Catheters: Advice for patients discharged from the Emergency Department with a new urethral catheter

• Your doctor has advised that you require a catheter inserted into your bladder to drain urine from it.

• A catheter is a small, flexible tube that is inserted through the water pipe (urethra) into the bladder to drain urine into a bag which is usually strapped to your leg. When the bag becomes full of urine, it will need to be emptied by opening the tap at the bottom of the bag either over the lavatory or into a suitable receptacle.

• The catheter will be inserted by a doctor or a nurse who will explain the reason for the catheter and whether it may only be a temporary measure. The catheter will feel strange at first and you will certainly feel conscious of it, constantly feeling that you want to pass urine. This sensation, however, is quite normal and will soon pass.

• Once your catheter has been inserted, the nurse looking after you will give you any additional information that you require, together with any spare equipment you may need. Once your GP has been notified of the catheter, any additional equipment can be bought on prescription from your local chemist.

• Your GP or district nurse should be able to help you with any problems you may have with your catheter.

• The catheter must be treated as a part of your own body and will need to be kept clean in the same way. It can be washed each day with warm, soapy water, either in the bath or in the shower, at the same time as you wash yourself.

• You are advised to wash the catheter away from the urethra so as not to encourage germs to enter the body and cause infection.

• Whilst you are using the catheter, you will need to drink plenty of fluids in order to prevent urinary infections and constipation. You should also take care not to kink the catheter or to raise the drainage bag above the level of your bladder, as this will impede drainage.

While at home, you will need to care for the catheter and drainage system. The different parts are

• The catheter. You need do nothing to the catheter apart from keeping it clean on the outside by carefully washing yourself and the catheter tube itself. Ensure that you dry yourself to prevent soreness.
• The leg-bag for daytime use is attached directly to the catheter tube and will collect all the urine produced during the day. It will become heavier as it fills so do not allow it to become too full as this may risk pulling out the catheter. Always wash your hands before and after using the tap on the end of the bag to empty urine into the toilet.
• The leg-bag support is rather like a footless sock and is used to keep your leg-bag securely attached to your leg.
• The G-strap prevents the catheter from being pulled. It has a Velcro strap around the catheter and your leg to hold the catheter firmly in position.
• The night drainage bag this is connected directly to your leg-bag at night without disconnecting the leg-bag. To connect the night drainage bag:
  • Remove the leg-bag support.
  • Wash your hands carefully.
  • Empty the leg-bag and, with the tap still open, push the end of the night bag into the small piece of tubing at the end of the tap. This should form a direct route for urine to collect in the night bag.
  • Attach the night bag to its stand; this stays on the floor by the side of your bed.
  • In the morning, turn off the tap at the bottom of the leg-bag. Disconnect the night bag, empty the urine into the toilet and rinse the night bag through with warm water. It is then ready to be used again the next night.

• Bladder spasms feel like abdominal cramp. The pain is caused by the bladder trying to squeeze out the catheter balloon. Your GP can prescribe medication to help.
• Leakage around the catheter (bypassing) is sometimes due to bladder spasms or can occur when you open your bowels. If your urine is not still draining, please contact your district nurse as soon as possible.
• Blood or debris in the urine is common with a catheter. It you see large clots or solid pieces of debris passing down the catheter, please contact your nurse for advice as this may cause a blockage.
• Blockage needs to be dealt with quickly. Check: the drainage bag is below the level of your bladder; the catheter has no kinks in it; there are no clots or debris in the catheter and that you are drinking enough. If the catheter will not unblock, contact your district nurse immediately.
• If your catheter falls out, contact your district nurse.
• If you have cloudy urine, burning when passing urine, unpleasant smelling urine or a high temperature, contact your GP immediately to determine whether you should have antibiotic treatment for a suspected urine infection.

• Type of catheter (Fr):
• Balloon size (ml):
• Date of insertion:
• Date for catheter change:
• Your leg and night bags should be changed only once a week unless there is a problem with one of them. After use, they can be rinsed out, put into a plastic bag and put out with household waste.

• You have been referred to the TWOC clinic. They will contact you to arrange a day for you to attend.

• At the clinic, a nurse will assess you before removing your catheter. You will then spend the day in the clinic to ensure you can pass urine adequately. If not, you may need the catheter to be reinserted. If further investigations are needed, the clinic staff will arrange these.

This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information in this article is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.