Troubleshooting Your Catheter

Catheters are highly specialized devices which facilitate the evacuation of urine from the bladder. They are used in patients which encounter problems during urination or are unable to move. They can be used on either short or long term, depending on the medical situation of the patient.

Modern catheters are single-use, sterile devices which are extremely safe, as they come in individual packages. They can either be inserted by nurses, in a hospital environment, or by the patients themselves, in special situations. Either way, insertion is simple and the package includes all the required instructions.

What happens when catheters don’t work properly?

Catheters normally work properly and should involve minimum pain or discomfort for patients. However, in certain situations, typically during long term use or because of a defective insertion, you may experience some issues. Most of them are not life threatening and can be resolved quickly by a health care professional, so make sure you contact your doctor or nurse.

Let’s take a look at some of the most common issues with catheters:

1. The catheter won’t go in 

(This section only applies to patients who are performing intermittent self-catheterisation)

In some cases, when trying to insert an intermittent catheter, the device may become stuck in a narrower passage. If this happens, don’t force it through. It may cause ruptures, lesions and tears on your inner urethra which can lead to urinary tract infections. Here’s what you should do instead:

• remove the catheter from the urethra and try again after an hour; slowly insert the catheter and pay attention to any discomfort; if you still find it impossible to insert it, visit your local hospital for assistance;
• if your bladder is full and you are in pain, you should visit the nearest emergency department as soon as possible; 

2. There is no urine draining

 (This section only applies to patients who are performing intermittent self-catheterisation) 

This usually happens when the lubricating gel on the catheter blocked the drainage holes. The gel is water based, so it should dissolve in urine in a couple of minutes, at the most. Here’s what you need to do:

• try coughing – this triggers the elimination of urine;
• check your catheter – is it inserted properly?
• if you are female – check out if you didn’t insert the catheter in your vagina, by mistake; if you did, you should use a new catheter to avoid urinary tract infections;
• if you are male – check out if you inserted the catheter far enough up the urethra – there should be about 10 cm (4 inches) of catheter visible;
• if you still cannot drain the urine, contact a doctor or a nurse as soon as possible;
• if your bladder is full or you are in pain, head to the nearest emergency unit; 

3. There is urine leaking around the catheter 

(this information is for patients using suprapubic or indwelling urinary catheters) 

Urine leaks around the catheter are called bypasses and happen when the urine cannot drain through the catheter. This urine overflow leaks around the outside of the catheter and can be very uncomfortable. Here’s what you’ll need to do:

• check for any deposits or kinks in the catheter or the drainage bag;
• look for any blockage;
• if you find blockage, head to the nearest emergency department, as the catheter needs to be changed as quickly as possible;
• if you encounter bladder spasms, talk to your doctor or nurse; 

4. Stomach cramps 

Cramps appear when a poorly inserted catheter irritates the inner bladder walls, resulting in what is known as bladder constipation or bladder spasms. If you feel any of these symptoms, you should talk to your doctor or nurse as soon as possible. Some patients may require drugs to calm their bladder pain, but this should be discussed with a health care professional. 

5. Smelly, discolored or cloudy urine 

These are some of the common symptoms of urinary tract infection (UTI). Contact your doctor as soon as you encounter any of these symptoms, as well:

• cloudy, offensive smelling urine
• burning sensation in the urethra, bladder, and around the catheter
• itching, soreness
• bleeding
• high temperature
• nausea, discomfort in the lower back and loin area

Don’t panic – UTIs are easily treated with antibiotics, but only after the diagnosis was confirmed. 

6. The catheter has fallen out 

(this only applies to patients using an indwelling catheter) 

Although your catheter should not fall out (it’s held into place by an inflated balloon), but this can happen on rare occasions. When the balloon accidentally deflates, the catheter may fall out. If this happens, you should contact your doctor or nurse immediately. Do not try to reinsert it yourself.