Foley Catheters – Overcoming Basic Catheterization Issues

Foley catheter, also known as an indwelling catheter is used to drain urine from the bladder. It is held in place with the help of a water-filled balloon that is inflated inside the bladder. If you have a Foley catheter inside your bladder, you may face some common problems related to the drainage system. There is nothing to get panic about them. There are some things you can do on your own to overcome these issues. If the problem is ongoing and cannot be resolved, you should consult your healthcare provider for further treatment.

Difficulty Inserting the Catheter

If you find difficulty in inserting the Foley catheter, take some lubricant and apply it on the tip of the catheter. Once applied, try inserting the catheter again but do not force it inside. If you are still not able to insert it and you are getting uncomfortable because your bladder is full, consult a healthcare professional immediately.

Difficulty Removing the Catheter

Sometimes balloon gets deflated but is still stuck in the bladder, leading to difficulty in removing the Foley indwelling catheter. This could be caused by either a faulty catheter or an encrustation issue. You can perform the following steps to try and remove the catheter:

• Fill the balloon again and empty it slowly.
• Leave about 1 to 2 ml in the balloon.
• Put some drops of citric acid and let it remain there for 5 minutes.
• After 5 minutes, empty the balloon and try to remove the Foley catheter.
• If this does not work then contact a healthcare professional immediately.

Urine Leakage around the Catheter

Urine leakage, also known as bypassing, occurs when urine is unable to drain down the Foley catheter. This results in leakage around the catheter. Occasional urine leakage is not abnormal.

• Check for the kinks in the catheter or drainage bag tubing and remove if found.
• Change the Foley catheter, if you find that it is blocked.
• The amount of fluid in the balloon that holds the catheter in place should not be increased.
• Avoid constipation.
• Take a balanced diet and drink about 1.5 to 2 liters of water every day unless advised otherwise.

Call the healthcare professional immediately when you notice any of the following:

• Urine leakage gets regular or a large amount of urine is leaking
• Urine is cloudy and there is a strong odor
• Chills or fever above 99.4 degrees
• Lower back pain
• Blood in urine
• Disorientation or change in mental status
• Swelling at the catheter insertion site

No Urine in the Bag

If you see no urine in the drainage bag, check for the following conditions:

• Change the position of your body.
• Check if there is any kink or loop in the Foley urethral catheter and the drainage bag tubing.
• Make sure that the drainage bag is positioned lower than your bladder level when you are sitting, standing and lying.
• Ensure that the leg bag straps are not too tight and not causing obstruction.
• Catheter or drainage bag tubing should not be clamped.
• Catheter should not be irrigated unless instructed by a healthcare professional.
• Increase your fluid intake if you are not feeling the urge to urinate or any abdominal discomfort. You can do this by drinking 2 glasses of water and then waiting for a while. If there is no urine drainage even after 30 minutes, contact your healthcare provider.

If the above steps do not help in restoring the proper urine flow and below given conditions persist, contact your healthcare professional immediately:

• Abdominal discomfort
• Inability to feel bladder fullness
• Feeling the need to pass urine

Catheter has Fallen Out

Foley catheter should not fall out because it is held in place with the help of a retention balloon that is inflated with sterile water. In some rare situations, if the balloon is faulty, and it deflates, the Foley catheter will fall out. Whether the catheter falls out due to a faulty balloon or you accidentally pull it out, contact the healthcare provider immediately for re-insertion.

Cramping Pain and Discomfort

Cramping pain and discomfort can be caused due to following reasons:

• When a Foley catheter is first inserted, it is common to experience abdominal cramps. They usually subside after 24 hours.
• It is also possible that the catheter can shift from its place due to insufficient water filled in the balloon, causing abdominal pain and discomfort.
• Constantly unstable contractions of detrusor muscle can cause pain. This pain can be relieved by antimuscarinic drugs. These drugs should be used cautiously for people over 65 years of age after discussing with a general practitioner.
• Catheter tip poking into the bladder wall can also cause pain. Using a catheter valve can solve this problem.

Cloudy and Foul-Smelling Urine

Cloudy and foul-smelling urine can be a sign of urinary tract infection (UTI). Other symptoms of a UTI are:

• Burning sensation around the catheter
• Soreness and itchiness
• Bleeding
• Discomfort in the lower back
• Not feeling well
• High temperature

If you see any of these symptoms, you should see a doctor immediately. Your doctor might need a urine specimen for further testing. Urine sample should be taken after changing and inserting a new catheter. After test, you might be suggested a course of antibiotics to cure the infection. You can also increase your fluid intake, unless advised otherwise, to help flush the bacteria out from the system.

Blood in the Urine

Blood in the urine is not normal except for in the situations where you have gone through some surgical operations on the bladder or prostate. If you see blood in the urine, you should immediately consult your healthcare provider.