Why would a man need a catheter

A catheter is a tube that is inserted into your bladder, allowing urine (wee) to drain freely. The catheter tube is attached to a drainage bag (a catheter bag), where the urine can be collected.

Catheters are usually inserted through the urethra (the narrow tube that connects your bladder to the outside).

Some people with urinary problems need catheters permanently, but more often people need them for a short time.

What are the different types of catheters?

There are several different types of catheters.

• Short-term indwelling catheter: catheter that is passed through the urethra and left in place for a short time. For example, during surgery.
• Long-term indwelling catheter: The catheter is inserted in the same way as a short-term catheter, but is used for longer. It needs to be changed regularly (usually every 4-6 weeks).
• Intermittent catheter: A catheter that is used at regular intervals to empty the bladder. After the bladder is emptied, the catheter is removed. Some people are able to do this themselves — this is called self-catheterisation.
• Suprapubic catheter: A catheter that is inserted into the bladder through a tiny hole in the abdomen. This type of catheter needs to be changed regularly (usually every 4-6 weeks).
• External catheter: A device that is placed over the penis to collect urine.

Why might I need to use a catheter?

There are many reasons why you may need to have a catheter. Some reasons include:

• bladder problems (including problems with the muscles controlling the bladder)
• problems with the nerves controlling the bladder. For example, if you have a spinal injury
• urinary retention (when you can’t pass urine even though you feel the need to)
• during labour and childbirth if an epidural has been used
• some types of bladder tests and treatments
• having certain types of surgery
• people who are very unwell in hospital

Catheter problems — what to do

There are several problems you might encounter with your catheter.

There is no urine draining — intermittent catheter

If urine is not draining after inserting an intermittent catheter, try coughing to help start the flow of urine.

Check you have inserted the catheter correctly into the urethra.

Blocked catheter

If you have an indwelling catheter, check there are no kinks in the drainage bag tubing or that the leg bag straps aren’t blocking the flow. Make sure the bag is below your bladder when you are lying, sitting or standing.

If you still can’t get the urine to flow, see your doctor. The catheter may have to be flushed or replaced. Use clean towels or pads to keep yourself dry while you wait to see a healthcare professional.

If you have a full bladder or are in discomfort, you will need to go to a hospital emergency department for treatment.

Catheter leakage

Sometimes urine can bypass the catheter and leak out. This can happen if the catheter is too small or not placed properly. It can also be caused by:

• constipation
• bladder muscle spasms (sudden, involuntary contractions of the bladder muscle)
• a blocked catheter

Seek advice from your doctor or continence advisor if you have catheter leakage.

Catheter has fallen out

If you have an indwelling urinary catheter and it falls out, call your doctor or nurse immediately or go to a hospital emergency department for treatment.

Infection

Symptoms that may mean you have a urinary tract infection (UTI) include:

• cloudy or strong-smelling urine
• a burning feeling around the catheter, or itching or soreness
• blood in your urine
• abdominal (stomach) pain

You may also feel unwell, have a fever or have discomfort in your lower back or around your sides.

See your doctor straight away if you suspect you have a urinary tract infection (UTI). If you have an infection, you may need antibiotics. It’s also usually a good idea to drink more water, to flush the bacteria away.

When should I see my doctor?

Always see your doctor if you notice any blood in the urine or have symptoms of a urinary tract infection.

You should see your doctor or continence advisor if your catheter keeps getting blocked or if you have any pain due to your catheter.

Seek medical attention for any of the catheter problems mentioned above that cannot be managed with simple self-care measures.

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General catheter care

• Keep the area where the catheter is inserted clean. You should wash it gently using mild soap. Rinse well and dry thoroughly afterwards.
• Wash your hands before and after touching the area where the catheter is inserted.
• Avoid the use of talcum powder.
• Try to avoid constipation.
• Drink plenty of water as it will help to flush bacteria from your bladder and urinary tract, unless you have a medical condition which means this is not possible.

CHECK YOUR SYMPTOMS — Use the Symptom Checker and find out if you need to seek medical help.

It’s possible to live a relatively normal life with a long-term urinary catheter, although it may take some getting used to at first.

Before being discharged from hospital, a specialist nurse will give you detailed advice about looking after your catheter.

Catheter equipment

You will be given a supply of equipment to take with you when leaving hospital, and told where to get further supplies in the future. In most cases, catheter equipment is available on prescription from pharmacies.

You will also be shown how to empty and change your equipment.

Self-catheterisation

If you have been taught to use intermittent catheters, you should insert them several times a day to drain urine into a toilet or bag. These catheters are usually designed to be used once and then thrown away.

How often intermittent catheters need to be used differs from person to person. You may be advised to use them at regular intervals spaced evenly throughout the day, or only when you feel you need the toilet.

Indwelling catheters

Indwelling catheters can either drain into a bag attached to your leg, which has a tap on the bottom so it can be emptied, or they can be emptied into the toilet or suitable receptacle directly using a valve.

Bags should be emptied before they become completely full (around half to three-quarters full). Valves should be used to drain urine at regular intervals throughout the day to prevent urine building up in the bladder.

Both bags and valves should be replaced and thrown away about every 5 to 7 days.

At night, you will need to attach a larger bag to your valve or regular bag. This should be placed on a stand next to your bed, near the floor, to collect urine as you sleep. Depending on the type of night bag you have, it may need to be thrown away in the morning or it may be emptied, cleaned and reused for up to a week.

The catheter itself will need to be removed and replaced at least every 3 months. This will usually be done by a doctor or nurse, although sometimes it may be possible to teach you or your carer to do it.

Preventing infections and other complications

Having a long-term urinary catheter increases your risk of developing urinary tract infections (UTIs), and can also lead to other problems, such as blockages.

You will be advised about measures to take to minimise these risks, such as:

• regularly washing your hands, body and catheter with warm water and soap – it’s particularly important to clean your hands before and after touching your equipment
• ensuring you stay well hydrated – you should aim to drink enough fluids so that your urine stays pale
• preventing constipation – staying hydrated can help with this, as can eating high-fibre foods such as fruits, vegetables and wholegrain foods
• avoiding kinks in the catheter and making sure any urine collection bags are kept below the level of your bladder at all times

Read more about the risks of urinary catheterisation.

Your regular activities

Having a urinary catheter shouldn’t stop you from doing most of your normal activities. You will be advised about when it is safe for you to go to work, exercise, go swimming, go on holidays, and have sex.

If you have an intermittent or suprapubic (inserted through your tummy) catheter, you should be able to have sex as normal.

Indwelling catheters can be more problematic, but it’s still usually possible to have sex with them in place. For example, men can fold the catheter along the base of their penis and cover them both with a condom.

In some cases, you may be taught how to remove and replace the catheter so you can have sex more easily.

When to seek medical advice

You should contact a district nurse or nurse practitioner (you may be given a phone number to call before discharge from hospital) or your GP if:

• you develop severe or persistent bladder spasms (similar to stomach cramps)
• your catheter is blocked, or urine is leaking around the edges
• you have persistent blood in your urine, or are passing large clots
• you have symptoms of a UTI, such as pain, a high temperature (fever) and chills
• your catheter falls out (if it’s indwelling and you haven’t been taught how to replace it)

If your catheter falls out and you can’t contact a doctor or nurse immediately, go to your nearest accident and emergency (A&E) department.

Support groups and further information

Living with a catheter can be a challenge and you may find it useful to seek more information and advice from support groups and other organisations.