Living with a urinary catheter

Sex and intimate relationships

Disability can affect a relationship both in positive and negative ways, but having a catheter can sometimes be more difficult for people who want a good sexual relationship.
An active sex life can be possible with either a urethral or a suprapubic catheter, but it may be easier with a suprapubic catheter than with a urethral catheter (see below).
Before sex, a man can tape a urethral catheter along the shaft of the penis and cover it with a condom, a woman can tape it up along her abdomen. But people may not like having sex with a urethral catheter in place, and some find it uncomfortable. Sara’s urethral catheter made having sex unpleasant because the catheter moved around and caused pain. Iain, a 35-year-old with MS, also found that his urethral catheter made sex uncomfortable.  
Jade, a 22-year-old with Fowler’s Syndrome, had a suprapubic catheter for a number of years. During sex, she pushed her catheter to one side but sometimes it got in the way. She had it removed and started intermittent self catheterisation (ISC). Then she became pregnant.
Frances, on the other hand, said that her suprapubic catheter did not affect her sex life. Jennifer was also adamant that having a catheter did not affect her relationships.
A suprapubic catheter can affect self image too. Vicky had a sky diving accident nine years ago and was paralysed at the age of 31. She has avoided sexual relationships since.
Carol had a urethral catheter for four months. During that time she said she lacked the ‘confidence’ to have sex. Her leg bag felt ‘just too obvious’ and the catheter had changed how she felt about her body.
 
Alex needed a catheter because of incontinence but worried that, if she had a catheter, her husband would find her sexually unattractive. She chose a suprapubic catheter but was apprehensive when she found that the surgeon had placed it very low down, near to her pubic bone and clitoris (see ‘Indwelling catheters' suprapubic catheters’). Her surgeon had put it there without discussing it because he assumed she might want to wear a bikini and hide the scar.
Some women we talked to had found blood in the urine after penetrative sex. They were alarmed – no one had told them that this might happen.
Jade found it very hard to talk to her doctor about her sexual problems. Stuart, another person we interviewed, pointed out that, unfortunately, medical staff do not always consider sex an important subject.
After Gavin’s accident and spinal injury, he and his wife wanted to have a second child so Gavin felt that a urethral catheter was unsuitable for him.

Some older men said they hadn’t entirely lost their libido. They had a close emotional bond with their wives but sex was no longer part of their relationship. Pat said the dynamics of a relationship can change when someone becomes disabled. Although her relationship with her husband, Rob, had changed and she was now his carer, she wanted to ‘think of him as my husband’. Although at first she did everything for him, over time Rob had resumed some of the things he’d done before he got ill. Alok and his wife were both in their 30s when he became paralysed from his neck down after a car accident. He now lives in a residential care home. He knew that he could no longer be the husband he was before his accident. Although he and his wife were still together, he said he could understand if she wanted to leave him and start again with someone new. Such changes in a relationship related to the disability rather than having the catheter.

Last reviewed June 2015.

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