A to Z of MS Catheters

A catheter is a tube used to drain urine from the bladder. Catheters may be used when needed (intermittently), or on a more permanent basis.

Intermittent self-catheterisation

Intermittent self-catheterisation (ISC) is the term used to describe passing a catheter into the bladder via the urethra - the tube that connects the bladder to the outside of the body - drawing off urine, and then removing the catheter. The term 'intermittent' is used because this normally takes place several times a day using disposable catherters. The procedure should be taught by a nurse or continence advisor.

Intermittent self-catheterisation is usually used by people who experience incomplete emptying of the bladder (urinary retention)

Benefits may include a reduction in the number of urinary tract infections and better control over bladder problems leading to improved confidence and less reliance on ensuring that toilets are closely available.

Long-term catheter use

Long-term catheters are normally used only when other treatments have not been successful. They can be useful if someone experiences a continuing lack of control over their bladder both during the day and at night./p>

There are two types of long-term catheter:

• Indwelling urinary catheters
• Suprapubic catheters

Indwelling urinary catheters

Indwelling urinary catheters are normally used where intermittent self-catheterisation is not possible.

Indwelling urinary catheters are inserted into the bladder through the urethra. They are similar to the catheters used in intermittent self-catheterisation, but have an inflatable balloon at the bladder end that keeps the catheter in position.

The free end of the catheter is then attached to a collection device. During the day, people may use a leg bag, which may come with Velcro straps or a similar attachment device, and can be easily emptied into a toilet when full. Some indwelling catheters come with a valve, rather than a bag, so that the bladder is simply emptied directly into a toilet. At night, indwelling catheters may be attached to a night drainage bag that hangs by the side of the bed; this may be in addition to or instead of a leg bag.

There are a variety of types of indwelling urinary catheters. They are only available on a doctor's prescription, and the doctor and/or nurse should discuss the range of options and catheters. A doctor, nurse or continence advisor should fit the catheter and give training and advice about how to manage and empty it.

One of the most common side effects of indwelling urinary catheters is urinary tract and urine infections. These are often caused by hygiene problems when changing drainage devices. It is therefore important to be aware of proper aseptic techniques for managing catheters: a nurse or continence advisor should be able to teach these.

Suprapubic catheters

Suprapubic catheters may be used if a long-term catheter is needed as a permanent solution to bladder problems. A suprapubic catheter is a tube that is passed through the abdominal wall directly into the bladder, bypassing the urethra. This insertion is a surgical procedure performed by a urologist (a surgical specialist in bladder problems).

Suprapubic catheters may be preferred over indwelling urinary catheters as many people feel they are less intrusive, allow full sexual activity to continue easily, and can be easy to manage. However, they do carry some complications including problems with healing at the insertion site, and the introduction of urine infections due to hygiene problems when changing bags.

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