Catheters

What is a catheter?

People who have difficulty emptying their bladder use a catheter, which is a thin tube that is passed into the bladder (usually through the urethra) and allows the urine to drain freely. There are two main types of catheter:

Intermittent catheters – also called Nelaton or “in/out” catheters are inserted into the bladder temporarily to allow it to empty and are then removed.
Indwelling catheters - also called Foley catheters. These are designed to remain in the bladder continuously for longer periods of time.

Catheters should only be used after a thorough assessment by a healthcare professional.¹

What are supra-pubic catheters?
What are supra-pubic catheters made of?
Would a supra-pubic catheter be suitable for me?
A supra-pubic catheter may be suitable if:
Supra-pubic catheters are not usually suitable for those people with:
How do I clean them?
How much do supra-pubic catheters cost and where can I buy them?
Are there any disadvantages to using supra-pubic catheters?

What are supra-pubic catheters?

A supra-pubic catheter is inserted via your lower abdomen (just above the pubic bone) into the bladder, it is held in place by a small balloon
It can be a temporary method of bladder drainage but is generally only done for those people who require long-term catheterisation or when urethral catheterisation is impossible
The first insertion of a supra-pubic catheter is a small surgical procedure and would require you to go into the hospital usually just for the day
The first catheter change is often performed in hospital or as an outpatient/during a doctors/physician visit. Subsequent changes can usually be performed by a community nurse/practice nurse in your own home or at the health clinic. Some people learn to change their own supra-pubic catheter

What are supra-pubic catheters made of?

Supra-pubic catheters are made of silicone-elastomer coated latex, hydrophilic polymer coated latex or silver-alloy coated materials (anti microbial)
These materials are known to cause less friction and tissue reaction and are therefore recommended for supra-pubic use. They are also less vulnerable to rapid colonisation by bacteria and encrustation by mineral deposits
Some, but not all urethral catheters may also be used supra-pubically

Would a supra-pubic catheter be suitable for me?

You would need to feel OK/comfortable about the idea of having a supra-pubic catheter inserted. For some people having a catheter in their abdomen in understandably unacceptable, and you may have to consider issues surrounding altered body image. For others it allows more freedom for sexual activity
You should discuss with your health care professional the advantages and disadvatanges of a supra-pubic catheter for your circumstances

A supra-pubic catheter may be suitable if:

You are likely to need long-term catheterisation
you have had problems with a urethral catheter, for example, the catheter does not remain in place, damage has occurred to the urthra

Supra-pubic catheters are not usually suitable for those people with:

Blood in the urine of unknown cause
Bladder tumours or small contracted bladders which may have resulted from long-term urethral catheterisation on free drainage
Obesity where the entry site for the catheter is concealed under folds of skin

How do I clean them?

Supra-pubic catheters are single-use items only and must be thrown away after each period of use

How much do supra-pubic catheters cost and where can I buy them?

The cost of catheters varies according to the design and which country you live in. For example if you live in the UK then you will be able to get your catheters free when prescribed by your health care professional.

Are there any disadvantages to using supra-pubic catheters?

Using a catheter is rarely trouble free and should only be used as a last resort. It is now generally agreed by healthy professionals that catheter use should be avoided where possible and catheters should only be used for those people in whom alternative methods are unsuitable or unsatisfactory.
Decisions about whether or not to have a catheter and other aspects of catheterisation, for example, catheter type, should be made jointly by you with your health care professional after careful assessment of your needs.
As with all indwelling catheter use, the risk of catheter-related complications is high. The most common of these is catheter-associated urinary tract infection (Cauti).
Supra-pubic catheter removal is sometimes associated with slight bleeding and discomfort from trauma to the catheter passage into the bladder and the site where the catheter enters the abdomen. This can be a particular problem with all-silicone catheters where there deflation of the balloon may be uneven leaving ridges which prevent smooth removal. This problem may also occur with hydrophillic coated catheters but is less common.

Intermittent catheters in different lengths

Foldable intermittent catheter for easy carrying

Intermittent catheter with non-touch introducer

Discreet intermittent catheters for men and women

Discreet hydrophilic intermittent catheters

Intermittent catheter with introducer tip

If you are having difficulty inserting an intermittent catheter at the entry point of your bladder don't force it! Instead, wiggle your toes. I know this sounds strange but it's the best advice I was given.

Jay age 56

Top Tips

If you have an indwelling catheter try wearing open crotch knickers that allow easier positioning of your catheter, also stockings worn with a suspender belt are less restricting than tights

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For males who experience discomfort from an indwelling catheter moving about and rubbing the urethra, close fitting underwear can be the answer. Choose wide crotch pants with a high elastane content for stretch and support available from a well know retailer or on-line in a range of styles.

If catheterised with an indwelling catheter when sitting on the toilet there is a risk of the catheter tube dropping into the toilet pan and contacting unclean surfaces. Wearing stockings and suspenders allows you to loop the catheter through a suspender strap and through the lacy suspender belt at the waist if necessary, keeping the catheter tube close to your body and away from unclean surfaces. A lacy suspender belt with lace top stockings gives a pretty appearance appreciated by partners.

I stick the mirror I use for intermittent catheterisation to the toilet seat with microporous tape to secure it. It's easy to remove after. I always wash the mirror afterwards.

Look for intermittent catheters with smooth eyes

You can use a catheter valve with an indwelling catheter, but have a bag on when you’re out. If your bladder starts to spasm because it’s full you can open the valve and pass urine into the bag.

If you have an indwelling catheter with a valve and you are going out for the day, connect it to a leg bag with a catheter retaining strap. When your bladder gets full you can empty in to the bag and then find a loo.

Lift up the toilet seat and lower your trousers and pants before washing your hands to begin with before performing intermittent catheterisation. I wipe down there with an anti-bacterial wipe before inserting. Ask your gp for a radar key.

If you use water for intermittent catheterisation and you are flying, you may not be allowed to take your own water through security. A doctor’s letter can help with this but even that may not work! Allow plenty of time at the airport to purchase bottled water on the flight side of security.

Intermittent catheters can be disposed of using scented disposal bags (the sort used for disposing of feminine hygiene products or babies’ diapers).

When performing intermittent catheterisation, I have found that extra urine flows at the end of the process by leaning backwards then forwards when standing. Experiment for yourself and I hope it works for you.

If you use intermittent catheters that need water for lubrication, take a bottle of water with you when away from home. It may also be useful to bring a small towel for washing hands/genitals.

When doing intermittent catheterisation away from home you may need to take a small towel with you for washing hands/genitals

When travelling overseas - some catheter companies have a travel certificate (Medical Validation Certificate) that you can easily download from their website and fill in to use for customs staff or TSA officials at airports.

Not all intermittent catheters are made of PVC. There are more environmentally friendly catheters available that are PVC and phthalate free. They are POBE: Polyolefin based elastomer.

Shake an intermittent catheter a bit before removing it. Sometimes a few extra drops of urine will come out.

Use compact type intermittent catheters when away from home e.g. at work.

A small travel kettle may be useful if you wish to use boiled water for intermittent catheterisation

Some places use low energy light (which may not be as bright) be prepared for this and take a torch if you need light for intermittent catheterisation or ask for a standard light bulb

Women can use luke warm water to lubricate a non-coated intermittent catheter before use

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What are supra-pubic catheters?
What are supra-pubic catheters made of?
Would a supra-pubic catheter be suitable for me?
A supra-pubic catheter may be suitable if:
Supra-pubic catheters are not usually suitable for those people with:
How do I clean them?
How much do supra-pubic catheters cost and where can I buy them?
Are there any disadvantages to using supra-pubic catheters?

What are supra-pubic catheters?

A supra-pubic catheter is inserted via your lower abdomen (just above the pubic bone) into the bladder, it is held in place by a small balloon
It can be a temporary method of bladder drainage but is generally only done for those people who require long-term catheterisation or when urethral catheterisation is impossible
The first insertion of a supra-pubic catheter is a small surgical procedure and would require you to go into the hospital usually just for the day
The first catheter change is often performed in hospital or as an outpatient/during a doctors/physician visit. Subsequent changes can usually be performed by a community nurse/practice nurse in your own home or at the health clinic. Some people learn to change their own supra-pubic catheter

What are supra-pubic catheters made of?

Supra-pubic catheters are made of silicone-elastomer coated latex, hydrophilic polymer coated latex or silver-alloy coated materials (anti microbial)
These materials are known to cause less friction and tissue reaction and are therefore recommended for supra-pubic use. They are also less vulnerable to rapid colonisation by bacteria and encrustation by mineral deposits
Some, but not all urethral catheters may also be used supra-pubically

Would a supra-pubic catheter be suitable for me?

You would need to feel OK/comfortable about the idea of having a supra-pubic catheter inserted. For some people having a catheter in their abdomen in understandably unacceptable, and you may have to consider issues surrounding altered body image. For others it allows more freedom for sexual activity
You should discuss with your health care professional the advantages and disadvatanges of a supra-pubic catheter for your circumstances

A supra-pubic catheter may be suitable if:

You are likely to need long-term catheterisation
you have had problems with a urethral catheter, for example, the catheter does not remain in place, damage has occurred to the urthra

Supra-pubic catheters are not usually suitable for those people with:

Blood in the urine of unknown cause
Bladder tumours or small contracted bladders which may have resulted from long-term urethral catheterisation on free drainage
Obesity where the entry site for the catheter is concealed under folds of skin

How do I clean them?

Supra-pubic catheters are single-use items only and must be thrown away after each period of use

How much do supra-pubic catheters cost and where can I buy them?

The cost of catheters varies according to the design and which country you live in. For example if you live in the UK then you will be able to get your catheters free when prescribed by your health care professional.

Are there any disadvantages to using supra-pubic catheters?

Using a catheter is rarely trouble free and should only be used as a last resort. It is now generally agreed by healthy professionals that catheter use should be avoided where possible and catheters should only be used for those people in whom alternative methods are unsuitable or unsatisfactory.
Decisions about whether or not to have a catheter and other aspects of catheterisation, for example, catheter type, should be made jointly by you with your health care professional after careful assessment of your needs.
As with all indwelling catheter use, the risk of catheter-related complications is high. The most common of these is catheter-associated urinary tract infection (Cauti).
Supra-pubic catheter removal is sometimes associated with slight bleeding and discomfort from trauma to the catheter passage into the bladder and the site where the catheter enters the abdomen. This can be a particular problem with all-silicone catheters where there deflation of the balloon may be uneven leaving ridges which prevent smooth removal. This problem may also occur with hydrophillic coated catheters but is less common.

What is a catheter?

Contents

What are supra-pubic catheters?

What are supra-pubic catheters made of?

Would a supra-pubic catheter be suitable for me?

A supra-pubic catheter may be suitable if:

Supra-pubic catheters are not usually suitable for those people with:

How do I clean them?

How much do supra-pubic catheters cost and where can I buy them?

Are there any disadvantages to using supra-pubic catheters?

Top Tips

Contents

What are supra-pubic catheters?

What are supra-pubic catheters made of?

Would a supra-pubic catheter be suitable for me?

A supra-pubic catheter may be suitable if:

Supra-pubic catheters are not usually suitable for those people with:

How do I clean them?

How much do supra-pubic catheters cost and where can I buy them?

Are there any disadvantages to using supra-pubic catheters?

Resources

Evidence

Continence Product Advisor

Catheters

What is a catheter?

Contents

What are supra-pubic catheters?

What are supra-pubic catheters made of?

Would a supra-pubic catheter be suitable for me?

A supra-pubic catheter may be suitable if:

Supra-pubic catheters are not usually suitable for those people with:

How do I clean them?

How much do supra-pubic catheters cost and where can I buy them?

Are there any disadvantages to using supra-pubic catheters?

Top Tips

Contents

What are supra-pubic catheters?

What are supra-pubic catheters made of?

Would a supra-pubic catheter be suitable for me?

A supra-pubic catheter may be suitable if:

Supra-pubic catheters are not usually suitable for those people with:

How do I clean them?

How much do supra-pubic catheters cost and where can I buy them?

Are there any disadvantages to using supra-pubic catheters?

Resources

Evidence

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Continence Product Advisor

Continence Product Advisor