Urethral catheter care

Who needs a catheter?

Some people with bladder problems will need a catheter. The bladder is a balloon-like organ that holds wee. Some people cannot empty their bladder properly. There are a few reasons why this might be, including problems that they were born with, surgery, and voiding problems.

If the bladder does not empty properly, or a child has retention, this causes a risk of infection. Urine can also track back up to the kidneys, which will cause damage. This can also cause incontinence. A catheter may be put in to drain your child’s bladder more effectively, which helps to reduce these risks.

What is a catheter?

A catheter is a hollow tube made from a soft, flexible material. This allows wee to drain from the bladder. The tube is inserted through the urethra (where your wee comes out of your bladder). This then goes into the bladder. A balloon on the inside end of the tube is filled with water, to stop the tube from falling out.

What does the urine drain into?

Normally, a bag is put on the end of the catheter for the wee to drain into. The bag can be attached to your child’s leg with a Velcro strap. You will be given a bigger bag to use overnight, while your child is asleep.

Other children will have a valve on the end of their catheter. This can be used to control the flow of wee. The valve can be closed during the day, and then opened over the toilet to empty the bladder. This can give a child a sense of normality, as the bladder can fill and be emptied when able.

If your child gets a lot of infections, or has a large bladder, it might need to be continuously drained into a bag.

Your doctor or specialist nurse will be able to tell you what should be best for your child. Bags and valves, whatever kind they are, all need to be changed every 5 to 7 days.

How do I change the bag or valve?

1. Get the new bag or valve ready
2. Protect the floor, in case the catheter drips
3. Wash your hands thoroughly
4. Empty the catheter or bag into the toilet – if using a valve, make sure that the bladder is empty
5. Squeeze the end of the catheter to prevent any wee escaping
6. Take off the old bag or valve
7. Firmly push in the new bag or valve
8. Throw away the old bag or valve by double-bagging it, and placing in the household waste
9. Wash your hands thoroughly again

When will the catheter need changing?

It can stay in place for up to 3 months. The catheter will then need changing. It will be changed at hospital by a nurse. If your child is very scared or worried about having their catheter changing, they may be able to have some Entonox gas. This will help them to relax while it is changed. Please be aware that this may only be offered for the first catheter change.

After some time, you or your child will be taught how to change the catheter at home by yourselves.

Catheter care

Keeping it clean

The best way to keep the catheter clean is to have a bath or shower every day. Take extra care to make sure that the catheter site is dried properly, to stop it from becoming sore.

Keeping it secure

To stop the catheter from pulling, tape it securely to the leg. Make sure that there are no kinks in the tubes, so the wee can continuously drain.

Make sure that the catheter is taped below the bladder. This means that gravity can drain the bladder properly.

Troubleshooting

The catheter site looks red and sore

This may be because the skin was not dried properly after washing.

Make sure that the skin around the catheter is properly dried after baths and showers.

If the problem continues, get in touch with your specialist nurse.

Pain and discomfort from the catheter

Pain and discomfort may be caused by:

• bladder spasms
• the bladder not draining well

Check that the catheter is not kinked or blocked.

Get in touch with your specialist nurse, as your child might need some medicine to help with the spasms.

Wee is smelly, or my child feels unwell

This may be due to a urine infection.

Encourage your child to drink at least 1.5 to 2 litres of clear fluids, like water or dilute squash.

Get in touch with your GP to arrange for a urine sample to be sent. Note that this sample has to come directly from the catheter, and not the drainage bag.

No urine, or small amounts draining

This could be because:

• the catheter might be blocked
• the tube might be kinked
• the catheter is taped above the bladder
• your child has not had enough to drink

To fix this, you can try checking the position of the catheter. If needed, reposition it, and unkink the tube.

If there is not a problem with the tubing, encourage your child to drink more.

If this does not fix the problem, contact your specialist nurse. They will tell you how the flush the catheter.

Catheter has fallen out

The catheter may fall out if:

• the balloon has deflated
• the balloon has burst
• the catheter has been pulled on very hard

If this happens, replace the catheter straight away, if you can.

If your child is not able to wee, get in touch with your specialist nurse or the ward, or take them to the nearest emergency department.

If they are able to wee, get in touch with your doctor or specialist nurse when you can.

Frequently asked questions

Is there anything my child cannot do?

Having a catheter should not stop your child from doing any of the things that they like to do at school or at home.

How will I know if there is an infection?

You should get in touch with your GP or specialist nurse if your child has:

• smelly wee
• vomiting or feeling sick
• a temperature
• abdominal or back pain

You should take a sample of wee to the GP or hospital. Samples should be taken from the catheter, and not the drainage bag.

How do I get more supplies?

Bags, catheters, and valves are available to get on prescription from your GP. Your specialist nurse will let you know about the home delivery service you can sign up for. It is then up to you to get in touch with your GP or the home delivery service when you need more supplies.