Catheters: When Are They Needed?

Medically Reviewed by Zilpah Sheikh, MD on October 25, 2023
8 min read

Peeing is something that we all must do several times a day. It helps remove wastes and fluid from your body. If you're having trouble peeing on your own, you may need a catheter. Catheters are also used to remove urine from your body before having some types of surgery. The type of catheter and length of time you'll need one depends on your health.

Catheters are usually made out of one of these materials:

  • Rubber
  • Silicone
  • Latex
  • Polyvinyl chloride (PVC)
  • Polyethylene

Nowadays, the most popular material is PVC.

Depending on your health and how long you'll need help peeing, your doctor might recommend:

  • External catheter. For those with female anatomy, this device fits against the urethra (the tube that takes pee from your bladder out of your body) and attaches to a urine collection bag. It reduces the risk of a urinary tract infection (UTI). It's designed for use when you're sitting or lying down, as opposed to walking around. For those with male anatomy, the external catheter is called a condom catheter.
  • Condom catheter. Nothing goes into your bladder. Instead, a sheath similar to a condom fits around your penis. A tube takes the urine from there into a bag. It may seem more comfortable than other types of urinary catheters, but it can slip or leak.
  • Foley catheter. This is also known as an indwelling catheter because it's left in your bladder, as opposed to the type that you take in and out several times a day. A tiny balloon filled with water keeps one end inside your bladder. The other end drains out into a bag that's either strapped to your leg (a leg bag) or hanging from the side of a bed or a stand (a night bag). The bag is emptied when it's full. A Foley catheter needs to be replaced every 3 months or so by a doctor or nurse.
  • Intermittent catheters. You use one of these several times a day, either at scheduled times or whenever your bladder feels full. It usually goes in through your urethra and drains your bladder. Your doctor or nurse will teach you how to put it in and take it out.
  • Suprapubic catheter. Your doctor puts this indwelling catheter into your bladder through a cut in your belly, a little below your belly button. It isn't as likely to give you an infection.

There are a few things to watch when you use urinary catheters other than external and condom catheters.

Infection. This is the most common problem. The catheter may let germs into your body, where they can cause an infection of your bladder, urethra, urinary tract, or kidneys. Call your doctor if you:

  • Feel pain in your belly or groin
  • Have fever or chills
  • Feel suddenly confused

Leaks. This may be a sign that your catheter is blocked by clotted blood or debris. Tell your doctor if you see blood clots in your urine or you think something is blocking the flow of urine.

Bladder spasms. These can happen if your bladder tries to push out the catheter. Medicine can help.

Other less common side effects are:

  • Pain
  • UTI
  • Bladder stones
  • Blood in urine
  • Injury to the urethra
  • Kidney damage (with long-term Foley catheters)

Your catheter might feel a bit uncomfortable at first, until you get used to it, but it shouldn't feel painful. If it does, be sure to talk to your doctor. Most people are able to get on with their daily lives while wearing a catheter.

Some catheters (like the external kind) are for one-time use. Others (like indwelling catheters) are designed to be reusable. Either way, you want to do all you can to prevent infection in your urethra and bladder.

Disposable (one-time use) catheters come in sterile packaging, so you only have to wash the area where the catheter enters with soap and water.

If you have a reusable catheter, clean the catheter with soap and water every day, as well as the area where the catheter enters. In addition, you should:

  • Make sure there aren't any twists or kinks in the catheter that would block the flow of pee.
  • Drink one to two glasses of water or other liquid every 2 hours when you're awake so you don't become dehydrated.
  • Prevent constipation by eating high-fiber fruits and vegetables.

Indwelling catheters, like the Foley catheter, need more care.

Living with an indwelling catheter

You can live a pretty normal life with a catheter and a leg bag. You should be able to wear them under clothes and go to work, exercise, and have sex. You can also shower with your catheter in place and your night bag, rather than your leg bag. But you need to take care to avoid getting infections.

Make sure you:

  • Clean your catheter every day with mild soap and water.
  • Wash your hands with mild soap and water or hand sanitizer before touching your catheter.
  • Clean your penis or vagina daily with soap and water, as well as the area where your catheter enters your body (urethra).
  • Change your drainage bags every day. In the morning, use the leg bag, and before bedtime, use the night bag.
  • Clean your drainage bags daily by pouring a mix of three parts water to one part vinegar in the bag. Shake and let it sit for 15 minutes. Then rinse it with cold water and hang to dry.
  • Replace your bags with new ones every week.
  • Keep the drainage bag below the level of your bladder.
  • Keep the catheter attached to your thigh and make sure there aren't any twists in it that may block the pee flow.

These give you medicine or fluids straight into your bloodstream. It's also just called an IV, short for "intravenous," a word meaning "within a vein." There are two kinds of IV catheters:

Peripheral venous catheter. If you need an IV for a short time, you'll probably have this type, which is connected to a vein in your hand, forearm, or foot. This is the simplest, least expensive kind. It can stay in for up to 4 days before your nurse has to replace it. If it's there longer, it might irritate your vein or cause other problems.

This may not be the right kind of catheter for you if:

  • You'll need medicine for more than a few days.
  • You're not in the hospital but instead go to your doctor's office or hospital when it's time for a dose.

Central venous catheter (CVC). If you need medicine for longer time, you'll probably get this catheter, which goes into your neck, leg, arm, or the top of your chest and is connected to one of the large blood veins that go in and out of your heart. The catheter is connected to a port, a small plastic or metal disc surgically placed under your skin that allows you to receive medicine repeatedly in your body without damaging your veins. You might see a small lump near the port's side.

A CVC can stay in for months or even years. Your doctor might recommend one if:

  • You'll need intravenous medicine for long time. A large vein can handle a catheter better than a small one. If you need chemotherapy, you'll probably have this kind of catheter.
  • You'll get IV medicine as an outpatient. These catheters are less likely to come out, so you can be more active between treatments.
  • You need a lot of medicine or blood quickly.
  • Your doctor wants to measure the blood pressure in one of your large veins.
  • Your doctor needs samples of your blood several times a day. With this, the nurses don't have to keep sticking you with a needle.
  • You can't take in food through your mouthstomach, or intestines, so the nutrients have to go directly into your blood.
  • Your kidneys aren't working right. To take their place, your medical team will connect you to a dialysis machine, which cleans the waste material out of your blood.
  • You need medicine that might hurt your skin or muscles if it leaks out. That's not as likely to happen with this kind of catheter.

To put in the catheter, your medical team probably won't put you to sleep, but they will give you medicine to relax you and make you sleepy. And they'll numb the area where they'll put the catheter in.

There's a related kind of catheter called a peripherally inserted central catheter. It goes in near your elbow and runs up through a vein in your arm.

When your medical team puts a CVC in, there's a small chance of a few issues:

  • The catheter might injure the vein.
  • Blood might leak out and cause a bruise or other problems. In most cases, the bleeding stops on its own.
  • The catheter might cut your lung, which would make it collapse. If that happens, your medical team can reinflate your lung.
  • Your heart might go off its normal rhythm. If so, it usually returns to normal by itself.

When your catheter stays in for a while, other problems might crop up:

  • The catheter might leak. Be careful when you handle the part outside your skin.
  • The catheter might get twisted. Your nurse or doctor may have to straighten or replace it.
  • Clotted blood might block your catheter. Your nurse will show you how to flush it out to prevent that.
  • The catheter might come loose from the vein. If the catheter is sticking farther outside of your skin than usual, that's a sign that this has happened. Your nurse or doctor will need to fix it.
  • You might get an infection where the catheter goes in through your skin. That's less likely if you keep the catheter and skin around it clean. Redness, tenderness, or swelling can be signs of infection. So can a fever or chills.
  • blood clot might form in the vein or the vein might get narrow. Your medical team will watch you carefully for these issues.

Health care professionals may have more difficulty placing an IV in people who:

  • Are overweight or have female anatomy because they have more subcutaneous fat (fat you can pinch under the skin)
  • Have small veins
  • Are dehydrated, which reduces the vein size
  • Have darker skin tones, which make the veins less visible
  • Have a history of injecting street drugs
  • Have health conditions like cancer, diabetes, and sickle cell anemia, which damage your veins

However, an experienced nurse should be able to place your IV successfully.

Your nurse or another member of your care team will teach you how to care for your IV, but here are some general tips:

  • Wash your hands with soap and water or hand sanitizer before touching your catheter.
  • When you shower, keep the catheter dry by covering the end of the IV line with plastic wrap and taping it over. You don't want the dressing to get wet because moisture attracts bacteria, which can lead to infection.
  • If your dressing gets wet, change it.
  • Clean the area around the IV with soap and water at least once a day.
  • Make sure the tubing doesn't have any bends or breaks in it.
  • If the IV line breaks, clamp it or tie it off, then go see your doctor.
  • If you have any signs of infection, like fever or chills, tell your doctor immediately.
  • If you want to exercise with your IV, talk to your doctor first. You won't be able to swim with it.

It depends on the type you have. A short-term catheter should stay in no longer than 28 days and often may be in only a few days.

A long-term or Foley (indwelling) catheter will normally be in place up to 3 months.

If you have any discomfort wearing or peeing with your catheter, be sure to tell your doctor.