Urinary catheter (indwelling): Care at home

What is a urinary catheter?

A urinary catheter is a tube that is placed into the bladder to drain urine. This will keep the bladder empty and allow it to heal. There are 2 types of catheters:

• Foley catheter - a tube that is inserted into the bladder through the urethra (opening where urine comes out)
• Suprapubic catheter - a tube inserted during surgery into the top of the bladder through your child's lower abdomen (belly)

How should I care for my child?

Your child should drink plenty of fluids. Extra fluids will help prevent mucous plugs that can block the catheter. A nutritious diet will promote healing.

Urine flow

Check the catheter and drainage tubing for urine at least every 4 hours during the day. The amount of urine depends upon how much your child is drinking. If your child did not drink fluids during the night, there will be less urine and it will be darker colored when your child wakes up in the morning.

If your child has been drinking plenty of fluids, and there is very little urine or the drainage has stopped, follow these steps:

1. Check the tubing for any kinks.
2. Check for mucus or clots in the tubing.
3. Try to squeeze or reposition the tubing.
4. Irrigate the catheter if directed by the doctor. (See the education sheet "Urinary catheter irrigation.")
5. Call the doctor if you cannot get the urine to flow.

Tubing

• Tape the catheter to the leg, the same way it was done in the hospital, so that it does not pull out of your child.
• The drainage bag should be kept lower than your child's bladder at all times.
• The tubing should always be positioned above the drainage bag so the urine flows "downhill."
• Empty the drainage bag when it is half-full and at bedtime.

How should I clean around the catheter?

Foley catheter

Wash the area where the tube enters your child's body 1 or 2 times a day with plain water. Gently remove any crusts or mucus around the catheter.

Do not use powders or lotions around the catheter.

Suprapubic catheter

Check the skin around the catheter every day for signs of infection (redness, swelling, tenderness) or drainage.

Wash the area around the catheter with plain water, and apply a new bandage. Do this every day or whenever the bandage is wet or soiled.

Ask the doctor when your child can take a tub bath or shower.

Will my child have pain?

Sometimes bladder spasms can occur, especially during the first few days after the catheter is inserted. Bladder spasms are a contraction in the bladder wall due to any of the following:

• healing of the bladder wall incision
• catheter irritating the wall of the bladder
• kinked or blocked catheter (urine not able to drain out of the bladder)
• constipation (hard bowel movements)

Check to be sure that the catheter is draining (see "Urine flow" in this document). If the catheter is draining and your child is having pain, use the medicine prescribed by the doctor for pain.

How active can my child be?

While the catheter is in, do not let your child play actively: no bike riding, swimming, digging in the sand, or recess play; no sports or gym class.

Leg bags

Your child's doctor may allow the catheter to be attached to a leg bag when your child is active. When changing from the longer drainage bag to a leg bag, take care not to touch the ends of the tubing. To change the bag:

1. Wash your hands with soap and water, rubbing all surfaces briskly, or use an alcohol hand sanitizer.
2. Gather equipment:
   • baby wipes
   • clean towel
   • connection cover
   • leg bag
3. Scrub the connection between the catheter and the drainage bag tubing with an alcohol wipe for 30 seconds. Let it dry.
4. Pinch the catheter tubing to prevent urine from flowing out.
5. Disconnect the catheter tubing.
6. Connect the leg bag to the catheter.
7. Place a connection cover on the disconnected drainage tubing.
8. Wrap the leg bag strap around your child's leg.
9. Wash your hands again.

Drain the leg bag when it is half full.

When your child lies down for a nap or at bedtime, change back to the drainage bag following the above steps.

All drainage tubes and bags must be cleaned well before being re-used.

How do I clean the leg bag or drainage bag?

1. Mix two solutions:
   • dish soap and water
   • solution of 1 part liquid bleach to 50 parts water (1 teaspoon liquid bleach to 1 cup water). Use a pure, fragrance-free, additive-free bleach, such as Hilex® or Clorox®. Do not use other products.
2. Rinse clear water through the bag.
3. Wash the bag in soapy water.
4. Rinse with water to remove the soap.
5. Soak in bleach solution for 30 minutes.
6. Drain the bleach solution from the bag and rinse well with water.
7. Hang to dry.
8. If you cannot get the bag clean, throw it away and use a new one.

When should I call the doctor?

• severe or continuous pain
• urine leaking around the catheter
• temperature of 101.5° F or higher
• the flow of urine stops and your child has been drinking enough fluids
• urine has blood in it, is cloudy, has sandy particles, or smells bad
• your child becomes constipated - this could cause problems with the urine drainage
• unusual drainage around the catheter
• pain in the lower back area where the kidneys are

What else do I need to know?

If you are not disconnecting the bag at all, change the bag after one month of use.

If the catheter will be in for more than 4 weeks, check with your doctor how often it should be replaced.

Questions?

This is not specific to your child, but provides general information. If you have any questions, please call the clinic.

Children's Hospitals and Clinics of Minnesota
Last reviewed 8/2015

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