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BackTable / Urology / Article
Indwelling Catheter Overview
Bryant Schmitz • Updated Dec 5, 2024 • 96 hits
An indwelling catheter is inserted through the urethra and drains urine to a collection bag. It is an essential tool in urologic practice, widely used for both short-term and long-term management of various medical conditions. This article provides an overview of indwelling catheters, covering their types, indications, insertion procedures, care, potential complications, and removal. This guide aims to equip healthcare professionals with the necessary knowledge to effectively use and manage indwelling catheters.
Table of Contents
(1) What is an Indwelling Catheter?
(2) Indwelling Pleural Catheter
(3) Indwelling Catheter vs Foley Catheter
(4) Indications for Use
(5) Procedure for Insertion
(6) Care & Maintenance
(7) Potential Complications
(8) Removal of Indwelling Catheters
(9) Conclusion
What is an Indwelling Catheter?
An indwelling catheter, also known as a Foley catheter, is a flexible tube inserted into the bladder to drain urine. Unlike intermittent catheters, which are inserted and removed after each use, indwelling catheters remain in place for an extended period, secured by an inflated balloon at the catheter's tip. Indwelling catheters are crucial in managing urinary retention, during surgeries, and in patients with chronic medical conditions.
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Indwelling Pleural Catheter
Indwelling catheter may also refer to an indwelling pleural catheter, which used to manage pleural effusions, where fluid accumulates in the pleural space around the lungs. These catheters allow for continuous or intermittent drainage of pleural fluid, providing relief from symptoms like shortness of breath and discomfort. This article focuses on indwelling catheters placed in the bladder.
Indwelling Catheter vs Foley Catheter
The terms "indwelling catheter" and "Foley catheter" are often used interchangeably as they refer to the same type of device. Both refer to a catheter that remains in the bladder for an extended period. The distinction is mainly in terminology, with "Foley" being the name of the original inventor, Dr. Frederic Foley.
Indications for Use
Indwelling catheters are indicated in various medical scenarios, including:
• Urinary Retention: Inability to empty the bladder.
• Post-Surgical Care: To monitor urine output and ensure bladder drainage.
• Chronic Conditions: Such as neurogenic bladder or severe prostate enlargement.
Procedure for Insertion
The insertion of an indwelling catheter must be performed using sterile technique to prevent infections. The procedure involves:
1. Preparation: Assemble all necessary equipment and ensure aseptic conditions.
2. Patient Positioning: Position the patient appropriately (usually supine with legs spread).
3. Sterile Field Setup: Clean the genital area with an antiseptic solution.
4. Catheter Insertion: Insert the catheter gently through the urethra into the bladder.
5. Balloon Inflation: Inflate the balloon at the catheter's tip with sterile water to secure it in place.
6. Connection: Attach the catheter to a drainage bag.
Care & Maintenance
Proper care and maintenance of indwelling catheters are crucial to prevent complications. Recommendations include:
• Regular Cleaning: Clean the catheter insertion site daily with mild soap and water.
• Hydration: Ensure adequate fluid intake to prevent blockages.
• Monitoring: Regularly check for signs of infection or blockage, such as cloudy urine or discomfort.
• Routine Changes: Replace the catheter as per clinical guidelines or if it becomes blocked.
Potential Complications
Complications associated with indwelling catheters include:
• Infections: Urinary tract infections (UTIs) are common and can be prevented with proper hygiene.
• Blockages: Caused by debris or encrustation within the catheter.
• Discomfort: Bladder spasms or urethral irritation.
• Leakage: Around the catheter due to bladder contractions.
Removal of Indwelling Catheters
The removal procedure involves:
1. Preparation: Explain the procedure to the patient and gather supplies.
2. Deflation: Deflate the balloon by aspirating the sterile water.
3. Extraction: Gently withdraw the catheter.
4. Post-Removal Care: Monitor the patient for urinary retention or infection symptoms.
Conclusion
Indwelling catheters play a vital role in urological care, providing effective management for various conditions. Proper insertion, care, and timely removal are essential to minimize complications and ensure patient comfort. Healthcare professionals must stay informed about best practices in catheter management to deliver optimal care.
Additional resources:
Murphy C, Cowan A, Moore K, Fader M. Managing long term indwelling urinary catheters. BMJ. 2018;363:k3711. doi:10.1136/bmj.k3711.
Bernstein J, Meddings J, et al. Urinary Retention Evaluation and Catheterization Algorithm for Adult Inpatients. JAMA Network Open. 2024;7(7):e2422281. doi:10.1001/jamanetworkopen.2024.22281.
Meddings J, Rogers MA, Krein SL, Fakih MG, Olmsted RN, Saint S. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf. 2014;23(4):277-289. doi:10.1136/bmjqs-2012-001774
Kepes JA, Wilhite JB Jr, Markland AD. Complications of Indwelling Urinary Catheter Care and Care Transitions: A Teachable Moment. JAMA Intern Med. 2016;176(6):816-817. doi:10.1001/jamainternmed.2016.1690.
Podcast Contributors
Dr. Anne Cameron
Dr. Anne Cameron is a urologist and assistant professor with University of Michigan Medical School in Ann Arbor.
Dr. Suzette Sutherland
Dr. Suzette Sutherland is the director of female urology with UW Medicine in Seattle, Washington.
Cite This Podcast
BackTable, LLC (Producer). (2023, December 27). Ep. 144 – Recurrent UTIs: Controlling Those Nasty Little Bladder Infections [Audio podcast]. Retrieved from https://www.backtable.com
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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