MALE URINARY CATHETER CARE SUGGESTIONS

You have been or may be discharged from the hospital with a urinary catheter.  These tubes (usually called "Foley", named after the inventor) are used to drain the urinary bladder of urine normally stored in the bladder.  Your physician can explain the reasons for the catheter's use and its expected length of stay.

Design:  The catheter is a hollow tube with a hole on each end.  A side arm can be seen on the catheter and this allows a small balloon to be filled in the bladder so that the catheter does not fall out.

Connection:  The catheter needs to be connected to a drainage bag to allow continuous and unimpeded drainage.  It is important not to obstruct the flow of urine, unless you are specifically asked to do so.

Drainage Bags:  These are the plastic bags to which the catheter is connected. The bags vary in design but all have a connection adapter for the catheter and a drainage port or spigot at the bottom to empty the bag.  Larger bags have long tubes so that they can be attached to the bed or carried. Larger bags are used around the house and overnight because of their larger capacity.  Small bags or 'leg bags'  have no tubing and must be attached to the leg with straps. They must be emptied every 2-4 hours depending on how much you drink.  Leg bags are easy to conceal under your pants and allow you to go outside with complete privacy.

              Note: both bags must be kept below the level of your bladder to drain properly.

              Note: Do not connect the catheter to the OUT or EXIT port - there is a one-way valve

                             which will prevent the urine from flowing into the bag

To change Bags: Patients will switch between bags as mentioned above.  To change bags properly, good hygeine must be observed.  Wash your hands first.  Before disconnecting the current bag, clean the connector of the drainage bag  that you wish to use with alcohol (if the end looks clean) or soap and water, then alchohol, if the end is dirty or crusted.  Pinching the catheter end to prevent leakage pull and twist the catheter from the connector.  Then firmly attach the catheter to the new bag connector.  Wash the old bag with soap and water, if available, and rinse well.  Store in a clean place for later use.

Care:  The major cause of irritation is at the tip of the penis.  You should wash this area daily with a mild soap and water at least twice a day.  In most cases, you will have less irritation of the tip of the penis if the catheter is secured to the leg with a gentle curve.  Tape is the best and least expensive way of securing the catheter.  Movement or tugging on the catheter will then pull on the tape, not on the penis.

Cleaning the drainage bags:  Rinse bags with warm water and soap every day or two, depending on how dirty and how much odor is present.  One teaspoon of vinegar may be used in the rinse water to reduce the odor.

Emptying bags:  Hold any bag over the toilet or suitable container and open the spigot at the bottom of the bag.  Let urine flow until empty and then close the spigot.

Problems:  The more urine that flows, the less the chance for a blockage.  You should be drinking 4-8 ounces of water every hour while awake.

Bleeding:  Bleeding can be seen on occasion with any catheter.  Small amounts of blood or clots are usually of  little concern.  Bleeding sufficient enough to make it impossible to see through the urine should be brought to your physician's attention.

Blockage:  Urine should drain constantly into the bags.  If you see no flow for more than an hour and feel the need to urinate, a blockage of the tube may be present.  Debris or blood clots are the most common causes and will need to be dealt with in your physician's office, if open, or the emergency room.  The catheter will either be irrigated until it is clear or the catheter changed.

(Optional) Removing the catheter:  In certain circumstances we will suggest that the catheter be removed by yourself at home.  The thought of doing something 'medical' may be frightening to some.  However, removing the catheter is quite easy and with no serious risks.  Normally this is done early in the morning during a weekday.  The reason for this is that if you are unable to urinate after removal of the catheter, we will still be in the office to assist you. 

From the diagram at the beginning of this pamphlet you can see the catheter stays in place in the bladder because of a balloon at the end that is inflated with water once the catheter end is placed into the bladder.  Therefore, removing the water from the balloon flattens the catheter and allows you to pull the catheter out.  Removing the water from the balloon requires that you cut the valve stem completely across with a scissors.  The balloon will slowly drain one to two teaspoons of water within 30 seconds.  The catheter can then be easily pulled out with a gentle tugging movement.  If removed, you may want to monitor the times and amount of urine that you pass for the next 24 hours. Expect a slight burning sensation with urination for the first day or so.  If you are unable to urinate, or have the sensation that you are not emptying your bladder, please call. You may then throw the catheter into the garbage.

DO NOT REMOVE THE CATHETER UNLESS SPECIFICALLY REQUESTED TO DO SO