All You Need to Know When Taking Out a Catheter

If you want to know the side effects after urinary catheter removal, you’ve come to the right place.

From 12% to 25% of hospitalized patients get a urinary catheter while staying in a hospital. Among urinary tract infections (UTIs) obtained in the hospital, around 75% are linked with a catheter, stated the CDC. 

The problem is, with prolonged catheter use comes possible risk factors for experiencing CAUTI (catheter-associated UTI). As well as other health complications. That’s why patients must remove their catheters in an appropriate setting when the catheter is no longer needed. 

Here, you will take a closer look at the urethral catheter removal process. We will cover some practical information and how you can avoid side effects after urinary catheter removal. So, let’s get right to it. 

Catheter – What Is It, Exactly?

The catheter is a somewhat bendable and hollow tube designed to collect urine directly from the bladder and transport it to a drainage bag. Urinary catheterization is used as a typical temporary urinary diversion. The device comes in different sizes and could be manufactured from various materials, such as silicone, plastic, and rubber. 

Catheters come in three types.

Urethral or suprapubic catheter (Indwelling catheter)

The indwelling urethral catheter, typically referred to as the Foley catheter, is a medical device meant for both long-term and short-term use. Often a nurse positions the indwelling urinary catheter through the urethra and into the bladder. In other cases, the device will be inserted through a small hole in the abdomen. Symptomatic UTI is uncommon in individuals with a short-term medical device.

Condom catheter (External catheter)

This type of catheterization is designed for individuals who don’t have urinary retention issues but do have severe mental and/or functional disabilities. Like, dementia, for example.

A condom catheter resembles a condom since it covers the head of the penis. The tube from the catheter leads to a drainage bag. This medical device is a lot more comfortable than a Foley catheter and has a lower risk for urinary infection.

Intermittent catheter (Short-term catheter)

With intermittent catheterization, patients are getting an in-and-out catheter. The patient can be trained to insert and remove the catheter with or without a healthcare professional’s help. 

Urethral catheterization is used on patients in need of assistance to manage their urinary incontinence, urinary retention, and control when urinating. 

The reasons people can’t urinate could be the result of surgery on the prostate gland, genitals. As well as other urinary problems, such as blocked urine flow, bladder injury, or impaired bladder muscle function due to certain medications. 

The incidence rate for postoperative urinary retention after having surgery and anesthesia ranges from 5% to 70%. Prostate surgery weakens the muscles and makes it difficult to manage the urine flow. 

Foley Catheter Removal – Key Facts You Should Know About

Over 50% of catheterized hospital patients develop some kind of urinary complications. A urinary tract infection is just a fraction of the urinary catheterization. Based on clinical reports, people can experience different problems, such as poor sexual function and pain. 

According to safety experts, UTIs can happen from a Foley catheter removal. But, patients can also experience bloody urine and urinary restrictions while the Foley catheter is still inside. When it gets removed, some people could have trouble with sexual and urinating functions. 

Reports indicate that it’s important to avoid the Foley catheter unless the medical device is absolutely necessary. 

Another research also showed similar results. To determine the safety of removing the catheter, scientists evaluated the effects of the medical device after radical retropubic prostatectomy (RRP) and postoperative day (POD). 

Based on the final results, removing the catheter early on didn’t cause a negative impact on the anastomotic strictures or continence. But, because of the high rate of acute urinary retention and the potential for bladder disruption, it is best to delay the removal until the POD 7 or later. 

Males who undergo radical prostatectomy can have the medical device removed safely 2 to 4 days after the procedure without urethral stricture risk, leak, incontinence, or other similar problems. 

Patients are advised to consult with a medical expert before they try removing the device on their own. Otherwise, they could expose the system to a range of different complications. 

Simply put, a medical professional can remove the device when it’s no longer necessary. People can remove it at home, as well. But, they need to have the proper supplies and guidance to make sure the catheter is properly removed and doesn’t expose the system to a bacterial infection. 

Why Do I Need a Catheter During Radiation Therapy?

If you need radiation to the prostate bed or prostate, you may also need a catheter insertion. This is to ensure that you have a full bladder during therapy. With this approach, the therapy can be delivered accurately. 

The reason for that is relatively simple. The size of the bladder affects the position of the prostate bed or gland. They have to be in the exact same spot for every treatment. Having a full bladder during therapy can also decrease the risk of side effects since the bladder can be moved outside the treatment area. 

What Happens During the Removal Process?

When working with a Foley catheter, the medical provider will use a syringe directly into the device’s balloon port. This is a practical opening that is not linked to the actual drainage bag. They will then suck out the water with the help of the syringe. This is a normal emptying process. 

To make sure the procedure goes smoothly, the healthcare expert will ask you to take deep breaths and exhale. This is meant to soothe the muscles of the pelvic floor and ease the discomfort. 

If you want to remove the device at home, you will do the exact same process. However, you first have to empty the bag and wash the hands. Scrub them with soap and water to make sure no harmful pathogens are lingering on the skin’s surface. You will then use a towel to dry the hands. This is a key step. 

Since bacteria thrive in a moist environment, you need to make sure the hands are completely dry before removing the catheter. This helps avoid side effects after urinary catheter removal such as possible urinary infections or bladder problems. Now remove the drainage bag. Try to clamp the ends to avoid leakage. 

Use the syringe to draw out the water. But, consult with a specialist on where to insert the syringe. It needs to be in the right position to draw the water out. When the bag is empty, the device will deflate inside the urinary bladder. 

It’s best to sit or stand in a shower as you remove the device. It’s possible for urine to drip the moment the catheter comes out. Then, gently pull the device out. Do a full circle in every direction and slowly remove the tube. If it can’t come out, contact a healthcare expert right away. After the removal process, wash the hands again. 

Don’ts

• Do not use overinflation to burst the balloon. This could break the device and force fragments to fill the bladder. 
  
  
• Don’t cut or damage the inflation arm of the medical device. If you do, the balloon may not be able to deflate, which could cause many problems for your bladder. 
  
  
• Do not apply creams and powders to the insertion area. The spot is still vulnerable and very sensitive. 
  
  
• Don’t insert the medical devices if it falls out by itself. Contact a doctor instead.

Do’s

• Do “milk” the catheter along its length. This can help you get rid of debris, blockage, and obstruction. 
  
  
• Use a couple of ml of sterile water to clear out the blockage in case you can’t deflate the balloon. 
  
  
• Do dispose of the equipment properly after removing the device like gloves, for example. 
  
  
• Observe your body for any sign of voiding. 
  
  
• Do drink 2 to 3L of fluid on a daily basis post removal. This will help flush out the bacteria from the system and prevent side effects after urinary catheter removal such as pain and burning sensations. 

What Happens After the Removal Process?

The doctor could advise you to drink plenty of liquid and keep the body hydrated. This can remove the bacteria from the system that might have piled up while you were using the catheter. Make sure to watch the liquid intake and stick to your doctor’s guidelines. 

If there is a symptomatic urinary tract infection that’s affecting the urinary system, you might have to take proper antibiotics, especially if you’ve had surgery on the urinary tract. And, if you’ve contracted a bacterial infection, then the doctor may suggest antibiotic prophylaxis to treat the urinary problem.

If you’ve had a transurethral resection of the prostate, the prostate tissue will have to recover before you can improve the urine flow. During the procedure, the doctor uses a resectoscope to trim some of the tissues from inside the prostate. 

The device should remain in place for a minimum of 24h to 48h. In this case, you might have to stay in the hospital for 1-2 days after the surgery. This catheterization is an efficient procedure for an enlarged prostate. It has a quick recovery period and fewer risks than other minimally invasive procedures. 

The Possible Risks With Foley Catheter Removal

There are many risks with a catheter. As previously mentioned, the device can allow bacteria to enter the system. After urinary catheter removal, you can encounter side effects such as infection in the bladder, kidneys, or urethra. These are UTIs. But, there is more to the medical device than it meets the eye.

Based on in-depth interviews of well over 2,000 patients, plenty of men experience complications after their Foley catheter is removed. 

Reports from the JAMA Internal Medicine indicate that 76% of patients had their device removed three days after it had been inserted. Exactly 57% of patients stated they experienced at least one complication. The study showed that 10% of patients developed infectious complications. While 55% developed non-infectious issues. 

Typical Risks

• Infections 
  
  
• Pain
  
  
• Bleeding
  
  
• Bladder spasm
  
  
• Urgency
  
  
• Urinary leakage
  
  
• Sexual problems
  
  
• Bladder cancer

CDC reports show that indwelling catheters are easy to colonize. They are incredibly sensitive to bacteria, making the incidence of bacteriuria 3% to 7% a day. 

Although people don’t feel anything during surgical removal of the device, 31% report pain after removal. Whereas over 50% of them stated the device caused some level of discomfort and pain while it was still inside. 

A 2002 study found that males who use an indwelling urinary catheter had 4.9 times bigger odds of developing bladder cancer compared to those who didn’t use this medical device. The biggest contributor to the illness seems to be the length of usage. In case of cancer, you could have a cystectomy to remove the urinary bladder. Radical cystectomy is meant to stop the spread of the disease. 

Less common complications

• Urethra injury (when the tube is inserted, it can damage the urethra)
  
  
• Bladder injury (this happens if the device is inserted improperly)
  
  
• Narrowing of the urethra (it occurs as a result of scar tissue from repeated catheter use)
  
  
• Bladder stones (in extremely rare cases and typically in individuals who’ve been using the device for years)

How to Strengthen the Bladder After Catheter Removal?

After catheter removal, your main focus will be bladder retraining. According to experts from the Manchester University, bladder retraining can help avoid side effects after urinary catheter removal such as urinary frequency, urgency, and insentience. 

With retraining, you can teach the organ to hold more urine and empty it less often. In other words, people get to train their system to go to the toilet normally. But, this is a very slow process and could take a couple of months. When time passes, people can get their urinary health back on track. Here is how retraining works.

Timed Voiding

• Patients do a 3-day bladder diary. They use it to work out how long it takes for their body to go to the toilet and urinate. 
  
  
• Doctors give a 6-week chart in which the patient records the time they need to wait before urinating. 
  
  
• The doctor will advise on an interval for when patients need to go to the toilet. The goal is to stick to this interval and not urinate before or after, even if they experience urine leakage. This lasts for one week.
  
  
• A patient can increase the time between each toilet visit by 15 min a week. The idea is to reach 4 hours. 

What Happens If You Have Urgency?

The longer the time interval between toilet visits becomes, the harder it is to hold it in. When you do have an urgency, you will need to:

• Look for a distraction-for example, count backward from 100.
  
  
• Use the muscles of the pelvic floor to squeeze it in.
  
  
• Take a seat on a firm chair or standstill.

Watch the Fluid and Food Intake

When it comes to timed voiding, fluid and food intake have a major role to play. When you drink too much, you need to go to the bathroom more often. Therefore, when you want to train the bladder, it is best to drink anywhere from 1 and a half to 2 L of fluid every day. Take smaller drinks and more often. 

It’s best to skip the fluid 3 hours before bed. That way, you can have a more restful sleep and don’t have to worry about urinary problems at night. However, be sure to avoid consumables that irritate the bladder. That includes acidic fruits and juices, fizzy drinks, alcohol, and coffee. Artificial sweeteners and spicy foods are other bad choices.

When the bladder is irritated, it becomes incredibly difficult to hold the urine in. Thus, you should opt for cordial diluted with water or plain water instead. Fruit and herbal teas are also good choices. 

RELATED: How To Sleep With UTI Discomfort.

Conclusion 

Removing the tube can be an uncomfortable and painful process, especially for those who’ve had the device for a very long time. Although it may not be the most comfortable experience, it is a very important process. It helps manage multiple urinary problems, all with the help of urine drainage. 

When it comes to removing the device, doctors or patients can take out the tube from the bladder. But, it is crucial to follow the removal guidelines to avoid side effects after urinary catheter removal or wounding the body.

The information listed here can help you understand the risks associated with the removal, including the things you should and shouldn’t do. Now that you know exactly how the process looks like, you will have an easier time getting your health back on track.  

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