Urinary (Foley) Catheters

What is a urinary catheter?

A urinary catheter is a narrow tube that goes into the bladder. The urine (pee) drains through the tube into a bag. 

A urinary catheter might be needed:

• If your child cannot urinate or leaks urine
• To measure the amount of urine that is made (such as if your child is in intensive care)
• During and after certain surgeries
• During some kidney or bladder tests

Urinary catheters are only used when they are necessary. They should be removed as soon as possible. Care team members are trained in the best way to insert them to lower the risk of infection.

Types of catheters

Most catheters stay in the bladder for a certain amount of time and collect urine in a bag. These are called indwelling catheters. Most indwelling catheters, including Foley catheters, are inserted through the urethra. A suprapubic catheter is a urinary catheter that is inserted through a small hole (stoma) in the belly. 

Some patients may not have an indwelling catheter. The catheter may be inserted into the urethra to empty the bladder and then removed. This is sometimes known as clean intermittent catheterization or a self-catheter. 

Your care team will help you know what type of catheter is best for your child’s medical needs and teach you any instructions for care at home.

How to care for a urinary catheter

Follow the care team’s instructions for catheter care. All caregivers should wash their hands with soap and water or use an alcohol-based hand cleaner before and after touching your child’s catheter.

If you do not see staff members clean their hands, please ask them to do so before touching the catheter.

Tips for family members

• Do not disconnect the catheter and drain tube. 
• Keep the catheter secured to the leg. This keeps it from pulling.
• Do not twist or kink the catheter.
• Keep the bag lower than the bladder. This stops urine from flowing back into the bladder. 
• Do not let the bag get too full. The weight of a full bag can pull and hurt the urethra. 

How to care for the urinary drainage bag

If your child has a catheter that is left in the bladder (indwelling catheter), a drainage bag will collect the urine. The bag can be hung from a bed or wheelchair. Some patients may have a leg bag that can be strapped around the leg to secure it. Follow your care team’s instructions for emptying and changing the bag.

• Limit the movement of the drainage bag to keep the tube from coming out.
• Keep the bag below the level of your child’s bladder so urine does not back up.
• Keep the bag off the floor.

How to empty the drainage bag

Only empty the bag if you have been trained to do so. If your child is in the hospital, a care team member will empty the bag. Empty the bag when it is 2/3 full, or at least every 8 hours even if it is not full.

Wash your hands well with soap and water and dry well or use an alcohol-based hand sanitizer. Put on gloves if you have them or if told to use them.

• Do not allow the spout to touch anything while emptying the bag.
• Put a clean empty container under the drain spout and open the spout to let urine drain out.
• Do not touch the spout to the container or touch the spout with your hands. Clean the spout with an alcohol wipe if you do either of these things.
• Close the spout when the bag is empty.
• Pour urine into a toilet to discard.

Catheter-associated urinary tract infection (CAUTI)

Germs can travel through the catheter and cause an infection in the bladder or kidney. This is called a catheter-associated urinary tract infection (CAUTI). It can be serious and lead to other infections.

People with urinary catheters have a much greater chance of getting a urinary tract infection (UTI) than people who don’t have catheters. The urinary system includes the bladder and the kidneys. Germs do not normally live in these areas. But, if germs get inside the bladder or kidneys, an infection can occur.

Symptoms of a urinary tract infection

Signs and symptoms of a urinary tract infection may include:

• Blood in the urine
• Cloudy or abnormal color of urine
• Pain or burning when urinating
• Pain or pressure in the back or lower abdomen (below the stomach)
• A need to urinate often or an increase in how often your child urinates after the catheter is removed
• Urine or catheter smells bad or has an odor
• Fever

Some people can have an infection without any of these symptoms. Contact your doctor right away if you think your child may have an infection.

Steps to prevent a catheter-associated urinary tract infection

• Always clean your hands before and after doing catheter care.
• Always clean your hands before and after touching any part of the catheter system.
• Give your child daily baths with specialized cloths, wipes or soap and water.
• Clean the genital area and catheter tubing every 12 hours and after each bowel movement using special wipes, cloths, or soap and water. This should be done by trained caregivers.
• Keep the urine bag below the bladder level.
• Do not tug or pull on the tubing.
• Do not twist or kink the catheter tubing.
• Ask your child’s care team each day if the catheter is still needed.