The female patient with a catheter

Catheters are widely used for effective bladder drainage, either temporarily or permanently, when physiological and anatomical defects or obstruction of the lower urinary tract are present. Before long-term catheterization is considered, all other possibilities for treatment or management must be explored following appropriate investigation. The urethral catheter is the most frequently used but for long-term catheterization supra-pubic catheterization is the preferred route. They are not without associated complications including urinary tract infection, encrustation, trauma, stricture formation, urethral perforation, bladder calculi and even neoplastic changes. All catheters used in the UK must conform to British Standards. Plastic or PVC and latex rubber are for short-term use only. To reduce urethritis and encrustation, latex catheters have been ‘siliconized’, producing a lubricant effect to facilitate insertion and coated in Teflon (polytetrafluoroethylene or PTFE)) to make it more inert. Silver alloy hydrogel coated latex catheters have been advocated for the inhibition of bacterial growth. For long-term use (12 weeks) in both urethral and supra-pubic catheters, hydrogel coated latex should be used whenever possible.

Catheters are measured in ‘French’ gauge (Fg) or ‘Charriere’ (Ch). Catheters used in women should range from size 12Ch to 16Ch, with a 10ml balloon. Catheters can be either connected to a drainage bag or a valve. Whenever possible, intermittent catheterization should be taught to patients to facilitate bladder emptying. Long-term indwelling catheterization should be a last resort as ‘treatment’ for women with lower urinary tract dysfunction.