Catheters are tubes designed to deliver or drain fluids from the body. Urinary catheters drain urine from the bladder when one is unable to urinate, become incontinent, experience prostate problems, or develop other medical disorders. In hospitals and clinics, nurses or medical assistants usually insert catheters, but one can insert a urinary catheter themself or train a family member to do the job. Doing the job on one’s own is called intermittent self-catheterization, and it is the preferred method of draining urine. [1]

Intravenous catheters are used to deliver medicine, blood, plasma, and fluids directly into the bloodstream. These can also be used to draw blood for testing. IV catheters are used on patients who need extensive intravenous treatments or regular blood testing for an extended period of time. This period might be a few days or several weeks.

Urinary Catheters

Urinary catheters come in many sizes and types, and can be bought them at medical supply stores with a valid prescription. Your doctor will prescribe the right kind for your needs. You will also need some other supplies including lubricant and towelettes. These supplies can also be ordered by mail. [2]

Catheters are inserted into the tip of the penis and threaded down until they reach the bladder. In female patients, the catheter is inserted into the urethral meatus. That requires spreading the labia to reveal the urethral opening. The urine generally drains directly into a toilet or a special container that need to be emptied periodically. You should empty your bladder four to six times per day, which means every four to six hours.

The types of urinary catheters include urethral and suprapubic indwelling catheters and external, or condom, catheters. Short-term or intermittent catheters, the most common type, come in all sizes. Some are pre-lubricated.

Benefits and Drawbacks

Unfortunately, each type of urinary catheter has benefits and drawbacks.

• Short-term catheters are recommended, but they certainly slow the process of emptying your bladder. Inserting catheters can be painful and annoying. However, the process of controlling your bladder can have a beneficial effect on your mental state since you’re not completely dependent on technology.
• Condom catheters offer a key advantage in that you don’t need to insert them. Condom, or external, catheters only work for males. A sheath — similar to a condom — rolls over the penis and is attached with adhesive. The urine is collected in a bag that you empty regularly. The benefits of condom catheters include a lower risk of infection. There’s never a need for surgery or insertion into the urethra. Cons of the procedure include possible skin damage and difficulty keeping the sheath in place. [3]
• Self-catheterization is the most common approach of using urinary catheters. The benefits of self-catheterization include better odor control, no collection bag, and a lower risk of infection. These catheters are drained directly into the toilet just like urinating. The cons include possible swelling of the urethra, some insertion pain, and a learning curve to develop a technique for inserting and removing the catheter with minimal pain and/or infections.
• Suprapubic and urethral catheters provide continuous drainage for long-term therapeutic needs. These catheters are inserted directly into the bladder either through the urethra, which is called a “Foley” catheter, or through the abdomen, which is called a suprapubic tube. The benefits of indwelling catheters include convenience and a lower risk of accidents such as spillage and leakage. Cons include odor from an unemptied collection bag. These catheters, which are inserted surgically, generate the highest risk of infection.

Indwelling catheters are used on patients who are incontinent or can’t empty their bladders normally. These patients include people suffering from spinal injuries, enlarged prostates, multiple sclerosis, spina bifida, stroke, and other chronic and terminal illnesses. [1]

Intravenous Catheters

Intravenous indwelling catheters can be used to drain urine or deliver blood, fluids, and medication into the body. These catheters are designed for long-term use and don’t need to be inserted every time you want to drain your bladder. Indwelling catheters are chosen by your doctor based on your condition, mobility and needs.

The benefits of indwelling catheters make it possible for patients who can’t use their hands or have lost cerebral functions to avoid the consequences of incontinence. Urine collects automatically into a collection bag. Caregivers or the patient must empty the containers.

Benefits and Drawbacks

Intravenous catheters are used in hospitals and clinics, but they can also be used in home care. Some medicines are more effective when delivered intravenously. An intravenous catheter allows blood to be drawn regularly for testing, IV delivery of fluids, and multiple kinds of health treatments such as chemotherapy for cancer and other conditions. IV catheters require insertion by a medical professional, but most catheters can be used in home therapy.

The following types of intravenous catheters provide direct access to the circulatory system: [4]

• Short Peripheral Catheters: These intravenous catheters are short — less than three inches. These are generally used for IV therapy that isn’t expected to exceed six days. Although meant to replace multiple injections, short peripheral catheters might require re-injection — usually in a hand or arm vein. Recently, more and more health professionals — including the entire Canadian health industry — limit peripheral catheters to three days.
• Midline Peripheral Catheters: These measure between three and eight inches. These are generally used when at least three catheters are needed. The catheter requires a large-diameter blood vessel such as the basilic vein. This catheter is used for those who require therapy for more than six days. Midline peripheral catheters share some of the pros and cons of short catheters. They allow quick access to veins, deliver continuous fluids, medication and pain control, and are easy to monitor. Disadvantages of midline peripheral catheters include that these can’t be used indefinitely and there are risks of infection.
• Peripherally Inserted Central Catheter, or PICC: The tips of these catheters end up in the superior vena cava. This catheter is recommended for all infusion therapies. Duration of the therapy usually exceeds six days and can be continued up to several months. Insertion requires the use of a maximum sterile barrier during insertion and a radiographic confirmation of the tip’s location.
• Tunneled Central Venous Catheter: This catheter requires surgical placement, but the end result has a low rate of infection because a cuff secures the catheter and prevents bacteria from entering the bloodstream.
• Percutaneous Non-Tunneled Catheter: This catheter is used for short-term access to centrally located blood vessels. It’s not recommended for home care, but each case is judged on an individual basis.
• Implanted Port: These catheters are usually situated in the arm or chest, and they usually require minor surgery for placement and removal. Medications require injection through the skin.
• Subcutaneous Infusion: This fine-gauge type of catheter is placed subcutaneously in the upper arm, chest, upper back, thigh, or abdomen. It can be used for intermittent or continuous infusions of certain medications and isotonic fluids.

Regardless of whether you need a urinary or intravenous catheter, you can buy your supplies for home therapy with a prescription. Some types of catheters are only available if your doctor approves, but most physicians will accommodate reasonable requests unless there are medically based objections. You can get supplies at medical supply stores in your area or order them by mail. Many medical supply companies offer free samples of urinary catheters for patients who are trying to choose the best brand for their needs.

Sources

1. “Living with a Urinary Catheter.” org Youthhealthtalk.org, DIPEx, 2015, www.healthtalk.org/peoples-experiences/long-term-conditions/living-urinary-catheter/reasons-needing-long-term-indwelling-catheter.
2. MedlinePlus Staff. “Self Catheterization – Male: MedlinePlus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, 21 Feb. 2017, medlineplus.gov/ency/patientinstructions/000143.htm.
3. Harris, R. “Catheter Basics: The Difference between Condom, Intermittent and Indwelling.” AHM Exposed, WordPress, 18 Feb. 2016, ahmexposed.wordpress.com/2016/02/18/catheter-basics-the-difference-between-condom-intermittent-and-indwelling/.
4. “Type of Vascular Access Devices.” iaBPG, Registered Nurses’ Association of Ontario, 2018, pda.rnao.ca/content/type-vascular-access-devices.