Long-term use of urinary catheters

Urinary catheters may be used by people who have problems passing urine. Long-term use is when a person uses a urinary catheter for at least 4 weeks.

People who use a urinary catheter are at increased risk of getting an infection. If you need to use a catheter at home, you and your family and carers should be given information and training to help you with this, including how to minimise the risk of infection. You should also get ongoing support and training for using a catheter at home.

Healthcare workers should make sure that a record is kept of your care, including catheter insertions and changes. They should check regularly whether you still need the catheter, and remove it as soon as possible if you no longer need it.

Types of urinary catheter

There are two types of urinary catheter – intermittent and indwelling catheters – and you should be offered the one that is best for you.

Intermittent catheter

An intermittent catheter is inserted at regular intervals or when you need to urinate. You should be offered an intermittent catheter if it is suitable for you and you are able to manage it, because the risk of infection is lower with this type of catheter. You should have a choice of two types of intermittent catheter for single use: these are called hydrophilic catheters and gel reservoir catheters.

Indwelling catheter

An indwelling catheter is in place all the time. You should only be offered an indwelling catheter once all other options have been considered. The indwelling catheter you are offered will depend on your particular characteristics and requirements, with your comfort and preferences being important factors. Your healthcare worker should talk with you about the options.

Inserting and looking after the catheter

If you are managing your catheter yourself, it is very important to clean your hands (as described in 'Keeping hands clean') both before and after handling the catheter. The same is true of any carer who is helping you. Healthcare workers should also wear a new pair of clean gloves whenever they handle the catheter.

When inserting the catheter, a lubricant should be used (sometimes the catheter is lubricated already). This makes it easier to put the catheter in place and helps avoid infection. If you are using a sachet of lubricant, this should be used once and then thrown away. Containers or tubes of lubricant can be used more than once, but should only be used by one person.

The place where the catheter enters your body (sometimes called the 'meatus') should be cleaned before the catheter is inserted. If you have an indwelling catheter, the meatus should be washed every day with soap and water.

Healthcare workers should make sure that the risk of an indwelling catheter becoming blocked is as low as possible. For example, they might advise you to drink more fluids.

Indwelling catheters should only be changed when necessary or according to the manufacturer's instructions. You may be offered antibiotics when a catheter is changed, but this should only be the case if you are prone to getting infections after catheter changes or if there are difficulties at the time of the catheter change.

Managing the catheter drainage system

There are two drainage system options for indwelling catheters. In the first option, the catheter is connected to a large drainage bag that is emptied at intervals so that it doesn't get too full. The bag should be positioned below the level of the bladder, but it should not touch the floor.

Alternatively, the catheter is controlled by a valve that is opened to allow the bladder to empty into a small drainage bag (leg bag) at intervals or when the person feels uncomfortable. When the bag is full, the urine is drained via the bag so that the system is kept intact, reducing the risk of infection. An extra bag can be added to the small bag to increase capacity overnight.

Your healthcare worker should advise you about how and when to change your drainage bag.

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