Indwelling urinary catheters for managing your bladder. Information for patients Northern General Hospital

Transcription

1 Indwelling urinary catheters for managing your bladder Information for patients Northern General Hospital

2 What is an indwelling catheter? An indwelling catheter is a tube, usually with a balloon on the end, that stays in your bladder all of the time to drain urine. Balloon Fluid in to inflate balloon This type of catheter (with a balloon on the end to keep it in place) is called a Foley catheter. There are two common types of indwelling catheter; urethral and suprapubic. In either case the catheter is usually the same: it is just the route into your bladder that is different. Urethral catheters Urethral catheters also known as IUCD (indwelling urethral catheter drainage) use the urethra (water pipe) to enter the bladder. Bladder Inflated balloon Pubic bone Catheter Uterus Vagina Rectum Inflated balloon Pubic bone Prostate Female urinary tract with catheter in place Bladder Male urinary tract with catheter in place Catheter Rectum page 2 of 8

3 Suprapubic catheters Suprapubic catheters (also known as SPCs) enter your bladder through a small opening in your abdomen. The opening is usually made between your pubic area and your umbilicus (belly button). For further details please see our separate SPC leaflet. To collection bag Catheter Pubic bone Bladder Vagina Uterus What are the benefits of having an indwelling catheter? The main benefit of having a catheter is being able to empty your bladder and keep dry. If you have a spinal cord injury you may not otherwise be able to control your bladder. Immediately after injury, most patients have an indwelling catheter. page 3 of 8

4 Are there any risks to having an indwelling catheter? Long term indwelling catheterisation (either urethral or SPC) can cause problems which can include: Damage to the urethra and bladder caused by the long-term presence of the catheter, or by it being pulled accidentally. The inside of the catheter can become encrusted (silted up) with stone-like debris, or stones can form in the bladder due to the constant presence of a foreign body. An indwelling catheter provides a route for bacteria to get into the bladder, and can provide them with shelter from the body s defence systems. Stones in the kidneys and ureters are more common if you have an indwelling catheter. If you have an indwelling catheter and keep it on free drainage, your bladder will always be empty. This can cause your bladder to shrink (lose capacity), which will eventually cause problems with bypassing (getting wet around the catheter) If you have an injury above T6 autonomic dysreflexia can be a potential risk If the catheter is blocked by encrustation, or the drainage bag tubing is kinked, you may get wet due to bypassing, or suffer autonomic dysreflexia. Or your bladder may become too full (over-distended), which can cause bleeding (haematuria). Any of these things can also trigger a UTI flare-up. Is there anything I can do to prevent these problems? If you follow the advice in the leaflet Looking after an indwelling catheter you can greatly reduce the chance of these adverse effects. A well-managed indwelling catheter is still probably safer for you than sheath drainage or intermittent self-catheterisation if they are not well managed and do not keep you dry. page 4 of 8

5 How to manage a blocked catheter All indwelling catheters, whether suprapubic or urethral, can become blocked due to encrustation. The encrustation is due to a combination of chemical (the mineral waste produced by your body and excreted in your urine) and bacterial reaction to the presence of the catheter. Persistent blockage is often a sign that the catheter is not being well managed, so make sure that the steps given in the leaflet Looking after an indwelling catheter are being followed. How will I know that the catheter is blocked? The urine will stop flowing into your urine bag. If you are a tetraplegic, you may develop autonomic dysreflexia*, the most obvious sign of which is a severe headache. Your lower abdomen may become tight and distended. If you have sensation in your bladder, this might become painful. You may bypass (pass urine around) the catheter and get wet. If you have a SPC you may pass urine down your urethra. Once your catheter has been blocked a few times, you may learn some early warning signs that are particular to you. Increased spasm, sweating or a blotchy rash, for example. This is a serious situation, particularly if you are at risk of Autonomic Dysreflexia *Make sure you know if you are 'at risk' of autonomic dysreflexia before you are discharged. This is a serious condition so it is important that you have had this complication explained to you fully. page 5 of 8

6 What should I do if my catheter is blocked? Do not try to wash out a blocked catheter - you might force fluid in, but not get it to return. This can worsen the situation, and it wastes time. Take the catheter out (if it is urethral), and you may pass urine when you do, which will ease any symptoms of autonomic dysreflexia. It is better to be wet than dysreflexic. As soon as you can, pass another catheter. Contact the spinal injuries centre (see contact numbers later in this leaflet). If I have a blocked suprapubic catheter, is that any different? You may well pass urine down your urethra when your suprapubic catheter is blocked. Do not try a washout or remove the suprapubic catheter initially. If your autonomic dysreflexia is under control, change the suprapubic catheter. You can pass a catheter urethrally if necessary, and get the suprapubic catheter changed at a convenient time. Catheter maintenance solutions There is common product called the catheter maintenance solution. This product is not for attempting to wash out a blocked catheter. It is used to try and extend the life of catheters in those who block regularly despite frequent changes. In other words, to prevent catheters from blocking in the first place. page 6 of 8

7 Other information you should be aware of Please make sure you have copies of these leaflets: Looking after an indwelling catheter (PIL2603) Clipping and releasing your catheter using a valve (PIL2590) You may also like to read: Suprapubic catheterisation (Male SPC PIL2587 / Female SPC PIL2588) These leaflets are available from the Spinal Injuries Centre and on the hospital website: What should I do if I have any concerns or would like any further information? If you have any symptoms you are concerned about or wish to discuss your bladder management, you can contact the Spinal Centre Urology Nurses. They can be contacted in the following ways. During working hours: Urology Nurse Specialists Paula Muter or Carol Eggington: or and ask for Bleep 2494 or Marie Watson: or and ask for Bleep 2882 page 7 of 8

8 Spinal Injuries Outpatient Department Liaison Sisters (Lissie Webster) or (Lisa Lewis) Out of hours: Osborn If necessary staff from Osborn 2 will contact the Spinal Injuires on-call staff to provide you with further advice. Produced with support from Sheffield Hospitals Charity Working together we can help local patients feel even better To donate visit Registered Charity No Alternative formats can be available on request. Please alternativeformats@sth.nhs.uk Sheffield Teaching Hospitals NHS Foundation Trust 2017 Re-use of all or any part of this document is governed by copyright and the Re-use of Public Sector Information Regulations 2005 SI 2005 No Information on re-use can be obtained from the Information Governance Department, Sheffield Teaching Hospitals. infogov@sth.nhs.uk PD9072-PIL3882 v1 Issue Date: June Review Date: June 2019