Guidelines for the care of Urethral & Supra Pubic Catheters

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Urinary Catheter

A urinary catheter is a long hollow drainage tube that is inserted into the urinary bladder. It can be urethral (inserted in to the bladder from down below) or supra-pubic (inserted through the abdominal wall just above the pubic bone) . A small balloon at the top of the catheter is then inflated in order to keep it firmly in place. A urine collection bag can then be attached to the bottom of the catheter. The purpose of your catheter is to drain urine from your bladder. Catheters can be used short term or long term, depending on instructions given by your GP or Consultant. No catheter should be left in for more than 3 months.

Catheter Comfort

Once your catheter is in place it is important to avoid any pulling or friction on the catheter as this will cause pain, discomfort and other complications. Catheter stabilising or fixation devices are available for both types of catheters.

Instruction For Care

You can have a shower with your catheter in situ. Avoid very hot /very cold water. Wash around the catheter (where it enters your body) twice daily with soap and water. Never use talcum powder or cream. Drink plenty of fluids to keep your urine flowing well. Drink 6-8 glasses per day.

  • Avoid excessive caffeine and alcohol and drink clear fluids where possible. Wash your hands before handling your catheter.
  • Avoid becoming constipated or straining when opening bowels.
  • Eating foods that are high in fibre is advisable.
  • Never pull on your catheters this may cause trauma or damage.
  • Only people who have been appropriately trained should care for your catheter and night bag.

Draining The Leg Bag Or Night Bag

A leg bag is a urine collection bag that is strapped to your leg. It is smaller than your night bag and allows you to move around more freely, however the leg bag must be emptied every 3-4 hours. To drain the bag, follow these steps:

  • Wash your hands with soap and water.
  • Unfasten the lower leg strap.
  • Open the clamp or tap and drain into toilet or urinal.
  • DO NOT TOUCH THE DRAIN PORT WITH YOUR FINGERS OR ALLOW IT TO TOUCH ANYTHING ELSE.
  • DO NOT FORGET TO CLOSE LEG BAG AND NIGHT BAG TAPS.

Care Of Your Leg Bags And Night Bags

Your leg bag should stay in place for 5-7 days. It is held next to your leg with 2 straps or a leg bag sleeve. At night time you should connect your night bag to the tap on your leg bag then, keeping the leg bag tap open whilst the night bag is attached, detach the night-bag in the morning and dispose of it; ensure leg bag tap is closed. Your night bag should be kept on a stand. Always keep the bag lower than your bladder to ensure correct drainage. The majority of night bags are of a disposable nature. Some have a single use tap which can only be operated once and then must be discarded. The drainable night bags can be drained and reused for 5-7 days. All bags should be washed after use and disposed of in a plastic bag, then into the dustbin.

Sexual Activity

You can still have sexual intercourse whilst you have your catheter in place. It is possible to maintain an active sex life with either a urethral or supra-pubic catheter in place. Men can tape the catheter along the shaft of the penis and cover with a condom. Women can tape the catheter up along her abdomen. Before intercourse both partners should wash their genitals thoroughly. It may help to use a lubricant such as K-Y jelly. After intercourse, both partners should wash their genitals thoroughly again.

When you first start using a catheter you may find you have:

  • The sensation that you need to pass urine (Bladder Irritation).
  • A bladder spasm or cramp. This usually stops within a few days.

Contact your District Nurse or GP if you suffer the following symptoms

  • Prolonged Pain.
  • Urine not draining after 2-3 hours.
  • Blood in the urine.
  • Cloudy, smelly urine or a burning sensation on passing urine.
  • Urine keeps leaking around the catheter.

For any further advice please contact your District Nurse / Urology Nurse / Continence Advisor or Nurses on the number provided.

Bibliography

  • ACA (2006) Notes on Good Practice: No. 7, No. 8, No. 9. www.aca.uk.com
  • National Institute for Clinical Excellence (Nice) (2007)
  • Urinary Tract Infection: Diagnosis, treatment & long-term management of Urinary Tract Infection in Children. Ref: CG54
  • RCN (2008) Guidelines for Indwelling Urethral Catheters and Catheterisation London: RCN