Care of indwelling or urinary catheter

What is an indwelling or urinary catheter?

An indwelling urinary catheter is a narrow and flexible tube inserted into the bladder to drain urine. It allows continuous drainage of urine from the bladder into a urine collection bag. An inflated balloon at the tip prevents it from slipping out of the bladder.

Why do I need a urinary catheter?

The urinary catheter may be inserted in the following scenarios:

To relieve urinary retention
For strict monitoring of urine output
After a major or prolonged surgery
For continuous washout of the bladder when there is bleeding to prevent retention from blood clots

A urinary catheter may be inserted on a long term basis, with regular changing, in patients with chronic urinary retention from various causes. An alternative procedure in this group of patients is to do intermittent self catheterisation.

General advice for patients with urinary catheter

Activity / Rehabilitation

Resume normal activities as your condition permits.
Avoid swimming.

Nutrition / Diet

Take a well-balanced diet.
Eat food high in fibre such as fruits and vegetables to prevent constipation.
Drink at least 8 glasses / 2 liters of fluids a day, unless otherwise instructed.

Safe and effective use of medication

Take prescribed medications as instructed by the pharmacist.

Catheter Care

Keep the drainage bag below waistline at all times.
Do not allow the drainage bag to touch the floor.
Please ensure that the catheter drainage tube is not kinked or twisted.
Secure catheter bag to leg firmly to prevent tension.
Clean your hands before and after handling the catheter or drainage bag to prevent infection.
Empty the drainage bag when it is ½ full. Exercise care to prevent contamination of the drainage port.
The catheter should always be attached to the urine collection bag to form a closed drainage system. Otherwise change the urinary collection bag if there is presence of blood stained or cloudy urine, obstruction and when a break in the closed drainage system is suspected.
You will be issued a 2000mls drainage bag, this is to be connected to the leg bag in the night and disconnected during the day.
You may shower as per normal but avoid soaking in a bathtub.
Maintain optimal genital hygiene. Do not apply talcum powder. For females, clean genital area from front to back.
For males, if you are uncircumcised, remember to ensure foreskin is replaced over glans.
Clean off secretions and bodily fluids around the catheter by wiping away from the body.

When and how to seek further treatment

Seek medical consultation with your regular General Practitioner (GP) or doctor at the nearest polyclinic if any one of the following conditions occur:

No drainage of urine seen in the bag
Urine leaking around the catheter
Bladder distension
Catheter slips out

Proceed to seek medical attention at the Urology Centre during office hours or at the Department of Emergency Medicine at the Singapore General Hospital after office hours, if you experience the following:

Fever of 38 °C and above
Cloudy and foul smelling urine
Blood stained urine
Pain in the urinary tract or genitalia
Severe pain in your lower back or lower abdomen
Any other unusual and persistent pain or discomfort related to the catheter