portions of urine. Infections are indicated by white blood cells, red blood cells, and bacteria in the urine.

• urodynamic studies

Includes a number of tests necessary to determine the type of incontinence and assess the functional state of the bladder and urethra.

• Imaging (ultrasound, MRI)

Ultrasound is used to determine the degree of displacement of the bladder and urethra when urinating or coughing, and MRI can detect various abnormalities that other imaging methods do not show.

Treatment of urinary incontinence in women

Therapy for any type of urinary incontinence begins with fairly simple and affordable, but effective methods. These include, first of all, lifestyle correction and the implementation of special exercises:

• normalization of weight in obesity (large body weight is a serious burden on the entire body, in particular, intra-abdominal pressure increases, which negatively affects the normal arrangement of internal organs, disrupting urination)
• reduction of caffeinated beverages consumed (coffee, tea and some other drinks provoke frequent urge to urinate)
• smoking cessation (chronic nicotinic bronchitis, which many smokers suffer from, exacerbates urinary incontinence problems)
• treatment of chronic respiratory diseases
• creation and maintenance of urination regimen (the method is based on emptying the bladder at strictly defined hours, regardless of the urge to urinate)
• pelvic floor muscle training (special exercises to strengthen the sphincter muscles to get rid of involuntary urination).

Surgical methods for the treatment of stress urinary incontinence in women include:

• Sling (loop) operations

Modern minimally invasive TVT and TVT-O surgeries are considered one of the most effective ways to treat stress urinary incontinence.

The duration of the procedure is on average 30 minutes. During the operation, a special synthetic loop is placed under the middle part of the urethra, which holds the urethra in the required position and prevents involuntary leakage of urine.

The main advantages of the technique are minimally invasiveness, safety and quick recovery. In this case, the effect is felt almost immediately.

The disadvantage of TVT and TVT-O operations is the likelihood of recurrences. But, despite this shortcoming, the method is considered the most effective.

• Bulk injections

Injections of special drugs under the control of a cystoscope are injected into the submucosa of the urethra. Fillers replace the missing soft tissues and thus keep the urethra in the correct position.

Gymnastics in the treatment of urinary incontinence in women

Kegel exercises

Kegel exercises for urinary incontinence in women show particular effectiveness. At the heart of gymnastics is the training of the pelvic floor muscles. To find the “necessary” muscles, it is necessary to imagine the urge to urinate while sitting and try to “hold” the imaginary stream of urine. It is the muscles involved in this process that need to be trained.

Gymnastics is performed three times a day. During training, the muscles tense and relax, gradually increasing the contraction time from a few seconds to 2-3 minutes.

Biofeedback exercise program

During training, a special biofeedback apparatus (BFB) is used, which registers muscle tone. In addition to monitoring the correctness of the exercises performed, the device can also be used for electrical stimulation.

Gymnast using special equipment

If desired, during training, the patient can use special simulators that allow you to most effectively strengthen the muscles of the pelvic floor.

Prevention of urinary incontinence

To prevent problems with urination, the following rules must be observed:

• Maintain normal body water balance, which requires drinking up to 2 liters of water per day. But it should be noted: excessive drinking, as well as a lack of fluid, can adversely affect a person’s well-being.
• Create and maintain an individual urination regimen: the habit of emptying the bladder at a certain time helps to normalize urination, reduce the reactivity of the bladder.
• Do therapeutic exercises, strengthen the muscles of the pelvic floor.
• Maintain normal weight, get rid of extra pounds.
• Reduce consumption of coffee, tea, other caffeinated drinks, and salty foods.
• Quit smoking and other bad habits.