What is a Urinary Catheter?

A urinary catheter is thin semi-flexible tube that collects urine from the bladder and allows collected urine to drain into a drainage bag.  The drainage bag should be carefully monitored to make sure urine is being produced and draining properly.

Catheters may become medical necessary when someone can’t empty their bladder such as in the case of an illness, surgery, accident, or medical condition where the patient cannot physically get to a restroom or their body is unable to properly excrete urine on its own.

Urinary catheters come in many sizes and types, but are usually made of rubber, plastic (PVC), or silicone.  There are three main types of catheters: indwelling catheters, external catheters, and short-term catheters.

Indwelling catheters (urethral or suprapubic catheters)

There are two ways in which an indwelling catheter can be inserted into the bladder:

  • Urethral Catheterisation – A catheter is inserted through the urethra so that urine can drain into am external drainage bag.  This is a common procedure after surgery or when a patient is not able to move around on their own for short periods of times.  Urethral catheters may also be used in certain hospice situations to make caring for loved ones easier and less humiliating.
  • Suprapubic Catheterisation is performed in a hospital under local anesthetic or a light general anesthetic. A catheter is inserted through a small hole in the abdomen a few inches below the belly button.  Urine drains into a collection bag.

Both types of indwelling catheters have a small balloon inflated on the end to prevent the catheter from accidentally sliding out.   When the catheter needs to be removed, the balloon is deflated so the catheter can be easily removed.

Both suprapubic catheters and urethral catheters serve the same purpose — to drain urine, and only differ in how they are inserted into the bladder.

Older patients who develop an infection from a urinary catheter have an almost three-fold increased risk of death, according to the Journal Of The American Geriatrics Society. 

Causes of Bladder Stones, Infections, Kidney Failure and Other Serious Complications of Urine Catheterization

If the bladder is not able to empty itself, urine will build up and can cause pressure in the kidneys. The pressure can lead to kidney failure, an extremely dangerous condition that can result in permanent damage to the kidneys.

Urine can back up due to medications, illness, surgery, injuries sustained in an accident, certain disabilities, as well as other causes.  Catheters can help a patient by emptying urine until the person is able to do so on their own. Unfortunately, urine can also back up and harm the bladder and kidneys if urine catheters and their drainage bags are not properly inserted and maintained.

Common causes of urinary catheter complications include:

  • Wrong type or size of urine catheter was used;
  • Medical staff and/or those involved in patient care improperly trained in inserting, maintaining, and removing urinary catheters;
  • Urine tube gets kinked, twisted, or pressed upon;
  • Draining bag is not properly monitored or drained as needed to prevent urine backup;
  • Unsanitary conditions or practices the lead to infections;
  • Patient was unnecessarily catheterized for an extended period for the convenience of care takers in a nursing home or other long-term care facility.

The National Patient Safety Agency found that between June 2006 and December 2008, 114 female catheters were inserted into male patients, causing pain, blood in the urine and penile swelling. Seven caused significant hemorrhages and two led to acute kidney failure. Source: DailyMail

Additionally, catheters can cause infections and bladder stones which can contribute to the risk of kidney failure.  Improper insertion, or using the wrong size or type of catheter can also lead to serious injuries including infection, blood in the urine.  For example, catheters for females are not the same as for males.  If a male patient incorrectly receives a catheter designed for female patients, the catheter will not fit and work properly.  The balloon will inflate the urethra and not the bladder.  This can lead to serious complications.

Medical Complications of Catheter Use

Most catheters are necessary until you regain the ability to urinate on your own, which is usually a short period of time; however, elderly people and those with a permanent injury or severe illness may need to use urinary catheters for a much longer time or permanently.

  • Allergy or sensitivity to latex
  • Bladder stones
  • Blood infections (septicemia)
  • Blood in the urine (hematuria)
  • Kidney damage (usually only with long-term, indwelling catheter use)
  • Urethral injury
  • Urinary tract or kidney infections
  • Methicillin-resistant Staphylococcus aureus (MRSA Super Bug Infection)
  • Bladder cancer (only after long-term indwelling catheter)

Did your loved one suffer harm or death as a result of an injury or complication resulting from a urine catheter?