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Frequently Asked Questions

What are the Different Catheter Types?

A urinary catheter is any tube system placed in the body to drain and collect urine from the bladder. Your health care provider may recommend a catheter for short-term or long-term use because you have or had:

• Urinary incontinence (leakage of urine or the inability to control when you urinate)
• Urinary retention (being unable to empty the bladder when you need to)
• Surgery that made a catheter necessary, such as prostate or gynecological surgery
• Other medical conditions such as multiple sclerosis, spinal cord injury, or dementia

Catheters come in many sizes, materials (latex, silicone, teflon), and types (foley, straight, coude tip). In general, the smallest possible catheter is preferred. Some people may need larger catheters to control urine leakage around the catheter or if the urine is thick and bloody or contains large amounts of sediment.

There are three main types of catheters:

1. Intermittent (short-term) catheter
2. Indwelling catheter
3. External (condom) catheter

Intermittent Catheter

Intermittent catheterization is a method whereby a catheter is inserted into the bladder when it is full and then removed immediately after the bladder is drained. The number of times that someone is required to catheterize throughout a day may vary from person to person and will depend on the level of fluid intake. It is suggested that catheterization is necessary every 4 to 6 hours. In order for someone to catheterize themselves independently, they require a certain level of hand function and finger dexterity.

Indwelling Catheter

An indwelling urinary catheter is one that is left in place in the bladder. Indwelling catheters may be needed for only a short time, or for a long time. These catheters attach to a drainage bag to collect urine. A newer type of catheter has a valve that can be opened to allow urine to flow out, when needed. An indwelling catheter may be inserted into the bladder in two ways:

• Most often, the catheter is inserted through the urethra, which is the tube that brings urine from the bladder to the outside of the body
• Sometimes, the doctor will insert a tube, called a suprapubic catheter, into the bladder from a small hole in the belly. This is done as an outpatient surgery or office procedure.

An indwelling catheter has a small balloon inflated on the end of it. This prevents the catheter from sliding out of the body. When it's necessary to remove the catheter, the balloon is deflated.

External (condom) Catheter

There is no tube placed inside the penis. Instead, a condom-like device is placed over the penis. A tube leads from this device to a drainage bag. The external catheter should be changed daily.

Indwelling and external catheters require the use of a drainage bag. There are two types:

1. A leg bag is a small drainage device that attaches by rubber elastic or fabric straps to the leg. It is usually worn during the day, because it fits discreetly under pants or skirts. It is easily emptied directly into the toilet.
2. A down drain is a larger drainage device. It may be used during the night. This device is hung on the bed or placed on the floor.

How are Catheters Sized?

The French Scale is commonly used to measure the diameter of the catheter. As the scale below illustrates, 1 Fr = .33mm; therefore, in order to determine the diameter of a catheter in mm, simply divide the Fr by 3. For example: 12 Fr / 3 = 4 mm.

What are Potential Complications From Catheter Use?

Complications of catheter use include:

• Allergy or sensitivity to latex
• Bladder stones
• Blood infections (septicemia)
• Blood in the urine (hematuria)
• Kidney damage (usually only with long-term, indwelling catheter use)
• Urethral injury
• Urinary tract or kidney infections

Contact your health care provider if you develop or notice any of the following:

• Bladder spasms that do not go away
• Bleeding into or around the catheter
• Catheter draining very little or no urine, despite drinking enough fluids
• Fever or chills
• Leakage of large amounts of urine around the catheter
• Skin breakdown around a suprapubic catheter
• Stones or sediment in the urinary catheter or drainage bag
• Swelling of the urethra around the catheter
• Urine with a strong smell, or that is thick or cloudy

References:

Moy ML, Wein AJ. Additional therapies for storage and emptyhing failure. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Sauders Elsevier; 2007: chap 70.

Wierbicky J, Nesathurai S. Spinal cord injury (thoracic). In: Frontera WR, Silver JK, Rizzo Jr TD, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008: chap 147.