Many patients will go home with a temporary catheter after surgery. Before you are discharged, we will give you all of the catheter supplies that you need and explain how to care for your catheter. We will also arrange for a district nurse to contact you at home should you need additional support.
What is a catheter?
A catheter is a small flexible tube that drains urine from your bladder. The catheter tube is passed through the urethra (water pipe) into the bladder. The catheter is held in the bladder by a water-filled balloon that prevents it falling out. The urine drains from your bladder into a bag that is strapped to your leg (a leg bag).
Drainage bags
While you are an inpatient, the nursing staff will apply a leg bag to your catheter. This can be worn on your thigh, knee or calf. The leg bag is secured in place with Velcro straps. You must always keep the bag below the level of the bladder and avoid bending or twisting the tube.
There is a tap at the end of the catheter bag. When the tap is open the urine will drain out. Empty the urine straight down the toilet, taking care not to let the catheter touch the toilet bowl. Only empty the catheter when it is nearly full, this will help prevent infections.
To reduce the risk of infection, the leg bag should only be disconnected from the catheter when absolutely necessary. It should be changed every 5 to 7 days unless it is damaged or soiled. If you need to apply a new drainage bag to the catheter it is important not to touch the sterile connector.
When you go to bed, attach a night bag to the bottom of the leg bag. Be careful not to touch the sterile connector. Open the tap, this will allow the free drainage of urine. In the morning, close the tap and remove the night bag. If the bag is disposable (one use only), cut or tear the bag and empty the urine into the toilet. You can place it in a plastic bag and throw it in with your domestic waste. If it is a reusable bag, protect the sterile connector with the cap and using the tap, empty the contents into the toilet. Wash the bag thoroughly with warm soapy water. The reusable night bag should be changed every 5 to 7 days, unless it is damaged or soiled. To avoid the night bag touching the floor, please use the stand provided.
What is normal urine drainage?
Urine should be light yellow in colour. If your urine is dark orange you are most likely dehydrated and should drink more. Aim to drink 2 litres of liquid a day. If your urine becomes dark in colour, has a strong smell or becomes thick and cloudy and this does not improve by taking on more fluids, then please contact your GP.
Initially, you may find that your urine is pink in colour. This may be due to the surgery and catheter insertion. If you notice bright red blood in your urine or large blood clots, you should contact your GP or The Christie Hotline.
The amount of urine in the bag should be similar to the amount you are drinking. If there is nothing, or very little in the bag and you have been drinking plenty, then the catheter may be blocked. This can cause discomfort and puts additional pressure on your bladder and kidneys. Please contact your district nurse or The Christie Hotline as they will be able to offer advice on how to resolve this.
It is normal to get some leakage around the catheter site, particularly when opening your bowels. As long as the majority of your urine is draining into the catheter bag, then do not worry if this happens.
Hygiene
It is really important that you practice good personal hygiene and good hand hygiene to prevent infections. Shower daily and clean the area where the catheter enters your body with mild soap and water. Women should wash from front to back. Men should pay particular attention to washing under their foreskin, ensuring they pull it back afterwards. Do not remove your leg bag when showering, it is waterproof.
Diet and fluids
Unless your doctor or nurse tells you otherwise, aim to drink 2 litres (6 to 8 glasses) of fluid a day. This will help prevent infection and help avoid constipation. A healthy diet full of fresh fruit, vegetables and fibre is recommended as this will help maintain a regular bowel pattern. Constipation can prevent your catheter draining properly and is a common cause of urinary leakage around the catheter.
Catheter removal
Catheter removal is often referred to as a ‘TWOC’, this stands for ‘trial without catheter’. We are looking to see if you can pass urine normally once the catheter has been removed. Before you are discharged, please ensure you have your TWOC appointment. Catheter removal is nothing to worry about. It is a very quick and simple procedure. It can be uncomfortable but most people describe it as a painless but strange sensation. You will need to stay in the department until you have passed an adequate amount of urine.
This can take a few hours.
What supplies should I have?
Before you go home, please make sure you have all the supplies you need to last until your trial without catheter (TWOC) appointment.
Spare leg bags
Leg straps
Night bags
Catheter stand
Please contact your GP or The Christie Hotline if any of the following happen:
the catheter falls out
you have increased or new pain
the catheter stops draining urine
you have blood in your urine that does not clear after drinking more fluids
cloudy, discoloured or smelly urine
you feel feverish or generally unwell
Contacts
If you have any questions or concerns, please contact us on the following numbers available 24 hours a day, 7 days a week:
Surgical oncology ward: 0161 446 3860/3862
The Christie Hotline: 0161 446 3658