Urinary catheters are crucial pieces of medical equipment that help to drain urine from patients’ bladders. They’re some of the most-used medical devices in the world today, helping patients with a wide range of conditions, and there are various types and sizes of urinary catheters, as well as unique insertion methods and complications that medical personnel need to be aware of. In this guide, we’ll cover all you need to know about urinary catheters.

What Is a Urinary Catheter?

In simple terms, a urinary catheter is a specific type of catheter, used for draining urine. There are various types of urinary catheters, but they typically consist of a long, hollow tube that the urine flows through, along with a narrow tip at one end which is inserted into the patient’s body. At the other end, the urinary catheter connects to a urine drainage bag or urine collection bag. Urine passes from the patient’s bladder through the tube and into the bag.

When Are Urinary Catheters Used?

Urinary catheters are used in many different situations that involve a patient finding it difficult, painful, uncomfortable, or impossible to urinate naturally or control the flow of their urine. Here are some examples of situations in which a urinary catheter may be used:

• Urethra Obstructions – Obstructions or blockages inside the urethra (the tube that urine flows through to leave the body) can make it hard or painful to urinate normally.
• Bladder Weakness – Due to injuries, surgery, or other causes, some patients may have a weak bladder. This can make it hard for them to control the flow of urine.
• Childbirth – During childbirth, a pregnant person may be given an epidural, which makes their legs weak and prevents them from leaving their bed to use the bathroom.
• Surgery – During surgery, patients are often placed under anesthetic and may be unconscious for long periods. Catheters are used to drain urine from their bladders.
• Bladder Infections or Diseases – Various infections or diseases can affect the bladder, including bladder cancer. Catheters can be used to deliver medicine to the organ.
• Incontinence – Catheters can also be given to patients who suffer from incontinence, which is a condition that makes it difficult or impossible to control urination.
• Retention – Catheters can also be used to treat urinary retention, which is a condition in which the bladder does not fully empty itself during natural urination, due to blockages.
• Blocked Urine Flow – The flow of urine can be blocked due to a range of obstructions or other issues, such as blood clots, kidney stones, or an enlargement of the prostate.
• Mental Conditions – There are also mental conditions, including dementia, that may affect a person’s ability to control their urination.

How Is a Urinary Catheter Inserted?

The exact insertion process for urinary catheters can vary, depending on whether the patient is male or female, as well as the age and condition of the patient and the specific type of catheter being used. For example, some catheters may require the use of lubricant, while others have special hydrophilic coatings that give them their own lubrication. Below, we’ll outline the basic steps of standard Foley catheter insertion in both female and male patients.

Female Catheter Insertion 

1. Preparation – The first step of catheter insertion is preparation. The nurse or doctor should wash their hands carefully before touching the patient or any catheter equipment, as well as gathering the necessary pieces of equipment, including the catheter itself, lubricant, medical gloves, catheter bag, and so on.
2. Get the Patient Ready – Next, the member of medical personnel should speak with the patient, if possible, and explain the process, as well as getting the patient in the best possible position for insertion. Sheets and blankets should be removed and the patient’s genital region should be exposed, with legs spread and knees slightly bent to provide easier access.
3. Clean the Area – With medical gloves, the nurse or doctor should then use one “dirty” hand to clean the patient’s labia and vulva with Betadine swabs, keeping their “clean” hand away from the patient and only using the clean hand to touch the catheter tubing itself. Several swabs may be used to thoroughly clean the patient’s genital region.
4. Insertion – Using the clean hand, lubricate the end of the catheter. Push the labia apart with the dirty hand and then slowly and gently push the tip of the catheter tube into the urethra of the patient. Continue pushing the tube into the patient’s body until you see urine flow through. You can then stop, as the tube has reached the bladder.
5. Inflate the Balloon – Once the catheter is in place, it’s common practice with most urinary catheters to use a saline syringe to inflate a small balloon at the end of the tube. This helps to keep the catheter in position and prevents it from falling out or slipping out of place, making things easier and more comfortable for medical personnel and the patient.
6. Finishing – Finally, you can attach the catheter tube to the patient’s leg and the catheter bag to the side of the bed, making sure that the bag is below the patient’s hip level. You can then clear away any leftover items and cover the patient back up.

Male Catheter Insertion

1. With male patients, most of the insertion process is the same, and it begins with preparation. Clean your hands thoroughly and prepare all of the necessary supplies for the procedure, like Betadine swabs, medical wipes, gloves, the catheter tubing, the catheter bag, and so on.
2. Get the Patient Ready – Next, you can speak with the patient to explain the procedure and help them get into the right position for an easy and comfortable insertion. Ideally, if they’re able to do so, the patient should lie flat on their  back with the legs bent and spread slightly. The penis should be exposed, but a small sheet can be placed over the genital area for privacy.
3. Clean the Area – The nurse should then decide on a “clean” hand, which should not touch the patient at all, and a “dirty” hand, which can be used to handle the penis. Using the dirty hand, hold the penis and lift it upwards, then use the clean hand to swab around the glans of the penis using the Betadine swabs.
4. Insertion – Using the clean hand, lubricate the end of the catheter. With the penis held in the dirty hand, insert the catheter slowly and carefully into the urethra. Push it down through the penis and into the patient’s body until you see urine flow through the tubing. This signals that the catheter has reached the bladder, and you can stop pushing.
5. Inflate the Balloon – If the urinary catheter you’re using has an inflatable balloon, this is the time to inflate it. Use a clean saline syringe with the appropriate amount of saline solution to inflate the balloon. This will help the catheter stay in place and not fall out.
6. Finishing – Finally, with the catheter in place, you can attach the tubing and the bag to the patient’s leg and bed, respectively. Then clear away any items and check the patient is comfortable.

How Long Can a Urinary Catheter Stay In?

The amount of time that a urinary catheter can stay in position inside the body will depend on the type of catheter being used. Indwelling urinary catheters, for example, are designed to stay in the body for extended periods of time of up to three months, while other kinds of catheters will need to be changed every month or every couple of weeks. Some catheters are only used for a matter of hours.

How to Care for a Urinary Catheter?

Since urinary catheters go inside the body, there’s a high risk of infections and other problems occurring if the catheters are not handled with care and used correctly. For this reason, urinary catheters require regular cleaning. A typical Foley catheter should be flushed or irrigated every four hours, on average, and the area around the catheter insertion site should be cleaned with soapy water on a daily basis. Catheters also need to be monitored for any warning signs, like damages to the tubing or blockages that prevent urine from flowing.

Types of Urinary Catheters

There are many different types of urinary catheters, from standard Foley catheters, which are some of the most commonly-used devices, to external or condom catheters. The list below shows some of the main types, with brief explanations of each one.

1. Foley Catheters – Named after their inventor, Frederic Foley, Foley catheters are among the most common kinds of urinary catheters. They can be made of materials like latex or silicone and often have an inflatable balloon at one end to aid with insertion. They can be used to help patients undergoing surgery or dealing with various urinary problems.
2. Indwelling Catheters – As the name suggests, an indwelling catheter is a type of urinary catheter that is specifically designed to remain or dwell within the body for extended periods of time. These catheters can remain in place for several months, making them useful for patients with long-term or chronic problems.
3. Intermittent Catheters – An intermittent catheter is effectively the opposite of an indwelling one. These catheters are designed for short-term, intermittent use and are actually removed after urine has finished draining. They’re useful for patients who need catheters but are otherwise active and able-bodied.
4. Closed System Catheters – A closed system catheter is a kind of intermittent catheter in which the catheter and bag are all connected together, forming a closed system, without the need for any extra accessories or connections. Closed system catheters are safe and convenient to use, with low risks of contamination.
5. External Catheters – As the name implies, an external catheter is one that is used externally, without being pushed into the body. An example of an external catheter is a condom catheter, which is placed over the penis like a condom, allowing urine to flow out through a tube, into a collection bag. There are also female external catheters.
6. Straight Tip Catheters – A straight tip catheter is one which has a straight-shaped tip, without any curving or rounding. These are very common and are generally considered the standard shape for urinary catheters, being used in the vast majority of cases. 
7. Coudé Catheters – Coudé catheters differ from straight-tip catheters, as they have rounded or curved ends. The rounded end of a coudé catheter can make it easier and more comfortable to insert into patients who may have urethral blockages or other problems.

Sizes of Urinary Catheters (Diameter and Length)

Urinary catheters are available in not only a wide range of different types, but also different sizes. When we talk about the sizing of catheters, this can refer to both the length of the catheter tubing, and the diameter of the tubing, too.

• Diameter – Catheter diameters are typically measured in French sizes, which are numbered from as low as 6 up to 26, where 6 is the narrowest and 26 is the widest. The French size tells us the circumference of the catheter in millimeters, with each FR number being equivalent to 0.33mm or 0.013 inches. The average urinary catheter size for adult men is 14 FR, while female patients typically have 12 FR catheters, and children can have anywhere from 6 FR to 10 FR, on average.
• Length – In terms of length, catheters can range from around 6 inches long to 18 inches or even more. Typically, adult male patients require the longest catheters, as the catheter has to pass through the penis and then into the body to reach the bladder, with average sizes for males at around 14 to 18 inches. Standard lengths in female catheters are between 6 and 10 inches, while pediatric catheters typically range from 6 to 12 inches.

Potential Complications of Urinary Catheterization

1. Allergic Reactions – Some patients may have an allergic reaction to the material of the catheter tubing. This can cause redness, itching, and irritation around the insertion site.
2. Urethral Injuries – It’s also possible for catheters to cause damage on the inside of the urethra tube. This may lead to scratches and scarring of the urethra wall.
3. Infections – If they are not completely sterile and clean, catheters may introduce bacteria or viruses into the body, which can lead to bladder infections.
4. Kidney Damages – There’s also a risk of kidney damages with urinary catheterization, which can vary in severity, from mild cases to situations involving serious kidney injury.
5. Pain and Discomfort – Many patients find that the experience of having a urinary catheter inserted is quite a painful or uncomfortable one, and catheter removal can also be painful.
6. Blood or Debris in Tube – In some cases, blood or other bits of debris may be spotted within the catheter tube. This can lead to blockages and cause backflow of urine, raising the risk of infection and other issues.

Risk Factors That May Lead to These Complications

1. Long-Term Use – Patients who use catheters for very long periods of time are at a higher risk of issues like injuries and infections than those who have only brief usage of catheters.
2. Improper Insertion – If the catheter is not inserted correctly, there is a risk that the tube can cause damage and scarring to the urethra or bladder. 
3. Incorrect Size – If the wrong size of catheter is used, the insertion may be particularly painful for the patient and could lead to urethral damages. 
4. Repeated Use – Having catheters repeatedly inserted also raises the risk that a patient may experience a complication like infection or urethra damage.
5. Damaged or Scarred Tissue – If the patient already has a weak, damaged, or scarred urethra from previous operations or infections, they will be at a higher risk of further damages.
6. Lack of Care – Improper levels of care and catheter maintenance can also increase the risk of a patient experiencing complications like infections and pain. 
7. Wrong Material – If a patient is allergic to latex, trying to insert a latex catheter into their body will trigger an allergic reaction and various symptoms.

Potential Side Effects of Urinary Catheterization

1. Pain – Some patients continue to experience mild to moderate pain in the hours and days after a catheter has been removed. This pain should subside quite quickly.
2. Incontinence – After undergoing urinary catheterization, some patients have also reported experience of incontinence symptoms, like urine leakage and a general inability to control their urine.
3. Bladder Spasms – Some patients who have urinary catheters also suffer from bladder spasms, which feel like stomach cramps and can be particularly painful and uncomfortable to live with.
4. Urethra Damage – Patients may also struggle with long-term urethra damages and scarring after undergoing catheterization, especially if their urinary catheter was not inserted in a safe and correct manner.
5. Bladder Damage – Another possible risk for some patients is long-term bladder damage, which may be the result of infections caused by a catheter that was not properly maintained or damages due to a catheter that was inserted incorrectly. 

Frequently Asked Questions

Who Invented Urinary Catheters? 

The history of catheter usage goes back centuries to the days of Ancient China and Ancient Rome, with various civilizations using wooden, metal, or reed-based tubes as catheters. Benjamin Franklin invented the flexible catheter, the precursor to most modern urinary catheters, in 1752, to help his brother John, who was suffering from bladder stones.

When Were Urinary Catheters Invented? 

Even though catheters in various forms were in use throughout ancient history, the earliest known example of a modern-style, flexible urinary catheter, occurred in 1752. 

How Do You Know What Size Urinary Catheter to Use? 

A doctor or nurse will decide on the correct size of urinary catheter to use for each patient. The right length will be chosen based on the patient’s gender and age, as male patients usually require significantly longer catheters than females, and children need shorter catheters compared to adults. The diameter will be chosen based on the patient’s body size, age, and anatomy.

Can a Urinary Catheter Cause Incontinence? 

Studies suggest that there is a risk of some level of incontinence or urine leakage in patients who have had catheters inserted. One study revealed that around 20% of catheterized patients have reported some experience or incontinence.

Can a Urinary Catheter Cause Nerve Damage? 

There can be a risk of nerve damage if a urinary catheter is inserted correctly. The risk is low, but still present, which is why it’s so important for medical practitioners to insert urinary catheters safely and correctly to avoid any unwanted injuries to the patient.

Can a Urinary Catheter Break Hymen? 

No, a urinary catheter cannot break the hymen. The catheter is inserted into the urethra, which is a separate entry to the vagina (where the hymen is located). This means that the catheter tubing should not come into any kind of contact with the hymen.

Can You Shower with a Urinary Catheter? 

It is possible to have a shower while using a catheter with a leg bag. The bag should be kept dry and below the level of the bladder to prevent any backflow and minimize the risk of infection.

What Is Urinary Catheter Irrigation? 

Urinary catheter irrigation is the process of irrigating or flushing a catheter to wash out any bits of debris, blood, or blockages within the tubing and keep it as clean as possible. This helps to stop obstructions and also reduces the risk of infections.

How Much Does a Urinary Catheter Cost? 

The costs of urinary catheters can vary greatly, as there are lots of different types and sizes of urinary catheters to choose from. The cost of a condom catheter, for example, may be very different to the average price of a Foley catheter.

Where Can I Buy Urinary Catheters?

You can buy urinary catheters and many other kinds of catheters, as well as other pieces of medical equipment, from CIA Medical. We have a huge range of urinary catheters for sale, including Foley catheters, indwelling catheters, intermittent catheters, suprapubic catheters, external catheters, and more, with great prices and trusted brands.