Definition - Indwelling Catheters

A catheter is used for two common medical problems: urinary incontiinence (UI) and urinary retention.

catheter indications

Transurethral or suprapubic catheterization

Transurethral indwelling catheterization or urinary catheterization is defined as passage of a catheter into the urinary bladder via the urethra (urethral catheter). Transurethral indwelling catheterization is also called urethral catheterization. In this site we only use the term urethral catheterization.

supreapublic Suprapubic catheterization is the insertion of a catheter into the bladder via the anterior abdominal wall. A suprapubic catheter is also an indwelling catheter, but is inserted through an incision made above the pubic bone and below the umbilicus. The insertion of this type of catheterization is done by a urologists. A suprapubic catheter is used as a long term solution to bladder emptying. Long term catheterization can be associated with many serious problems including urinary tract infections, urethritis, bladder spasms with pain and urinary leakage, and other bladder complications.

An indwelling urinary catheter, generally referred to as a “Foley” catheter, is a closed sterile system with a catheter and retention balloon that is inserted either through the urethra or suprapubically to allow for bladder drainage. Indwelling urinary catheters are recommended only for short-term use, defined as less than 30 days (EAUN recommends no longer than 14 days).

lubrisilShort-term uses include management of acute urinary retention, postoperative bladder decompression, and monitoring urinary output in acutely ill patients. Long-term use, defined as greater than 30 days, is discouraged because it provides access for bacteria from a contaminated environment into a vulnerable body organ and system. As a result, catheter-associated urinary tract infection (CAUTI) is the most common type of infection acquired in hospitals and LTC facilities. Indwelling catheters are associated with multiple complications and side effects, as well as increased morbidity and mortality.

drainage bag

Closed drainage system
A closed catheter drainage system is an aseptic system in which the path from the tip of the catheter inserted into the bladder, to the bag which catches urine, is closed and should not be disconnected. This structure is designed to eliminate inoculation of the urinary tract with bacteria via the catheter drainage tubing and from the collection bag. The term ‘closed drainage’ is, however, not entirely accurate as there are often numerous portals of
entry of pathogens and the system must be opened to allow emptying and be disconnected when the drainage bag is changed.

 

This site provides in-depth information on the indwelling foley catheter from the indication through the complications and prevention strategies. It also has resources that offer tools and on-demand education webinars on appropriate use of the catheters to understanding CAUTI.

Written by: Gina B. Carithers

References:
Moy ML, Wein AJ. Additional therapies for storage and emptying failure. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Sauders Elsevier; 2007:chap 70.
Resnick NM. Incontinence. In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 25.
Wierbicky J, Nesathurai S. Spinal cord injury (thoracic). In: Frontera WR, Silver JK, Rizzo Jr TD, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 147.

 

 

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