Indwelling Urethral Catheters
What is a Catheter?
A catheter is a plastic or rubber tube that is placed in the bladder to drain urine. Catheters may be passed to empty the bladder or they may be left in place (indwelling) and connected to a draining bag to store the urine until it can be emptied into a toilet.
Indwelling Urethral Catheters (Foley Catheterization)
For the urologist, indwelling catheters are to be avoided at all costs. They cause infection, they cause kidney damage, they can erode through the urethra causing incontinence and they can cause bladder and kidney stones. In men, they cause strictures or scars in the urethra which after removal of the catheter can cause serious blockages and, rarely, they can cause bladder or urethral cancer. For the patient who cannot catheterize themselves, either because of disability or infirmity due to age, there may be no other practical solution.
Those sound like awful complications; why would anyone use an indwelling catheter?
For some patients there simply isn’t any other alternative. In addition, short term catheter use – days, weeks or a few months – is very unlikely to cause any of those problems. Further, the chances of those complications occurring, even with long term catheter use can be greatly minimized if a number of precautions are taken. Firstly, within the limitations of comfort, the larger the catheter that you use, the better and the safer.
Why would a large catheter be preferable to a smaller one?
A large catheter has a larger hole which is less likely to become twisted or blocked and the flow of urine through the catheter is much more likely to be unimpeded. Small catheters actually are smaller than the natural urethra. This means that every time the bladder contracts it is as if there is a blockage; in fact there is a blockage, the blockage is the catheter itself. The long term consequences of blockages in the urethra are bladder damage, kidney damage, stones, and infections. Therefore, a larger rather than a smaller catheter is preferable.
But doesn’t the large catheter hurt more than the small catheter?
In fact, no. It’s only if the catheter gets so large that it stretches the urethra that it might be painful. The catheter sizes that we’re talking about are all small enough to be comfortable for the great majority of patients. Further, a larger catheter is easier to pass into the urethra because it is stiffer than a small catheter. The second precaution to take is that the catheter should be changed as often as is practical. Under no circumstances should the same catheter be left in place for more than about a month but it is far preferable to change it at weekly or biweekly intervals. The longer the same catheter stays in the bladder, the greater the chances of it developing encrustations, blockages and stone formation.
Why Choose a Uro Center Urologist in New York?
The urologists at the Uro Center in New York are experts in their field, bringing academic and research based innovation to the clinical forefront. Our urology team specializes in areas of treatment such as: robotic surgery, reconstructive urology, men’s health & infertility, kidney stones, urologic oncology, penile implant surgery, urethral stricture, BPH, Urinary incontinence treatment, Mesh complications, Enlarged prostate treatment, Urodynamics, vesicovaginal fistula and female incontinence in New York.
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