There are many times that you might need to use a catheter, on either a temporary or permanent basis, to collect and remove urine on your own. If you’ve ever been hospitalized for surgery or immobilized and unable to get out of bed or use a bedpan for awhile, you may have had a urinary catheter inserted into your bladder so that urine can be eliminated as needed. Some of the medical conditions that may require catheter use in an everyday or home setting include either urinary incontinence or retention (when you can’t empty your bladder at will), surgery that affects the bladder, like a gynecological or prostate procedure, or a disabling illness like a spinal cord injury, MS or even dementia.
A few different types of catheters are available. The right one for you typically depends on the medical reason you need it.
There are three main types of catheters:
An indwelling catheter, like a Foley catheter, is inserted through the urethra, stays in place within your bladder and attaches to a drainage bag. It has a small balloon on the end of it that is inflated to keep it from sliding out; the balloon is deflated when you want to remove the catheter.
An intermittent catheter is used on a temporary basis, inserted through the urethra to the bladder to remove urine, but taken out after the flow of urine has stopped. Most are made of rubber or a clear plastic and, because they aren’t left in, their design is more simplistic. These are often referred to as CISC (clean intermittent self-catheterization) catheters and are most often disposable. Because they are inserted as needed rather than left in place for longer periods of time, there is less chance of a bladder infection with their use. Many are made of materials specifically designed for the lowest possible amount of friction upon insertion. For instance, the FloCath Hydrophillic Intermittent Catheter has a hydrophilic coating that allows water to bind to the catheter, creating a slippery, low friction surface; it is activated by soaking the catheter in water for 30 seconds.
A male external catheter was originally called a condom catheter, after the product that inspired early designs. An external catheter goes over the penis, is held in place with adhesive or another form of attachment and is connected to a drainage bag to collect urine. It needs to be changed daily. Unlike catheters that are inserted into the urethra and are primarily a thin tube, an external catheter comes in many different shapes. Some cover the entire penis while others are shorter. You can also choose from a variety of materials including latex, silicone and plastic; the more form fitting, the better for snugness to avoid leaks. Examples include the Gizmo Male External Catheter, a two piece male external catheter with single-sided adhesive strip that does not come in contact with skin and a soft latex-reinforced funnel end, and the Conveen Security+ Self-sealing Male External Catheter with a gentle adhesive and a push ring for easier connection to a leg bag and anti-kink bulb for added security.
Sizing. Working with your doctor on proper sizing is crucial to achieve a comfortable placement on a traditional tubal or female catheter and to have a secure fit with no leakage when using a male external catheter. Usually, the smallest size possible is the best choice. When picking sizing for an external catheter, specific penis circumference measurements—29mm, 32mm, 36mm and 41mm—will offer a better fit than those offered in small, medium or large. You may need to try a few choices to find the best one. Foley and other internal catheters are measured using French sizes, measured in the 12-22 range.
Additional items. A catheter is usually attached to a drainage bag and you’ll want to choose the style that’s best suited to your level of mobility. A leg bag is a smaller drainage device that attaches to the leg. It is usually worn during the day because it fits under clothing and can be easily emptied into a toilet.
Larger devices are available for overnight use. This style of drainage bag must always stay lower than the bladder to prevent urine from flowing back upward. Kits like the Urinary Night Drainage Set include everything needed—tubing, 2-quart bottle, detergent and deodorant since cleaning the drainage bag periodically is recommended. Depending on your circumstances, you may need two drainage bags so that one is available for use when the other is being cleaned.