The urinary bladder, located in the lower abdomen just below the navel, is similar to a balloon. Its purpose is to collect urine output from the kidneys, store the urine and then contract as it empties.
Urinary retention occurs when the bladder cannot completely empty. When this happens, the condition can be either acute or chronic. Chronic urinary retention often causes kidney damage.
This article will discuss what a urinary catheter is, and the catheterization risk that comes from having one.
What is a urinary catheter?
A urethral catheter is a tube you insert through the urethra an into the urinary bladder to empty it. It is typically long enough to be fed through the length of the penis and urethra in a male. For a female, it is shorter – typically only the length of the urethra. A medical professional often does catheter insertion, but some men with long-term prostate issues learn self catheterization.
Types of Urinary Catheters
A urinary catheter consists of a plastic tube long enough to pass through the entire urethra and reach into the bladder. There are several types of urinary catheters available, but each serves this same essential basic function.
There are four main types of urinary catheters:
An indwelling catheter is a Foley catheter that you place in the body until its removal. The end of the drainage tube is fixed to a collection bag to allow for regular emptying. This type of catheter is typically used in the hospital or urologist environment.
As long as you keep it clean, you can leave a Foley catheter in place indefinitely. However, the longer it is in place, the higher the risk of a catheter-associated UTI.
A suprapubic catheter is an indwelling catheter inserted into the bladder through a small hole in the abdomen rather than passing through the urethra. It is used when the anticipated time for the catheter to be in place is estimated to exceed the usual norm of a few days.
You can insert an intermittent catheter as needed to drain urine several times a day. It is placed in the bladder for just long enough to drain it and then removed.
Condom catheters are a special type of intermittent catheter. Men who have nighttime urinary incontinence problems typically use condom catheters. They collect urine as it drains out of the penis into a collection bag.
They are less invasive than internal indwelling catheters and the patient can install or remove them as needed, usually during the sleep cycle.
The catheterization procedure is simply to thread the plastic tube into the tip of the penis at the urethral opening (urethral meatus) until urine begins to flow freely. A collection bag is usually affixed to the far end of the tube to collect the urine.
Urinary catheterization is often done in a hospital setting with a Foley catheter, but some men with persistent prostate and bladder issues learn to self-catheterize.
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The main side effect of any urinary catheter is a bladder or urinary tract infection (UTI). Indwelling catheters, used both at home and in the hospital, have the highest risk of inducing a UTI.
According to a 2011 report, nosocomial (acquired in a hospital or similar setting) UTI′s account for more than 12 percent of reported infections. When the catheter is left in place for long periods, the risk increases.
Bladder spasms are also a common effect of a urinary catheter, especially an in-dwelling one. A bladder spasm can occur at any time. But, it is a frequent visitor when a man has a catheter in place, especially in a hospital setting or with the general placement of a Foley catheter.
The bladder spasm is often the body′s attempt to expel the foreign object. In this case, the catheter itself or the retention balloon of a Foley catheter.
Repeated catheterization can sometimes cause injury or chronic inflammation of the urethra. The scar tissue that gradually forms due to the injury results in urethral strictures, causing the urethra to narrow and making it more difficult for urine to flow. Often this is due to catheters or instruments placed in the urethra during surgery or various other procedures.
Catheter-associated UTI′s account for many urological visits. When using an intermittent catheter, sterility is not necessary, but cleanliness is essential.
You can easily acquire a UTI in any setting if the catheter, the surroundings, or the person inserting it is not scrupulously clean. The urinary outlet is not far from the fecal outlet, and any fecal matter contamination on or around the catheter is likely to lead to an E. coli based UTI.
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There are very few real risks with long-term urinary catheterization except those related to acquiring a UTI. This is far more likely in a hospital than in a home setting.
Often a man that requires surgery or hospitalization receives an indwelling catheter in the hospital. On discharge, the doctor directs him to consult with a urologist to remove the catheter. Once he has removed the catheter in the urologist′s office, it is a frequent occurrence that he may not be able to urinate normally at that time.
However, many men do not realize that urinary function will likely return to normal in a few days. At this time, the man is most vulnerable to suggestions from an unscrupulous doctor who might insist that they can fix the problem with a Transurethral Resection of the Prostate (TURP), medication, or another procedure and they need to do it immediately.
A TURP removes part of the prostate gland through an instrument passed through the penile urethra. The instrument holds a cutting tool (knife or laser), a viewing instrument (cystoscope) with an associated light (and possibly a camera) so the surgeon can view the internal area. The doctor removes excess prostate tissue through the tube and discards it.
This is an invasive procedure that is often unnecessary and has several side effects.
While the prostate is healing after an acute incident, surgery, or a lengthy illness, people typically use a simple intermittent catheter. People that have disturbed sleep because of frequent nighttime urination often self-catheterize at bedtime for a better night’s sleep. You can use an intermittent catheter as needed and remove it after draining the bladder.
You can use an intermittent catheterization several times per day and older men that do not want to subject themselves to the risk of a TURP, other surgery, or strong medications often use it.
If you use self-catheterization regularly, you should select an intermittent catheter of the smallest diameter to do the job effectively. This will help reduce the possibility of urethral injury, strictures, and bladder spasms.
Long-term hesitancy in urination or inability to fully empty the bladder is dangerous. It can even lead to permanent severe kidney damage. The main benefit of self-catheterization is that, if done regularly, it eliminates the potential for urinary retention and associated kidney damage.