A-Z

Living with a urinary catheter

Looking after the catheter and catheter site

Everyday care of the catheter and drainage bag is essential to reduce the risk of infection. When living with a urethral catheter the precautions include:
  • Cleaning the urethral area (where the catheter comes out) and the catheter itself
  • Using only clean hands to disconnect the drainage bag from the catheter
  • Disconnecting the drainage bag as little as possible
  • Keeping the drainage bag connector as clean as possible and cleaning the drainage bag periodically
  • Using a thin catheter where possible to reduce the risk of harming the urethra during insertion
  • Drinking enough liquid to produce at least two litres of urine every day
 

Peter Y talks about the importance of hygiene and drinking lots of fluids to help prevent urinary...

Peter Y talks about the importance of hygiene and drinking lots of fluids to help prevent urinary...

Age at interview: 65
Sex: Male
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The best advice I think I could say is to manage the situation yourself. Try to understand what’s happening and to be not concerned about it. Place an emphasis on hygiene; place an emphasis on monitoring your urine. Just, especially in the beginning, make sure it’s working alright. 
 
But you’ll soon become quite confident of it I think, in that if it is working well. If you get an infection, get it treated quickly. You might be able to get another start as it were, but acidic drinks are a good idea especially if you do get an infection. Get some acidic drinks into you. As I say, I drink six pints a day which might be a lot for some people, but that’s what I do. And do that at the same time as the antibiotics again as well. If, you know, and they can argue who cured you, the antibiotic or your acidic drink, but make life as difficult as possible for the bacteria that have entered the bladder.
 
So that’s the main advice I’d give is general hygiene, and prevention is much better than a cure. And I think for some bladder infections cure is extremely difficult. 

 

John Y and Charles describe what they do every day to look after their catheter:
 

Charles’ wife cleans his catheter site at least once a day with saline solution and a single use...

Charles’ wife cleans his catheter site at least once a day with saline solution and a single use...

Age at interview: 57
Sex: Male
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Could you talk about cleaning the catheter site?
 
Basically, although nurses have said, “Well, just wash it”, my wife cleans it at least once a day with a saline solution and a single-use cloth.
 
Just round the site?
 
Just round the site. So basically it keeps it clean. Any deposits on the pipe or round there are all taken off. And it’s kept clean, you know, at least once a day. 
 
But I, obviously if I shower every day as well, so that I try to keep the site clean from that point of view. So that’s, you know, it’s an infection point, so keeping that clean is very important. 
 
As the consultant who I’ve recently seen says, “It’s not necessary to use sterile stuff” although, you know, it’s convenient because the saline solution comes in these little tubes which is very convenient to use. “But it’s important to keep it clean.” Get rid of, you know, detritus of, you know, because your body will exude stuff, whatever it’s called, I’m not quite sure.

 

 

John Y showers every other day with his wife's help. They carefully avoid touching the inside of...

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John Y showers every other day with his wife's help. They carefully avoid touching the inside of...

Age at interview: 77
Sex: Male
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I used to have a shower every day but I now shower alternate days because it’s such an effort for my wife to do it. And once a week we change the bag. And that’s really the only routine thing we do. 
 
And we’ve got that off fairly smart and we lift it [the catheter] up so as the join is the highest point between the catheter and the leg bag, and pull it, it’s quite hard. And I hold the catheter and we are both very careful not to touch anything so that the inside of the catheter is kept sterile and the new bag is kept in. 
 
So really that’s the only thing. And the only other thing we do regularly is change the sleeve that holds the bag if I’m going to have a shower because it [the water] tends to make it go a little bit floppy and not so effective. 
 
So we keep one for showering and put a dry one on afterwards. So once changed, once a week changing the leg bag. 
 
And after every shower do you put a new sleeve? 
 
No, no we go back, we change the sleeve whenever it needs to be. No, we can make a sleeve last three or four weeks, but not if we put it in the shower so we just keep a separate one for the shower. 
 
I see, yes. 
 
And so once a week changing the leg bag, and eight to ten weeks changing the catheter. 

 

Some people talked specifically about looking after their suprapubic catheter and keeping the site clean.
 
Looking after a suprapubic catheter
  • Always wash hands before and after emptying the drainage bag, or before and after emptying the bladder using the valve. The area around the insertion site should be washed with cooled boiled water. Some people find cleaning the catheter site with a sterile saline solution a good way of keeping the area clean.
  • A dressing covers the catheter site after the operation and should be kept in place until it has healed. Although not always necessary, many people prefer to wear a dressing around the catheter site all the time. The type of dressing may vary. A dry gauze dressing is sufficient for some people
  • Do not put any cream or talc around the site.
  • Showers are better than baths as prolonged sitting in water can delay wound healing. For the first few days after the operation, use a waterproof dressing. Once the wound has healed, normal showering is fine but scented products should be avoided as they can irritate the skin.
 

Michelle and her carer keep everything as clean as possible, especially around the time of her...

Michelle and her carer keep everything as clean as possible, especially around the time of her...

Age at interview: 45
Sex: Female
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The one thing I did find that I did have difficulty with having the urethral catheter was because, although my bladder and my bowels decided to stop work on the day that I had my injury, the one thing that I never got any problems with was my monthly menstruation. So I would always have my menstrual cycle and, even when all this happened, I never missed one period. 
 
So, because of having the urethral catheter, my mother to start with and then my carers obviously had to be very careful about when I had my periods on, to make sure that the catheter and the site and everything there, down in that area, was cleaned carefully to avoid any possible infection being introduced that way. 
 
Yes, that must have been quite difficult. 
 
Yes, and although I discussed with my GP about going onto the pill or something like that to try and stop some of the periods, some of the bleeding happening because of some of the side effects of the medication that I could have had at the time, I really didn’t want to sort of introduce anything else into my system. So in a way it was, I decided that it was best just to let nature take its course. 
 
But, as I say, obviously it did sort of introduce into the whole care regime a bit more careful consideration around making sure that everything was kept as hygienic as possible. 
 
Summing up now, thinking in your mind, are you glad that you changed to the suprapubic catheter? 
 
Yes, I think yes, so as I say, from my carers’ perspective it’s a lot easier to cope with. Even from just things, particularly around sort of my period now. You know, whilst I can be in quite a bloody mess, even sort of using tampons because I can’t, because it’s, I don’t get on and off the bed two or three times a day to change the tampons when I’ve got a heavy period, you know I still leak blood onto my continence pads. So whilst my carers still have to clean and make sure hygiene wise that that’s all alright, certainly we don’t have any worries that the catheter itself is getting infected from that. So from that perspective, that helps. 

 

 

Dave washes around the catheter site every day with saline solution. He takes care not to pull...

Dave washes around the catheter site every day with saline solution. He takes care not to pull...

Age at interview: 31
Sex: Male
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Since you’ve been home, can you say a little bit more about caring for your catheter once you’re at home? Was it very different once you’re at home? And replacing it by the district nurse?
 
Not too different in that, every day, I would wash around the catheter site with saline solution. I would move the night bag into a day bag. That [the night bag] would be taken off. I think overnight and during the day I’m still very careful that the catheter doesn’t pull. So I make sure there’s plenty of give in the tube on the bed, and then again when it’s attached to my leg I affix it in three places to make sure that injury to the catheter site is minimised because you don’t want the catheter to pull on the site.
 
So you have special straps that you put round your leg?
 

Yes, I have two straps that are round the leg bag itself and one that I put higher on my thigh to grip on to it.  

Some people’s partner or carer changed the dressing every day and cleaned the catheter site. They stressed the importance of washing hands before and after handling the catheter, and cleaning the site with soap and water. A few people said they sometimes had ‘over granulation’ around the catheter site. Over granulation is excessive granulation tissue, which stands above the rest of the skin. A mild topical steroid cream is sometimes used to reduce over granulation.
 

District nurses gave Badg a steroid cream, which he dabs on with a cotton bud. He shaves around...

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District nurses gave Badg a steroid cream, which he dabs on with a cotton bud. He shaves around...

Age at interview: 58
Sex: Male
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I get over granulation occasionally, which the local district nurse has given me a tube of Aureocort for. It’s a steroid cream. So, periodically if that starts to get a bit long and in the way, I go dab that with a cotton wool bud and a bit of cream. 
 
I shave round the hole because I'm personally convinced that the hairs getting in the hole aggravate the skin inside the hole and can promote the granulation. And also it means that I don’t have quite so much of a problem with the, when I take the, I wear a pad over it ‘cos it does weep a little. And when I take the pad off, it doesn’t pull the hairs out as much. It’s just covered up the skin. I don’t have enough sensation to suffer so, only a little bit. 

 

 

Jennifer found a dressing that has stopped her having over granulation. She also discovered a...

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Jennifer found a dressing that has stopped her having over granulation. She also discovered a...

Age at interview: 26
Sex: Female
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Over the years I’ve found a brilliant dressing. I use Allevyn dressings which have an anti-microbial film on them and it also stops over granulation of the site where the skin is trying to heal itself and it forms like little blisters, bubbles kind of things. It stops that. 
 
So I use that and I also use a Mepitac tape, which is the most amazing tape ever because it doesn’t leave any marks on your skin, you can stick it, you can peel it and stick it as many times as you like and it never leaves a mark on your skin. 
 
Oh that’s useful. 
 
So it’s a brilliant tape. It’s not something, or to me, it shocked me when I found them out because it had been years down the line and I found it out. And I didn’t realise it had been going for so long. But it’s not always something that your practice nurse or district nurse will recommend to you because they’re quite expensive. 

 

Ann had had a suprapubic catheter for about 4 months and said she was still having problems with the wound. She has an infection where her catheter is inserted:
 

Ann visits her local surgery 3 times a week to have her dressing changed. She’s tried different...

Ann visits her local surgery 3 times a week to have her dressing changed. She’s tried different...

Age at interview: 81
Sex: Female
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What I am having a problem with is the wound has still got a bit of infection and I’m having to go up to the treatment room at my surgery three times a week to have the dressing done. And they’ve tried me on this and tried me on that, and I’m now on Inadine dressings. Having gone through antibiotics and honey as dressings, I’m now on Inadine, which seems to be drying it up. But there’s just a bit of inflammation on the tummy wound. 
 
I’ve had antibiotics for my wound infection. And the GP is always wanting to give me more antibiotics for my wound infection, and I am wanting not to have them. So in fact I’ve got some “in case of’s”. But I’m not taking them. 

 

 

Roger got a blister on his catheter site. At hospital he was told that his carer had not been...

Roger got a blister on his catheter site. At hospital he was told that his carer had not been...

Age at interview: 66
Sex: Male
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Yesterday they [carers] suddenly realised that there had been a blister. They didn’t mention it when they were cleaning me in the morning and I can’t see it, I can’t see when they’re cleaning me what goes on down there.

 
They said, “Oh, there’s a hole formed, the blister, the blister has burst and there’s a cavity formed around the hole that the SPC [suprapubic catheter] goes in.” I said, “Well what are you going to do about that?” “Er, well we’ll spray it possibly with, oh, no, no, we’ll put some saline lotion and some Aquacel on, which will fill the hole and put the new dressing on. And we’ll see what happens.”
 
But quite often when I’ve gone to the hospital to have it [the catheter] changed, they say, “Well this hasn’t been cleaned properly because there’s too much puss around the tube where it comes out of the body.” Because it often, there’s a yellow emission, which I don’t know whether that’s a sign of an infection or whether it’s just a quirk of my particular case. I don’t know. Obviously everybody is different and reacts slightly differently to even the same catheter.
 
Do they clean around it every day?
 
Well, they used not to but more recently I think the hospital wrote to them here and said it must be changed every day.
 
Cleaned every day?
 
Yes, the dressing taken off.
 
Oh, the dressing.
 
Taken off and around the tube cleaned. 

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Last reviewed October 2018.
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