The most common type of indwelling catheters are Foley catheters, named after the urologist who developed the design. An indwelling catheter can be inserted in the urethra. A supra-pubic catheter is also an indwelling catheter, but is inserted through an incision made above your pubic bone and below your umbilicus (belly-button). A Foley catheter is generally used in a short term situation during surgery and immediately postoperatively, for acute urinary retention (unable to empty your bladder), or when urinary output needs to be monitored for a short term period.
Patients with severe skin problems, most notably full thickness wound and pressure ulcers, where urinary incontinence prevents healing might benefit from a Foley catheter.
A supra-pubic catheter is used much less frequently and is a long term solution to bladder emptying. Long term catheterization can be associated with many serious problems including, but not limited to, urinary tract infections, urethritis (inflammation of the urethra), bladder spasms with pain and urinary leakage, and other bladder complications.
There are several different sizes and types of indwelling catheters. Your healthcare provider will order you the best option for your problem and length of time in use. Indwelling catheters are most frequently inserted and changed by healthcare personnel.
An indwelling catheter stays in place in the bladder by inflating a balloon with sterile water through the inflation port after insertion. To remove the catheter, the balloon is deflated by attaching a syringe to the inflation port and allowing the water from the balloon to flow into the syringe. Stabilization is very important when it comes to securing the catheter to avoid pulling on the urethra and experiencing subsequent pain and injury. Securing the catheter to the upper thigh with some slack on the tubing will prevent the catheter from tugging at the urethra. This can be accomplished with an anchor strap or catheter holder. The use of adhesive tape is not recommended in order to maintain the integrity of the catheter. A urine collection system for men is also available that eliminates the need to wear a leg bag. Its design consists of a reusable collection bag that fits into a pouch worn inside specially designed briefs.
Supra-pubic catheters can be secured by a plug and emptied into a toilet as needed. Foley catheters are attached to either a belly bag, leg bag, or night bag. A leg bag is used during the daytime and attached to the upper thigh by straps that are wrapped around the thigh. It stays in place by tightening the straps to your comfort and proper fit. A belly bag can be used 24 hours a day without interruption of the sterile system. The night bag is attached after removing the leg bag using the clean procedure as described in the following section on the care of leg bags and night drainage systems. It also may be helpful to place the night bag in a clean bucket on the floor in case there is any leakage from the bag. An extension of tubing is available if the length of the bag tubing is not adequate.
Both Foley catheters and supra-pubic catheters are intended for one time use only. Catheters are changed at the discretion of your healthcare provider. Daily, routine bathing or showering is all that is needed to maintain urethral hygiene. Avoid application of antibacterial creams or antiseptic solutions unless ordered by your provider.