What are the potential complications of urinary catheterization. How can catheter use lead to incontinence. What percentage of hospitalized patients experience catheter-related issues. How to properly care for a urinary catheter. When are urinary catheters typically used in medical settings. What are the different types of urinary catheters available. How to reduce the risk of urinary tract infections with catheter use.

Understanding Urinary Catheters: Types and Uses

Urinary catheters are flexible tubes used to drain urine from the bladder when a person is unable to urinate naturally. They are commonly inserted by healthcare professionals and can be either urethral (inserted through the urethra) or suprapubic (inserted through a small opening in the lower abdomen).

There are two main types of urinary catheters:

• Intermittent catheters: Temporarily inserted and removed after emptying the bladder
• Indwelling catheters: Remain in place for extended periods, held by an inflated balloon in the bladder

Are indwelling catheters more convenient than intermittent catheters? While many people prefer indwelling catheters for their convenience, they are associated with a higher risk of complications, particularly infections.

Common Reasons for Catheter Use

Urinary catheters are typically used in the following situations:

1. Urinary obstruction due to scarring or prostate enlargement
2. Bladder weakness or nerve damage affecting urination
3. Draining the bladder during childbirth with epidural anesthesia
4. Before, during, or after certain surgical procedures
5. Delivering medication directly into the bladder (e.g., chemotherapy for bladder cancer)
6. As a last resort for treating urinary incontinence when other treatments have failed

The Prevalence of Catheter-Related Complications

Recent studies have shown that more than half of hospitalized patients who receive urinary catheters experience complications. This high prevalence underscores the importance of proper catheter management and risk assessment.

Do all patients with catheters develop complications? While not all patients will experience issues, the risk increases with the duration of catheter use. Healthcare providers must carefully weigh the benefits of catheterization against potential risks.

Can a Catheter Cause Incontinence?

One of the most concerning potential complications of long-term catheter use is the development of incontinence. But how exactly can a catheter lead to this issue?

Prolonged catheter use can weaken the bladder muscles and affect the normal nerve signals that control urination. This may result in:

• Reduced bladder capacity
• Involuntary bladder contractions
• Weakened urethral sphincter muscles

These changes can contribute to the development of urinary incontinence, particularly after catheter removal. It’s crucial for healthcare providers to monitor patients closely and implement strategies to maintain bladder function during long-term catheterization.

Urinary Tract Infections: A Major Concern

Urinary tract infections (UTIs) are the most common complication associated with catheter use. These infections can affect the urethra, bladder, or, in severe cases, the kidneys.

Why are catheterized patients at higher risk for UTIs? The presence of a catheter provides a direct pathway for bacteria to enter the urinary system. Additionally, the catheter can irritate the urethral lining, making it more susceptible to infection.

To reduce the risk of UTIs, healthcare providers should:

• Use sterile techniques during catheter insertion
• Maintain proper hygiene and catheter care
• Remove the catheter as soon as it’s no longer necessary
• Consider intermittent catheterization when appropriate

Other Potential Complications of Urinary Catheterization

While UTIs and incontinence are significant concerns, catheter use can lead to various other complications:

1. Bladder spasms: Similar to stomach cramps, these can cause discomfort and leakage
2. Catheter blockage: Can lead to urinary retention and increased infection risk
3. Urethral damage: Improper insertion or prolonged use may cause trauma to the urethra
4. Bladder stones: Long-term catheterization can increase the risk of stone formation
5. Hematuria: Blood in the urine due to irritation or trauma

Is it possible to completely eliminate the risk of catheter-related complications? While it’s challenging to eliminate all risks, proper catheter management and regular monitoring can significantly reduce the likelihood of complications.

Living with a Urinary Catheter: Tips for Patients

For patients requiring long-term catheterization, adapting to life with a urinary catheter can be challenging. However, with proper care and management, many individuals can maintain a relatively normal lifestyle.

Key tips for living with a urinary catheter include:

• Follow proper hygiene practices to reduce infection risk
• Stay well-hydrated to promote urine flow and prevent blockages
• Regularly inspect the catheter and surrounding area for signs of irritation or infection
• Wear comfortable, breathable clothing to accommodate the catheter and drainage bag
• Engage in regular physical activity as approved by your healthcare provider

Can patients with urinary catheters participate in normal activities? In most cases, patients can continue working, exercising, swimming, and even engaging in sexual activity with proper precautions and guidance from their healthcare provider.

Alternatives to Long-Term Catheterization

Given the potential risks associated with long-term catheter use, healthcare providers often explore alternative options for managing urinary issues. Some alternatives include:

1. Intermittent catheterization: Inserting a catheter several times a day to empty the bladder
2. External catheters: Condom-like devices for men that collect urine without internal insertion
3. Bladder training exercises: Techniques to improve bladder control and function
4. Medications: Drugs that can help manage overactive bladder or other urinary issues
5. Surgical interventions: Procedures to address underlying causes of urinary problems

Are these alternatives suitable for all patients? The appropriateness of these options depends on the individual’s specific condition, overall health, and personal preferences. A thorough evaluation by a healthcare professional is necessary to determine the best approach.

The Future of Catheter Technology: Reducing Complications

As the medical community becomes increasingly aware of the complications associated with urinary catheters, researchers are working to develop innovative solutions to improve patient outcomes.

Some promising advancements in catheter technology include:

• Antimicrobial coatings to reduce infection risk
• Smart catheters with sensors to detect blockages or infections early
• Biodegradable materials to minimize long-term tissue damage
• Improved drainage systems to reduce the risk of reflux and contamination

How soon will these new technologies be available to patients? While some innovations are already in use, others are still in the research and development phase. It may take several years before these advanced catheter technologies become widely available.

The Role of Patient Education in Reducing Complications

Proper patient education is crucial in minimizing the risks associated with urinary catheterization. Healthcare providers should ensure that patients and their caregivers understand:

1. Proper catheter care and hygiene practices
2. Signs and symptoms of potential complications
3. When to seek medical attention
4. The importance of following up with healthcare providers regularly
5. Strategies for maintaining overall urinary health

Can improved patient education significantly reduce catheter-related complications? Studies have shown that comprehensive patient education programs can lead to better outcomes, fewer infections, and improved quality of life for individuals with long-term catheters.

The Importance of Regular Catheter Assessments

For patients with long-term catheters, regular assessments by healthcare professionals are essential to prevent and detect complications early. These assessments should include:

• Evaluation of the catheter’s position and function
• Inspection of the insertion site for signs of infection or irritation
• Review of the patient’s hydration status and urine output
• Assessment of the patient’s overall comfort and quality of life
• Consideration of alternative management strategies when appropriate

How often should catheter assessments be performed? The frequency of assessments may vary depending on the individual’s risk factors and overall health status. Generally, patients with long-term catheters should be evaluated at least every 4-6 weeks, or more frequently if complications arise.

The Role of Multidisciplinary Care in Catheter Management

Effective catheter management often requires a multidisciplinary approach, involving various healthcare professionals:

1. Urologists: Specialists in urinary tract health and function
2. Nurses: Provide day-to-day catheter care and patient education
3. Infectious disease specialists: Manage and prevent catheter-related infections
4. Physical therapists: Assist with bladder training and pelvic floor exercises
5. Psychologists: Address the emotional and psychological impact of long-term catheterization

Does a multidisciplinary approach improve outcomes for catheterized patients? Research suggests that collaborative care models can lead to better patient outcomes, reduced complications, and improved quality of life for individuals with long-term catheters.

Addressing the Psychological Impact of Long-Term Catheterization

The need for long-term catheterization can have significant psychological effects on patients. Common emotional challenges include:

• Anxiety about potential complications or leakage
• Depression related to loss of independence or body image concerns
• Social isolation due to fear of embarrassment
• Reduced self-esteem and confidence
• Relationship difficulties, particularly regarding intimacy

How can healthcare providers address the psychological impact of catheterization? A holistic approach to care should include:

1. Regular mental health screenings for catheterized patients
2. Referrals to mental health professionals when needed
3. Support groups or peer counseling programs
4. Education on coping strategies and stress management techniques
5. Involvement of family members or caregivers in the support system

The Economic Impact of Catheter-Related Complications

Catheter-related complications not only affect patient health but also have significant economic implications for healthcare systems. The costs associated with these complications include:

• Extended hospital stays
• Additional medical treatments and procedures
• Increased use of antibiotics for catheter-associated UTIs
• Lost productivity for patients and caregivers
• Long-term care needs for patients with persistent complications

What strategies can healthcare systems implement to reduce the economic burden of catheter-related complications? Some effective approaches include:

1. Implementing evidence-based catheter insertion and care protocols
2. Investing in staff education and training on proper catheter management
3. Utilizing technology to track catheter use and prompt timely removal
4. Developing comprehensive discharge planning for catheterized patients
5. Conducting regular audits to identify areas for improvement in catheter care

The Role of Policy in Improving Catheter Safety

Healthcare policies play a crucial role in promoting safe catheter use and reducing complications. Some key policy considerations include:

• Mandatory reporting of catheter-associated infections
• Implementation of catheter insertion and removal protocols
• Reimbursement policies that incentivize appropriate catheter use
• Guidelines for regular reassessment of catheter necessity
• Standards for patient education and informed consent

Can policy changes significantly impact catheter-related complication rates? Evidence suggests that well-designed policies, when effectively implemented, can lead to substantial improvements in catheter safety and reduced complication rates.

Emerging Research in Catheter-Related Incontinence Prevention

As the medical community continues to grapple with the challenges of catheter-related incontinence, researchers are exploring innovative approaches to prevention and treatment. Some promising areas of study include:

1. Novel materials that reduce irritation and inflammation of the urethral lining
2. Bioengineered tissues to repair catheter-induced damage to the urinary tract
3. Advanced imaging techniques for early detection of bladder and urethral changes
4. Targeted therapies to maintain bladder muscle tone during long-term catheterization
5. Gene therapy approaches to enhance tissue regeneration and function

How might these research developments impact the future of catheter care? While many of these approaches are still in early stages, they hold the potential to significantly reduce the incidence of catheter-related incontinence and improve outcomes for patients requiring long-term catheterization.

The Importance of Patient-Centered Care in Catheter Management

Adopting a patient-centered approach to catheter care is essential for improving outcomes and quality of life. Key elements of patient-centered catheter management include:

• Involving patients in decision-making regarding catheter use and care
• Tailoring catheter management plans to individual patient needs and preferences
• Providing comprehensive education and support to patients and caregivers
• Regularly assessing the impact of catheterization on the patient’s daily life
• Offering alternative management strategies when appropriate

Does a patient-centered approach improve satisfaction and outcomes in catheterized patients? Research indicates that patient-centered care can lead to better adherence to catheter care protocols, reduced complication rates, and improved overall patient satisfaction.

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.

Urinary incontinence: causes and treatments

How rehabilitation can help with urological problems

The topic of urinary incontinence is considered taboo, many are ashamed of the problem and put off visiting a doctor. At the same time, incontinence negatively affects important aspects of life – from the emotional state to the ability to leave the house and travel.

There are various causes of incontinence, such as post-surgery stress, stroke, spinal cord injury, and other nervous system disorders. In this text, we will analyze in detail the causes of incontinence, as well as effective methods of treatment and rehabilitation.

Causes and risk factors for urinary incontinence

One of the most common risk factors for urinary incontinence is older age. Women over 60 report daily urinary incontinence in the range of 9% to 39%, men over 65 experience this problem half as often – from 2 to 11%. Urinary incontinence in the elderly is statistically associated with a decrease in strength and overall muscle tone, especially in the pelvic floor muscles.

Regardless of age and gender, the risk of urinary incontinence is increased in people with diabetes and overweight. For young women, childbirth, gynecological and infectious diseases can become an additional risk factor – from 7 to 37% of women aged 20 to 39have been reporting this issue for years.

Urinary incontinence may be due to a stroke. In 32-79% of patients, incontinence occurs upon admission to the hospital and in 25-28% remains at discharge.

Normally, in order to prevent leakage of urine, the sphincters (valve muscles) of the urethra should be closed during the accumulation of urine in the bladder, and the bladder muscle should be relaxed.

When the bladder is full, signals from the bladder are transmitted to the spinal cord and then to the brain, after which the response signals follow the same path, causing the bladder to contract and the sphincters to open. As a result, urine flows out of the bladder.

Frequent urination after a stroke is associated with an overactive bladder muscle, which occurs due to impaired communication between the central nervous system and the bladder. Risk factors for urinary incontinence: paresis (decreased strength in any part of the body), depression, cognitive impairment, age over 75 years, dysphagia (impaired swallowing), loss of visual field and a large area of ​​\u200b\u200bbrain damage (lesion of the cortex and subcortical region) .

“Recently, a patient came to our clinic after a stroke with frequent false urge to urinate and episodes of urinary incontinence day and night,” says Ivan Kolbin, a neurourologist at the Three Sisters Clinic. – Before each physical therapy session, the patient goes to the toilet because he is afraid that involuntary urination will occur during the exercises. At night, a man does not get enough sleep, as he wakes up at least four times because of the desire to go to the toilet. All this greatly affects his quality of life and emotional state. But this is solvable. If you choose the right therapy, then after 2-3 weeks the symptoms will go away or significantly decrease.

The main functions of the bladder – the accumulation and excretion of urine – are also impaired in spinal cord injuries. It is not uncommon for patients with spinal cord injury to stop feeling bladder fullness and the need to urinate. It is also likely that the person will not control the work of the sphincter of the urethra.

“If the patient has damage at the cervical or thoracic level, then frequent urination and urinary incontinence is associated with a spastic bladder that does not hold urine when filled. Although the signals between the bladder and the spinal cord are passing, the signals between the brain and the bladder have disappeared, so the person does not feel the fullness of the bladder and cannot control urination. The bladder muscle and urethral sphincter in this case are hyperactive, in addition, the joint work of these muscles is disrupted, says Ivan Kolbin. – In patients with lesions at the lumbar or sacral level, the situation is the opposite: the tone of the bladder is reduced, there are no contractions, the bladder gradually overflows and incontinence from overflow occurs. Failure to completely empty the bladder can lead to problems. Temporary placement of a urethral catheter is recommended in these patients to avoid overdistension of the bladder and prevent urinary tract and kidney complications.”

Temporary placement of a urethral catheter is recommended for these patients to avoid overdistension of the bladder and complications of the urinary tract and kidneys

a number of other cases.

“Prolonged use of a catheter sometimes causes a nosocomial infection that can contribute to urinary incontinence. Hygiene and regular intermittent catheterizations are important to avoid inflammation of the urinary tract, because the longer urine remains in the bladder, the more likely bacteria will multiply and cause inflammation. It is also important that the bladder is completely emptied and that there is no residual urine left in it, which contributes not only to inflammation, but also to the formation of stones. An indwelling catheter should be changed regularly. During catheterization, it is important not to damage the urethra, as this also creates the prerequisites for inflammation.

Urinary incontinence, in both men and women, can be stressful. Stress incontinence in women is more often associated with birth injuries, hormonal disruptions, and surgeries. In men, stress incontinence in most cases occurs after a prostatectomy (surgery to remove all or part of the prostate for prostate cancer) and after a transurethral resection (surgery for a benign prostate tumor).

Incontinence after prostatectomy is also due to the fact that when the prostate gland is cut off from the urethra, its back wall is partially damaged. The function is restored, as a rule, within 6 months after the operation. The number of patients with persistent urinary incontinence after surgery can reach 11.9%.

Treatment and rehabilitation

Pelvic floor training

Regular exercise is said to make the pelvic floor muscles stronger and stronger. Classes are held under the supervision of a doctor or with a smartphone, which tell the patient when to contract muscles and when to relax. It takes an average of 20 weeks to achieve results.

Kegel exercises help strengthen your pelvic floor muscles. But they are not shown to everyone. For example, in men after a stroke, mostly neurogenic damage occurs, in which drug therapy is sufficient. Muscle tone is more likely to decrease in women, especially with additional risk factors such as childbirth.

Electrical stimulation

This method is effective for men with urinary incontinence after prostatectomy.

Electrical stimulation (ES) activates the pudendal nerve. This causes the pelvic floor muscles to contract and also keeps the urethral sphincter closed and reduces the urge to urinate.

Electrical stimulation can be anal – when a special probe is inserted into the anal canal, as well as percutaneous – when overhead electrodes are placed (for example, on the hamstring or in the sacrum).

Extracorporeal magnetic innervation

This technique is effective in the complex treatment of urinary incontinence and works on the same principle as MRI: a device that is built into the seat of the chair creates a magnetic field. Next to the chair is a power supply unit with which the doctor can adjust the strength of this field. The doctor selects an individual dose of magnetic radiation for the patient, which improves the conduction of the nerve impulse and stimulates the contraction of the pelvic floor muscles. Unlike anal electrical stimulation, this method causes less discomfort for the patient.

General advice for patients with urinary incontinence

It makes sense to consult with your doctor about some aspects of your life. Perhaps he will advise:

• Limit fluid intake, drink in doses (no more than 200 ml of water at a time), drink less after 18:00, and also empty the bladder before bedtime so as not to get up at night and get better sleep.

“These are temporary restrictions,” says Ivan Kolbin. “Once the bladder again accumulates and holds a large portion of urine, you can return to the usual way of life.”

• Avoid excessive consumption of caffeinated, alcoholic and carbonated drinks.

“Caffeine stimulates urination even in patients without neurogenic disorders and stroke. Therefore, it is better for patients with urinary incontinence to limit coffee and, if there is such a need, drink it in the morning. If the patient himself notes the relationship between the intake of caffeinated drinks and incontinence, then it should be completely excluded, ”Ivan Kolbin.

• Do physical exercises to strengthen the muscles of the pelvic floor.

“The intensity of exercise depends on the condition of the patient. In most cases, Kegel exercises are enough to do 30 sets 3 times a day, ”- Ivan Kolbin.

• Watch your weight – Being overweight can put pressure on your bladder and make you want to urinate.

The experience of the Three Sisters clinic in helping people with difficult urination

Patients with urinary incontinence are most often admitted to the Three Sisters Clinic after a stroke and spinal cord injury. In these cases, rehabilitation specialists work with them to strengthen the muscles of the pelvic floor. For example, Kegel exercises are recommended. The doctor supervises the exercises and teaches the patient to do them on their own so that they can continue exercising at home after discharge.

The main goal of rehabilitation is to regain control of urination and urinary retention. It is important that urination is voluntary and the patient, depending on the severity of the violation, has time to get to the toilet or other auxiliary means of rehabilitation.

If a person is holding urine, then the next goal is to increase the intervals between urination and work on control. For example, if an urge appears, the patient needs to learn how to hold urine so as not to interrupt the session and not immediately run to the toilet. The quality of rehabilitation and life in general depends on this.

Physicians also prescribe medication individually:

• Alpha-blockers, which are recommended for men because they help relax the sphincters and the prostate gland. This allows urine to pass freely, and alpha blockers also help reduce the pressure in the bladder that occurs when urine passes.

• In addition to alpha-blockers, botulinum toxin preparations can be used to relax the bladder and sphincters. This method helps to reduce spasticity and hypertonicity of the bladder.

• Anticholinergic drugs are given to people using intermittent catheterization. Anticholinergics relax the bladder and prevent contractions in the bladder muscle fibers that can cause urinary incontinence.

Text author: Polina Fomintseva, medical journalist, graduate of the School of Modern Journalism of the European University in St. Petersburg

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What to do after removing a catheter for prostate surgery

This information will help you know what to do after removing your catheter for 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, have your blood tested for PSA 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.