How Does Catheterization for Women Work?

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Whether you’re having surgery, undergoing tests or have other medical needs involving your bladder, your doctor may need to insert a catheter to assist in your diagnosis or treatment processes. A catheter is a device that’s inserted into your bladder to drain urine out of your body so it can then be collected for testing or disposed of. If you or a loved one need to undergo catheterization, learning more about what’s involved, along with some other important information related to catheterization for women, can help you feel more confident about and better prepared for the procedure.

What Are Catheters?

Catheters are simple devices; one of the most common, called a Foley catheter, consists of a hollow tube, a small balloon, a port and a drainage bag. The small balloon is situated on one end of the tube. This end is inserted up through a patient’s urethra — which is the small channel that moves urine from the bladder to the outside of a person’s body — and into her bladder. The balloon is then inflated with sterile water, which holds the catheter tube in place and prevents leakage. The port section splits the inserted portion of the tube into two separate tubes, one of which directs urine into the drainage bag. The other tube section allows for inflation and deflation of the balloon.

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A Foley catheter is a type of indwelling catheter. "Indwelling" means that the catheter remains inside the urethra and bladder for a short or long period of time, such as days or weeks, without removal. These types of catheters are generally used for managing long-term health conditions, such as urinary incontinence or an inability to urinate. Doctors also typically use indwelling catheters for people who are bedridden or unconscious due to conditions like a coma or because they’re under general anesthesia.

Another type of catheter insertion is called clean intermittent catheterization, or CIC. In this type of catheterization, the catheter doesn’t remain in the bladder and urethra and it also doesn’t have a balloon on the end. Instead, the catheter tube is inserted briefly — just long enough for the patient’s bladder to drain — and then removed immediately. Medical professionals may perform CIC to obtain sterile urine samples from patients who have trouble urinating or to measure a person’s urine output. Women who’ve had certain gynecologic surgeries may also opt to perform CIC on themselves if they’re unable to empty their bladders following those procedures.

How Do Doctors Insert Catheters?

The method of insertion for a catheter depends on the type of catheterization that you need. If you’re having an indwelling catheter placed, during your appointment you’ll remove clothing from the lower half of your body. You’ll need to lie flat, bend your knees and spread your legs so the clinician can access your urethra. They’ll then separate your labia to clean your urethral opening and the area around it. Following this, the clinician will use a smooth-tipped syringe to inject a small amount of lubricant into your urethra. This makes it easier for the catheter tubing to slide up to your bladder.

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Once this prepping is complete, the clinician will begin gently sliding the clean catheter up through your urethra until it reaches your bladder and urine begins flowing out. They’ll inflate the balloon to hold the catheter in place and, if they haven’t yet, attach the drainage bag to the open end of the catheter tubing. You’ll wear and empty this bag (or replacement bags) until you have the catheter removed. Most people who wear indwelling catheters secure the bags to their legs so gravity helps the urine reach and stay in the bag. If you’re having the catheter inserted for surgery, the doctor may wait until you’re already under anesthesia to place the device.

The process for placing an intermittent catheter is similar to that for the indwelling catheter. A clinician cleans around your urethra and lubricates it before placing the catheter tubing. After this, they can collect a urine sample and remove the catheter tubing. People also self-catheterize using CIC if they’re unable to void urine on their own or if they need to track their urine output for medical reasons. The process and the position your body is in may be somewhat different if you use CIC at home — some people sit on the toilet and perform CIC to drain their urine — and your doctor can show you the proper technique to use in this situation.

Are There Any Risks With Catheterization?

Catheterization is a relatively simple procedure — and one that’s common — but there are a few risks associated with having a catheter inserted. A urinary tract infection (UTI) is the most common problem for people who have indwelling catheters, according to the U.S. National Library of Medicine. This can happen if the catheter isn’t sterilized properly before insertion. If bacteria remain on the catheter when it’s placed into your bladder, this can introduce the bacteria into your bladder, where they begin multiplying — resulting in infection.

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After you’ve had an indwelling catheter placed, it’s important to be on the lookout for changes in your urine’s smell, amount and appearance. With a UTI, you might notice that your urine smells bad or has a much stronger odor than usual. Your urine might also look cloudy or thick, and you may notice blood in it. The amount of urine collecting in the drainage bag may lessen even when you’re still drinking fluids.

Other UTI signs and symptoms to look out for include a fever, pain in your abdomen or lower back, chills, aches, discharge leaking around your urethra where the tube comes out and general fatigue. If you notice any of these symptoms after your catheter insertion, call your doctor immediately. They can remove the catheter and give you antibiotics to help clear up the infection.

Insertion of a catheter can also cause damage to your urethra and to your bladder. Although it’s very rare, sometimes a catheter tube can puncture a person’s bladder wall. If you have any questions or concerns about using or maintaining your catheter — or if you’re experiencing pain after having it placed — don’t hesitate to call your doctor for assistance.

Resource Links:

https://medlineplus.gov/ency/article/003981.htm

https://www.hcd.com/urology/foley-catheter/

https://medlineplus.gov/ency/patientinstructions/000140.htm

https://www.med.uottawa.ca/procedures/ucath/

https://www.cdc.gov/hai/pdfs/uti/CA-UTI_tagged.pdf

https://medlineplus.gov/ency/article/000483.htm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865895/

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