While using a catheter can seem daunting at first, you will soon find that it will become second nature! Although using a catheter is not complicated, there are some common problems that people may encounter when starting. If you are encountering problems using a catheter, remember that you are not alone and that most catheter problems can be solved quite simply!
Perhaps the problem that those learning to use a catheter dread the most is discomfort. While using a catheter will cause some pressure, and maybe even a small amount of mild discomfort the first few times, it should not be painful. If you are experiencing pain during catheterization there are some things that you can do to make the process more comfortable.
Most pain during catheterization is caused by the friction between the catheter and the lining of the urethra. Lubricant is a slippery substance that is applied to a few inches of the tip of the catheter to make it slide easily over the lining of the urethra. The type of lubricant you use must be approved by your primary healthcare provider for use with a catheter, as using the wrong type can lead to infection. While you may already be using lubricant, under-lubricating may also lead to pain. Some pre-lubricated catheters may not include enough lubricant for your particular situation, and you may need to use more. You may also need to apply lubricant farther down the catheter. It is hard to use too much lubricant, so if you are experiencing pain with catheter use, using more lubricant is a good place to start.
Catheter Size and Design
If you have increased the amount of lubricant that you use and are still experiencing discomfort, you may need to consider having your primary healthcare provider change the type of catheter that you use. There are three main factors relating to catheter design that can affect comfort, these include:
- Flexibility - Although a more firm catheter is easier to insert, it can also put more stress on the lining of the urethra. Using a more flexible catheter can help to reduce the stress the catheter puts on the lining of the urethra and can make inserting the catheter more comfortable.
- Materials - Catheters are made with a variety of materials, and different materials will feel differently as they are inserted. Some catheters are coated to make them easier and smoother to insert. Asking your primary healthcare provider about using a catheter with different material may help to increase your comfort during catheterization.
- Size -The larger the catheter tube is, the more it will press on the lining of the urethra, creating friction and discomfort. Consider asking your primary healthcare provider if using a smaller catheter size could help you to feel more comfortable when catheterizing.
While changing catheter size or design can help to increase the level of comfort that you experience when catheterizing, it is something that is best done with a primary healthcare provider’s approval and advice. Changing catheters can affect other things that your primary healthcare provider will also take into consideration.
One common problem when learning how to insert a catheter, especially for men, is having the catheter get stuck during the insertion before it reaches the bladder. There are many possible reasons that a catheter might not insert all the way, but by far the most common reason is an enlarged prostate gland. The prostate gland is a gland that surrounds the urethra and can become enlarged in men as they age, making the urethra more narrow and harder to get a catheter through. While an enlarged prostate is a possible reason for problems during insertion, anyone who has had surgery, cancer, or an implant in the bladder, urethra, or genitals should stop and consult with their primary healthcare provider before continuing to try catheterizing themselves.
When having problems while trying to insert a catheter, it may be worthwhile to try a different type of catheter. There is a specially designed catheter called a Coudé catheter that has a curved tip, which can help the catheter get around the prostate gland or through areas that a typical catheter may not pass through. Men with enlarged prostate glands or those with scarring affecting the urinary tract will benefit from using a coudé catheter. Before trying this type of catheter, it is normally best to consult with your primary healthcare provider and make sure that this is the best fit for your particular situation.
Sometimes changing the size of the catheter can help it advance more easily. Changing the catheter size will be very dependent on the situation, as sometimes increasing the catheter size can actually help it to get past obstructions. Other times, decreasing the catheter size may help. If you think that changing your catheter size could help you to insert the catheter more easily, your primary healthcare provider will be able to make recommendations that fit your specific situation.
Frequent infection can be a problem for those who use catheters daily. Catheters can push bacteria up into the bladder, leading to bladder infections. If you are having frequent infections, there are steps you can take.
The best way to help prevent infection is to focus on inserting the catheter while making sure the entire process is as clean as possible. Any bacteria on the end of the catheter can start an infection, and there are several ways to help prevent this from happening:
- Wash your hands before starting.
- Wash the area around the opening of the urethra each time with soap and water before catheterizing.
- Use only sterile lube.
- If your lube is in a multi-use bottle, only use it if the opening of the bottle is clean and has not touched anything.
- Use only supplies and lube that are not expired.
- Avoid handling the part of the catheter that will be in your body.
By following these simple guidelines, you can significantly reduce the risk of infections.
Some people may find that when they insert the catheter, urine does not drain, drains slowly, or suddenly stops draining. There are two solutions that may help with drainage issues. It is important to keep in mind that if no urine drains, you do not feel an urge to go, and it has been three or more hours since the last time you catheterized, it could mean that you are not producing any urine. If this does occur, it is a medical emergency and you should consider going to your local emergency room. If urine is draining, but not well, or stops draining before it should, there are some things that could be affecting it.
One factor that can affect urine drainage from your catheter is if there is debris or other particles in your urine. There are typically two ways that solids can be in your urine, and these solids can plug your catheter or slow the flow of urine through it.
These two types of solids come from:
- Infection - When you have an infection in your bladder, it can create solid pieces of either clumps of bacteria or small pieces of the lining of your bladder. These solid pieces in your urine may affect how the urine drains. A bladder infection typically requires a primary healthcare provider to see you and prescribe antibiotics to treat it.
- Bleeding - If you are bleeding inside your bladder, the blood can clot while it is still inside your bladder, leading to blood clots that can clog the catheter. If you have bleeding in your bladder that is so bad it affects how your catheter is draining, you should consider going to your local emergency room as this can require advanced medical treatment.
By paying attention to how your urine looks, you will be able to catch problems early and ensure that you don’t have problems with drainage from your catheter.
If you are consistently having problems with how your urine drains, it may be necessary to consider using a bigger catheter. It is a good idea to discuss this with your primary healthcare provider first, but the larger opening in a bigger catheter can help urine to flow more easily.
If you are still having problems after trying our tips, we recommend that you call your primary healthcare provider and discuss your specific situation with them. Our suggestions should not replace the advice of your primary healthcare provider, and they will understand your specific situation and needs. While you may encounter some barriers as you start catheterizing, these problems will be temporary learning opportunities that you will soon overcome!