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Indwelling Catheter

When You Have an Indwelling Catheter: After Your Visit

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An indwelling catheter is a flexible tube that’s put into your bladder to drain urine. It’s held in place by a small, water-filled balloon inside your bladder. Your catheter (often called a Foley®) is connected to a tube that leads to a drainage bag. Urine from the catheter drains through the tube into the drainage bag.

What type of drainage bag do I need?

  • You can use a larger drainage bag that attaches to your bed or wheelchair. If you use a smaller leg bag during the day, you’ll connect the catheter to the larger drainage bag at night.
  • You can use a smaller bag (that straps around your thigh) during the day. The smaller bag can be worn under clothing. It needs to be emptied every 3 to 4 hours because it’s smaller.

How do I care for the catheter and drainage system?

Always wash your hands with soap and water or an alcohol-based cleaner before and after doing catheter care. Use soap and water if your hands look dirty, not the alcohol based cleaner. Only people that know how to do catheter care should help you.

  • Make sure the catheter is secure to prevent pulling. Be careful not to pull on the catheter.
    • Females: Secure the catheter loosely to the upper thigh with a catheter holder, preferably using a leg strap or tape (see Figure 1).
       
    • Males: Secure the catheter to the upper thigh or tummy.
  • Make sure your catheter is connected to a drainage bag (see Figure 2).
     
     
  • Always keep the drainage bag below the level of the bladder to make sure the urine is draining out of the bladder and into the drainage bag.
  • Don’t put the collection bag on the floor.
  • Take a shower or bath every day. Gently wash the catheter and the area where it leaves the body with soap and water. Wash the entire pubic area. Rinse well and dry.
  • Don’t put powder or lotion on the catheter insertion site.
  • Check that the tubing isn’t kinked, bent, or twisted (see Figure 3).
     
     
  • Don’t let the leg bag get too full (see How and When Do I Empty the Drainage Bag?).
  • Change to a new drainage bag :
    • when you change the catheter (as per your schedule)
    • if there’s a smell, the bag is changes colour, leaks, or can’t be cleaned
    • if the anti-reflux valve lets water or urine to go back up the tubing (you can check the valve by turning the bag upside down)
  •  
  • Keep the bags capped between changes.

How do I disconnect/connect my drainage bag from the catheter?

Keep the system connected as much as possible. Only disconnect the catheter from the drainage system when changing bags. If the catheter/tubing must be disconnected, wipe it with a 70% isopropyl alcohol swab before you disconnect it.

To disconnect or connect the drainage bag from the catheter:

  1. Wash your hands.
  2. Empty the drainage bag (see the next section).
  3. Wipe the connection between the catheter and drainage tube with an alcohol swab.
  4. Clamp the catheter closed by pinching or squeezing the tubing.
  5. Disconnect the catheter from the drainage tubing. Don’t touch the tube or catheter ends as you disconnect them.
  6. Take off the cover cap and connect the clean drainage tubing and bag to the catheter. Keep the tubing straight and draining downhill. Save the cover cap and put over the disconnected tubing after it’s been cleaned.
  7. Unclamp the catheter.
  8. Wash your hands.

How and when do I empty the drainage bag?

Don’t the leg bag or night bag get full. Empty the drainage bag when it is ½ to ⅔ full (at least every 4 to 8 hours) or when switching from one type of drainage bag to another. If you’re using a leg bag, you may need to empty it more often (like every 3 to 4 hours) because it’s smaller than the night bag.

To empty the drainage bag:

  1. Wash your hands.
  2. Take off the stopper/clamp to drain the urine.
    • If you’re measuring and recording your urine output, drain the urine into a clean measuring cup.
    • If you don’t need to measure your urine output, drain the urine into the toilet.
    • Don’t touch the drain spout with your fingers. Make sure the drain spout doesn’t touch the toilet, measuring container, or the floor.
  3. After the urine has fully drained, wipe the drain spout and cap with an alcohol swab and put the stopper or clamp on.
  4. Wash your hands.

If you’re measuring your urine output, write the amount with the date and time on a paper or in a notebook. Use a container that has measure markings. Note the colour and smell of your urine. Urine should be clear yellow and have a mild smell. Below is an example of what to record:

Date Time Amount Drained Colour, Smell
July 178 am210 ccPale, clear, yellow, mild smell


How do I clean the drainage bag(s)?

  • Clean the drainage bag every day while it’s disconnected from your catheter.
  • Wash the leg strap with soap and water and air dry if it’s dirty.

To clean the drainage bag:

  1. Wash your hands.
  2. Once the bag is empty, rinse it and the tubing with cool tap water until it’s clear.
  3. Clean the outside of the bag and tubing with soap and water. Rinse with warm water.
  4. Pour warm soapy water through the drain and swish it around to clean the inside of the bag and tubing.
  5. Pour a solution of vinegar and water (1 cup of vinegar in 2 cups of tap water) in through the drain and swish it around the bag and tubing.
  6. Lay the bag flat in the bottom of a clean basin, bathtub, or sink for about 30 minutes. Make sure the tubing is also full of the mixture.
  7. Empty the drainage bag and tubing. Don’t rinse the bag with water after you drain it.
  8. Hang the bag with the emptying spout open and pointing down. Let it air dry, making sure it’s fully dry before you use it again.
  9. Wipe the tip that connects to the catheter and drainage spout tip with separate alcohol swabs and cover with clean caps.
  10. Store in a clean, dry place.
  11. Wash your hands.

What should I do if I think my bladder isn’t emptying?

  • Check to see if the tubing is twisted, bent, or plugged (e.g., with mucous or blood clots).
  • Check the catheter at the insertion site to see if it’s kinked or twisted.
  • Make sure you aren’t lying on the tube.
  • Make sure the bag is lower than your bladder level.
  • Change positions.
  • Call your caregiver if, after checking the above, you think your bladder still isn’t emptying.

When should I call my doctor?

Call your doctor for any of the below issues:

  • temperature of 38 ºC or chills
  • back or flank pain
  • feel sick to your stomach and/or throwing up
  • insertion site is sore, red, swollen, or you see blood
  • urine changes colour (red or brown), is cloudy, thick, or smells bad
  • urine leaking from the insertion site
  • unusual itching, swelling, or new pain in your bladder or urethra that doesn’t go away
  • catheter coming out or leaking
  • your bladder feels full or you think your catheter is blocked/plugged and you’re drinking enough fluid

Your Home Care Nurse Visit

Always have a catheter tray and catheter at home in case your Home Care nurse needs to change your catheter.

Your Diet

  • Try not to become constipated by drinking enough fluids to keep your urine pale yellow (constipation can cause the catheter to leak).
  • Extra fluids also help prevent the catheter from getting plugged.

Intimacy when You have an Indwelling Catheter

It’s common to have questions about having sexual intercourse with an indwelling catheter. Below are some tips that may help. Please speak with your doctor or Home Care nurse if you have questions or concerns.

  • Try different positions to find that one that works best for you and your partner. Some positions can cause extra pulling or traction on the catheter (such as the face–to-face position with the partner on top), which you don’t want.
  • You or your partner can learn how to take out the catheter before intercourse and put it back in afterwards.
  • Women can tape the catheter onto the abdomen.
  • Men can tape the catheter along the erect penis and secure it under the external catheter.
  • The drainage bag can be emptied and positioned out of the way.
  • The drainage bag can be disconnected from the catheter and a valve attached.
  • You can use a water-based lubricant (oil-based lubricants can damage the catheter).

For 24/7 nurse advice and general health information call Health Link at 811​​​.

* Source: Evidence-Based Guidelines for Best Practice in Urological Health Care: Urethral and Suprapubic, European Association of Urology Nurses 2012

Current as of: July 7, 2014

Author: Home Care, Alberta Health Services