Why is daily catheter care important?

A Foley catheter is a thin, flexible drainage tube put through the urethra to drain the urine in the urinary bladder. The catheter is attached to a drainage bag called the “Urobag” into which the urine drains. This is a “closed system,” & helps to keep bacteria and other germs from entering your urinary system and causing an infection. Urine is sterile; however having an indwelling catheter in the bladder creates a way for bacteria to easily enter your body. Hence daily cleaning of both the catheter and the urethral meatus is important to decrease the chances of getting a urinary tract infection. Cleaning is also important after each bowel movement to prevent infection.

How do I clean around the catheter?

The supplies needed for your catheter care would include:

• A basin of clean warm water or use of a clean sink with running warm water.
• Two clean wash cloths and a clean towel
• Soap

1. Wash your hands thoroughly with soap and water before and after cleaning and touching the catheter, drainage bag, or urine.
2. Apply soap and water to one washcloth and thoroughly clean the area around the meatus then rinse well to remove all soap.
3. Rinse the washcloth, apply more soap, and clean the rest of the area between your legs and buttocks. For female patients, it is important to wipe from front to back to prevent an infection. For male patients, it is important to begin at the tip of the penis and wash downward toward the body.
4.  Rinse and pat dry the area well with the towel.
5.  Change the water in the basin and clean the catheter next.
6. Apply soap to the second washcloth.
7. Firmly grasp the catheter to prevent tugging on it and gently wash the tubing. 
8. Begin at the meatus and wash the first 2 to 3 inches of the tube, moving away from the body toward the drainage bag.  DO NOT wash from the tubing toward the body because this may push bacteria into the meatus.
9.  Gently remove any drainage or crusting that may be present on the tube.
10.  Gently dry the tubing.
11. Do not use any powders in this area. Apply Soframycin ointment on the point where the catheter tip enters the urethral meatus. Move the catheter in and out across the meatus for 2-3 cms, a few times.
12.  After cleansing, the catheter should be secured to prevent irritation around the meatus and to prevent pulling the catheter out.

a. For females, secure the catheter to the inner thigh

b. For males, secure the catheter to the lower part of the abdomen, or secure to either thigh when walking.

Emptying the drainage bag?

Your drainage bag should be emptied, every 3-4 hours.

The bag should not be allowed to become full. This will put pressure on the catheter and cause tugging and irritation at the meatus. It also will be too heavy and bulky to carry around.

1. Wash your hands before and after emptying the bag.

2. The bag should be kept below the level of the hip (bladder) at all times to prevent urine from flowing back into the tubing and into the bladder. This is an important precaution to prevent infections.

3. Use a clean container to empty urine into if you have to measure the amounts in the drainage bag. Otherwise, you can also empty the bag directly into the toilet.

4. In case of a leg bag, carefully open the nozzle at the bottom of the bag to empty. Do not allow the nozzle to touch the container or toilet. This causes contamination of the bag with bacteria.

5. Clean the end of the nozzle with rubbing alcohol on a gauze pad or cotton ball.

6. Close the nozzle securely to prevent leaking.

7. In case of a routine urinary bag/ urobag, the nozzle is at the top of the bag.

8. Do not allow the drainage bag to rest on the floor.

Difference between a Routine Urobag & Leg Bag.

A routine Urinary Bag (Urobag)

This bag has a larger capacity & longer tube length. The advantages are that it can store larger capacity of urine & the length of the tube being longer , the patient can comfortably sleep in bed without the risk of causing tugs or stretch injuries on urethra. The emptying nozzle in this bag is on top of the bag.

A Leg Bag

A Leg Bag is more useful for patients having an active work life. This bag is smaller in size, has a small tube length & has a small nozzle at the bottom to empty it easily. This bag also has elastic straps & can be easily strapped onto the thigh beneath the trousers.

However it may need to be emptied frequently being smaller in capacity. There is also the risk of stretch onto the meatus or the urethra when a person lies down due to shorter tube lengths. However each individual has specific requirements & the bag is chosen keeping these in mind.