How often should you change an indwelling urinary catheter?

I have had an indwelling catheter in place for 3 months.It works well. can I leave it in place indefinitlyor does it have to be changed? If so how often should it be changed ? thanks

Doctor's Response

Date:Aug / 2010

Thank you for your question.

 I am delighted to hear that you have become accustomed to a long term indwelling urinary catheter, and the life style changes that this entails; the use of leg bags during the day and larger bags which can hang out of your bed at night.

The catheter is made of a special material called silastic which is essentially a silicone containing rubberised plastic. Its essential quality is that it does not upset or inflame your lower urinary tract; the bladder and your urethra (the tube that runs from your bladder to the end of your penis). However it is a foreign body and will be susceptible to three problems if left in situ indefinitely.

The first is that calcium salts in the urine are not that soluble and can tend to crystallise out on any foreign object. In time the crystals can grow over the surface of the part of the catheter in the bladder. If they do this they will eventually cover the holes at the end of the catheter through which your urine passes, blocking the catheter and stopping the flow of urine, this will result in a painful retention of urine which will require urgent attention (change of the catheter). This growth of calcium salt crystal usually takes several months to form; at least 3 to 6 months.

The second is that being a foreign body, especially if the calcium salt encrustation has commenced, any infection that may occur will “take hold” on the foreign body and will prove extremely difficult to eradicate with the use of antibiotics even if given continuously for several weeks. The longer the catheter remains in situ, the more likely this is to occur.

The third problem relates to the construction of the catheter itself. The catheter is held in place by a balloon at the end of it which is filled with sterile water at the time of insertion. Although the balloon is elastic at first, if left inflated for several months and especially if it becomes covered with calcium salt deposits, the balloon will lose its elasticity and will remain in its inflated state even if the water inside is drained away. If this happens, removal of the catheter will cause considerable trauma to your lower urinary tract with significant pain and bleeding on removal, with increased risk of infection of the new catheter that is put in to replace it. Insertion is also likely to be more difficult for the nurse or doctor to put in, even if they are experienced, and more uncomfortable for you as well.

Therefore it is highly recommended that your catheter is changed regularly every three months. At this interval, you will avoid suffering from any of the recognised problems detailed above, and will enjoy essentially trouble free function for the foreseeable future. As you have had your current in for three months, now is the time to arrange with your doctor to have it changed. Your doctor may be happy to do it at every four months, but it should be changed at regular intervals. This process is usually straightforward and pain free.

I hope you have many years of trouble free use of your indwelling urinary catheter.

Thank you for using Thanks Doctor. I do hope this information is of use to you.
Yours faithfully,
The Thanks Doctor Team

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